Review supports probiotic benefits for Multiple Sclerosis patients
Conclusions found supplementation with Lactobacillus casei , L. acidophilus, L. reuteni, Bifidobacterium bifidum and Streptococcus thermophiles promoted production of anti-inflammatory agents and/or inhibited production of pro-inflammatory markers.
Commenting on the analysis of 152 papers found, the research team calls for physicians and dietitians to consider probiotic supplements for managing the health-related concerns that characterise MS.
“The evidence supports probiotics supplementation among Relapsing-Remitting Multiple Sclerosis (RRMS) patients to disease disability, depression, and general health,” they add.
“Patients with RRMS also have an increased risk of a more progressive form. The probiotics may prevent the RRMS from becoming more severe.”
Literature search
The team began an English literature search using PubMed, Scopus, Web of Science, and the Central Cochrane Library through to January 2021.
The study selection criteria included all clinical trials with either parallel or cross-over design and at least two arms that investigated the effects of probiotics supplementation on disease progression (EDSS), depression (BDI-Ⅱ) and general health (GHQ).
Studies that also included anthropometric measurements such as BW and BMI for more than two weeks with concurrent control groups in MS population only were also considered.
The selected studies were open-label (single, double, or triple blind) randomized trials. There were no inclusion criteria for systematically reviewed studies.
Study criteria included subject profiles, with both males and females aged 18-60 years old and MS duration between 2-20 years included.
From the studies included in the review, the team from Iran’s Isfahan University of Medical Sciences found a significant reduction in the Expanded Disability Status Scale (EDSS), a measure of quantifying disability in multiple sclerosis, observed in patients who received supplementation.
In a pooled analysis of studies totalling 173 participants, the use of probiotics appeared to positiviely influence how respondents answered the General Health Questionnaire (GHQ), and The Beck Depression Inventory (BDI-II).
The BDI-II is one of the most commonly used methods for measuring depression; the higher overall score indicates the more severe depressive symptoms. All included trials in the review reported significant effects of probiotics on BDI-II overall score reduction in RRMS participants.
“Based on our knowledge, this is the first meta-analysis investigating the effects of probiotics supplementation on anthropometric measurements in MS,” the team highlights.
“One recent study reanalysed three published trials (sample size, 173; intervention, 86; control, 87) and observed a significant reduction in EDSS, BDI-II and GHQ in MS patients. Our results were somewhat similar to the previously mentioned study.”
Gut-CNS axis
While the exact mechanism of MS pathogenesis is still unclear; the role of the gut microbiota has been reinforced since the discovery of the ‘gut-CNS axis’ concept.
The existence of the axis has been supported by results garnered from faecal transplantation or probiotics supplementation that seeks to rebalance microbiome diversity and facilitate MS treatment.
Trials investigating this link are few and far between with those in existence featuring relatively short duration
Recently, a meta-analysis on the efficacy of probiotics in MS reported the significant beneficial effects of probiotic supplementation on EDSS, BDI-II, and GHQ.
Source: International Journal of Clinical Practice
Published online: doi.org/10.1111/ijcp.14724
“Effect of Probiotics Supplementation on Disease Progression, Depression, General Health and Anthropometric Measurements in Relapsing-Remitting Multiple Sclerosis Patients: A Systematic Review and Meta-analysis of Clinical Trials.”
Authors: Shahrzad Mirashrafi et al.
