Efficacy of probiotic supplementation and impact on fecal microbiota in patients with inflammatory bowel disease: a systematic review and meta-analysis of randomized controlled trials

Mengque Xu; Wenluo Zhang; Beibei Lin; Yue Lei; Yu Zhang; Yu Zhang; Binrui Chen; Qingyi Mao; John J Kim; Qian Cao

doi:10.1093/nutrit/nuae022

Efficacy of probiotic supplementation and impact on fecal microbiota in patients with inflammatory bowel disease: a systematic review and meta-analysis of randomized controlled trials

Nutr Rev. 2024 Mar 29:nuae022. doi: 10.1093/nutrit/nuae022. Online ahead of print.

Authors

Mengque Xu^{1

2}, Wenluo Zhang¹, Beibei Lin¹, Yue Lei^{1

2}, Yu Zhang¹, Yu Zhang^{1

2}, Binrui Chen^{1

2}, Qingyi Mao¹, John J Kim³, Qian Cao^{1

2}

Affiliations

¹ Department of Gastroenterology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
² Institute of Gastroenterology, Zhejiang University, Hangzhou, China.
³ Division of Gastroenterology and Hepatology, Los Angles General Medical Center, Los Angeles, CA, USA.

PMID: 38553410
DOI: 10.1093/nutrit/nuae022

Abstract

Context: Research regarding the treatment of inflammatory bowel disease (IBD) with probiotics has not yielded consistent results.

Objective: The aim of this meta-analysis was to evaluate the efficacy of probiotics supplementation in patients with IBD.

Data sources: Randomized controlled trials (RCTs) evaluating the efficacy of probiotics in patients with IBD were searched in PubMed, the Google Scholar database, Web of Science, and CrossRef for the period July 2003 to June 2023.

Data extraction: The RCTs were extracted, independently by 2 authors, according to the PICOS criteria.

Data analysis: Seven studies, including a total of 795 patients, met the study criteria. Five end points were selected to evaluate the efficacy. Of these, 3 indicators showed a statistically significant difference in efficacy: C-reactive protein (odds ratio [OR]: -2.45, 95% confidence interval [CI]: -3.16, -1.73, P < .01), the number of fecal Bifidobacterium (OR: 3.37, 95% CI: 3.28, 3.47, P < .01), and Lactobacillus(OR: 2.00, 95% CI: 1.91, 2.09, P < .01). The other 2 indicators (disease activity for Crohn's disease and for ulcerative colitis) showed no statistically significant difference, while the OR reflected a positive correlation.

Conclusion: Probiotics supplementation may have a positive effect on IBD by reducing clinical symptoms, reducing the serological inflammatory markers, and increasing favorable gut flora in patients with IBD. Additional RCTs are needed to evaluate the therapeutic effect of probiotics in IBD.

Keywords: C-reactive protein; disease activity; inflammatory bowel disease; intestinal microenvironment; probiotics.