A randomized controlled trial to evaluate the effect of influenza vaccination and probiotic supplementation on immune response and incidence of influenza-like illness in an elderly population in Indonesia

Aim To investigate the effect of influenza vaccination with or without probiotic supplementation on the immune response and incidence of influenza-like illness (ILI) in the elderly. Methods A randomized double-blind, placebo-controlled trial with a modified factorial design was conducted in 554 healthy elderly subjects aged 67 ± 5.6 (ranging from 60–90) years old in the Primary Health Care Center (Puskesmas area) of the Pulo Gadung District East Jakarta. Subjects received either a trivalent influenza vaccine or placebo at the start of the study, and a probiotic supplement (Lactobacillus helveticus R0052 and Lactobacillus rhamnosus R0011) or a placebo for 6 months. Subjects were randomly assigned into four intervention groups: influenza vaccine and probiotics (n = 141), influenza vaccine and placebo (n = 136), placebo and probiotics (n = 140), and both placebo (n = 137). The primary outcome was ILI incidence within 6 months. The secondary outcomes were seroprotection and seroconversion rates at 1, 4, and 6 months after administering the interventions. Results This study showed that the trivalent influenza vaccine increased seroprotection (RR 3.6 [95%CI 2.92–4.47]; p<0.010) and seroconversion (RR 29.8 [95%CI 11.1–79.5]; p<0.010) rates 1 month after vaccination in elderly people while the probiotic supplement did not alter influenza antibody titers (p = 1.000 and p = 0.210). The relative ILI incidence risk was similar between vaccinated and non-vaccinated groups, as well as in the probiotic group compared to the non-probiotic group. Conclusion The tested trivalent influenza vaccine significantly induced seroprotection and seroconversion in the vaccinated subjects, while probiotics administration did not influence these parameters. Vaccinated individuals displayed a similarly low ILI incidence as those in the Control Group. However, the observed trend towards a reduction of ILI incidence with probiotics supplementation warrants further assessments in a larger, at-risk population. Clinical trial registry number NCT03695432.

Probiotics alleviate inflammatory bowel disease in mice by regulating intestinal microorganisms-bile acid-NLRP3 inflammasome pathway

The objective of the present study was to elucidate the mechanism of intestinal microorganisms- bile acid- NLRP3 inflammasome regulation in mice with inflammatory bowel disease treated with probiotics. The abnormal activation of NLRP3 inflammasome is the main pathogenic factor that leads to the development of chronic colitis in IL-10–/– mice. In this study, we divided the IL-10–/– and wild-type mice on a C57BL/6 background into 3 groups: control group (wt mice, n=10), IBD group (IL-10–/– mice, n=10), and probiotic group (IL-10–/– mice treated with probiotics, n=10). The analyses included mRNA levels of cytokines and protein expression of NLRP3 inflammasome and NOD2, as well as colorimetric determination of Wnt, Notch and BMP activity in colon tissue and fresh colon mass. The fresh colon mass was increased in the IBD mice when compared with the control and the probiotic groups (P<0.05). The histological score of the proximal colon in the IBD group was higher than in two other groups (P<0.05). The probiotic group showed lower levels of IFN-γ, IL-17F, IL-1α and IL-25 mRNA compared to the IBD group (P<0.05). The main components of NLRP3 inflammasome (NLRP3, ASC, caspase-1 and IL-1β) and NOD2 were increased in IBD group compared to the control, and decreased after probiotic treatment (P<0.05). FXR, TGR5, vitamin D, and CAR were all increased in IBD group compared to the control and probiotic groups (P<0.05). In conclusion, probiotics modulated the intestinal microbial-bile acid-NLRP3 inflammation in IBD mice.

Bifidobacterium animalis subsp. lactis BB-12 Protects against Antibiotic-Induced Functional and Compositional Changes in Human Fecal Microbiome

The administration of broad-spectrum antibiotics is often associated with antibiotic-associated diarrhea (AAD), and impacts gastrointestinal tract homeostasis, as evidenced by the following: (a) an overall reduction in both the numbers and diversity of the gut microbiota, and (b) decreased short-chain fatty acid (SCFA) production. Evidence in humans that probiotics may enhance the recovery of microbiota populations after antibiotic treatment is equivocal, and few studies have addressed if probiotics improve the recovery of microbial metabolic function. Our aim was to determine if Bifidobacterium animalis subsp. lactis BB-12 (BB-12)-containing yogurt could protect against antibiotic-induced fecal SCFA and microbiota composition disruptions. We conducted a randomized, allocation-concealed, controlled trial of amoxicillin/clavulanate administration (days 1–7), in conjunction with either BB-12-containing or control yogurt (days 1–14). We measured the fecal levels of SCFAs and bacterial composition at baseline and days 7, 14, 21, and 30. Forty-two participants were randomly assigned to the BB-12 group, and 20 participants to the control group. Antibiotic treatment suppressed the fecal acetate levels in both the control and probiotic groups. Following the cessation of antibiotics, the fecal acetate levels in the probiotic group increased over the remainder of the study and returned to the baseline levels on day 30 (−1.6% baseline), whereas, in the control group, the acetate levels remained suppressed. Further, antibiotic treatment reduced the Shannon diversity of the gut microbiota, for all the study participants at day 7. The magnitude of this change was larger and more sustained in the control group compared to the probiotic group, which is consistent with the hypothesis that BB-12 enhanced microbiota recovery. There were no significant baseline clinical differences between the two groups. Concurrent administration of amoxicillin/clavulanate and BB-12 yogurt, to healthy subjects, was associated with a significantly smaller decrease in the fecal SCFA levels and a more stable taxonomic profile of the microbiota over time than the control group.

The Enhancement of Intestinal Immunity in Offspring Piglets by Maternal Probiotic or Synbiotic Supplementation Is Associated With the Alteration of Gut Microbiota

A total of 64 pregnant Bama mini-pigs were used to investigate the effects of maternal probiotic or synbiotic supplementation during gestation and lactation on immune response, intestinal morphology, and microbiota community of offspring piglets. The sows were assigned randomly to one of four groups, control group (basal diet), antibiotic group (basal diet supplemented with 50 g/t virginiamycin), probiotic group (basal diet supplemented with 200 mL/d probiotic fermentation broth per pig), or synbiotic group (basal diet supplemented with 200 mL/d probiotic fermentation broth per pig + 500 g/t xylo-oligosaccharides) during pregnancy and lactation periods. After weaning, two piglets close to the average body weight (BW) per litter were selected and fed a basal diet. Eight piglets with similar BW were selected from each group for sample collection at 65 d-old. The results showed that plasma interleukin (IL)-2 and lipopolysaccharide concentrations were decreased (P &lt; 0.05) in the probiotic group, while the immunoglobulin A (IgA) concentration in the probiotic and synbiotic groups was increased (P &lt; 0.05), when compared with the control group. The jejunal IL-10, interferon-α, and secretory IgA (sIgA) concentrations were increased (P &lt; 0.05) in the probiotic and synbiotic groups, as well as the ileal sIgA concentration in the probiotic group. The jejunal villus height (VH) and the ratio of VH to crypt depth were increased (P &lt; 0.05) in the probiotic group, as well as the ileal VH in the synbiotic group. Furthermore, the piglets from the antibiotic group exhibited a lower microbiota diversity in the jejunum and ileum. The piglets from the synbiotic group had higher relative abundances of Actinobacteria, Bifidobacterium, Turicibacter, and Clostridium in the jejunum compared with the antibiotic group. Dietary probiotic treatment increased (P &lt; 0.05) the relative abundance of Psychrobacter in the ileum compared with the antibiotic and control groups. Spearman's correlation analysis revealed that the relative abundances of Bifidobacterium, Clostridium, and Blautia in the jejunum and Psychrobacter in the ileum, were positively correlated with the alterations of immunoglobulin and cytokines. Collectively, these findings suggest that maternal interventions with probiotic or synbiotic are promising strategies for improving the immune response of offspring piglets by altering the gut microbiota.

Probiotic Lacticaseibacillus rhamnosus GR-1 and Limosilactobacillus reuteri RC-14 as an Adjunctive Treatment for Bacterial Vaginosis Do Not Increase the Cure Rate in a Chinese Cohort: A Prospective, Parallel‐Group, Randomized, Controlled Study

The purpose of this study was to evaluate the effectiveness of metronidazole and oral probiotics adjunct to metronidazole in the treatment of bacterial vaginosis (BV). One hundred and twenty-six Chinese women with BV were enrolled in this parallel, controlled trial, and were randomly assigned into two study arms: the metronidazole group, which was prescribed metronidazole vaginal suppositories for 7 days, and the adjunctive probiotic group, which received Lacticaseibacillus rhamnosus GR-1 and Limosilactobacillus reuteri RC-14 orally for 30 days as an adjunct to metronidazole. Clinical symptoms and Nugent scores at the initial visit, 30 days and 90 days were compared. There was no significant difference of the 30-day total cure rate between the adjunctive probiotic group (57.69%) and the metronidazole group (59.57%), with an odds ratio (OR) of 0.97 (95% confidence interval (CI), 0.70 to 1.35, p-value = 0.04), or of the 90-day total cure rate (36.54% vs. 48.94%, OR, 0.75; 95% CI, 0.47 to 1.19; p-value = 0.213). Also, no significant difference of the vaginal and faecal microbial diversity and structure between the two groups at 0, 30 or 90 days were shown based on 16S rRNA sequences. The probiotic species were rarely detected in either the vaginal microbiota or the faecal microbiota after administration which may revealed the cause of noneffective of oral probiotics. No serious adverse effects were reported in the trial. The study indicated that oral probiotic adjunctive treatment did not increase the cure rate of Chinese BV patients compared to metronidazole.

The Effects of Limosilactobacillus reuteri LR-99 Supplementation on Body Mass Index, Social Communication, Fine Motor Function, and Gut Microbiome Composition in Individuals with Prader–Willi Syndrome: a Randomized Double-Blinded Placebo-Controlled Trial

Prader–Willi syndrome (PWS) is a rare genetic disorder associated with developmental delay, obesity, and neuropsychiatric comorbidities. Limosilactobacillus reuteri (Lactobacillus reuteri, Lact. reuteri) has demonstrated anti-obesity and anti-inflammatory effects in previous studies. In the present study, we aim to evaluate the effects of Lact. reuteri supplementation on body mass index (BMI), social behaviors, and gut microbiota in individuals with PWS. We conducted a 12-week, randomized, double-blind, placebo-controlled trial in 71 individuals with PWS aged 6 to 264 months (64.4 ± 51.0 months). Participants were randomly assigned to either receive daily Lact. reuteri LR-99 probiotic (6 × 1010 colony forming units) or a placebo sachet. Groupwise differences were assessed for BMI, ASQ-3, and GARS-3 at baseline, 6 weeks, and 12 weeks into treatment. Gut microbiome data was analyzed with the QIIME2 software package, and predictive functional profiling was conducted with PICRUSt-2. We found a significant reduction in BMI for the probiotic group at both 6 weeks and 12 weeks relative to the baseline (P < 0.05). Furthermore, we observed a significant improvement in social communication and interaction, fine motor function, and total ASQ-3 score in the probiotics group compared to the placebo group (P < 0.05). Altered gut microbiota was observed in the probiotic group to favor weight loss and improve gut health. The findings suggest a novel therapeutic potential for Lact. reuteri LR-99 probiotic to modulate BMI, social behaviors, and gut microbiota in Prader–Willi syndrome patients, although further investigation is warranted.Trial registration Chinese Clinical Trial Registry: ChiCTR1900022646

Effects of a Lactobacilli Probiotic on Reducing Duration of URTI and Fever, and Use of URTI-Associated Medicine: A Re-Analysis of a Randomized, Placebo-Controlled Study

We previously reported on the effects of Lactoplantibacillus plantarum DR7 on reducing Upper Respiratory Tract Infections (URTI) symptoms’ score and frequency in 109 adults upon a 12-week consumption at 109 colony-forming units (CFU)/day, but several limitations were detected in the publication. Thus, the present study re-analyzed some data with the aim to address some of these weaknesses, and presents new data on duration of URTI and consumption of URTI-associated medication, as compared to the placebo. Our re-analyses found probiotic administration significantly reduced the proportion of patient days of URTI and of fever (all p < 0.05). Recent history of URTI was a prevalent co-factor in affecting duration of URTI symptoms and fever, while other demographic and clinical factors had no influence. Exploratory analyses suggested probiotic had an earlier benefit in patients without a recent history of URTI compared to those with a recent history of URTI. Therefore, recent history of infections could have a modulatory effect on probiotic efficacy. Average number of months with reported use of URTI-related medication was 3.4-times lower in the probiotic group as compared to placebo (p = 0.016) during the intervention. Taken together, our present new data further support previous findings that DR7 probiotic had a beneficial effect on URTI.

The Effectiveness and Safety of Multi-Strain Probiotic Preparation in Patients with Diarrhea-Predominant Irritable Bowel Syndrome: A Randomized Controlled Study

The aim of this randomized double-blind placebo-controlled study was to evaluate the effectiveness and safety of multi-strain probiotic in adults with diarrhea-predominant irritable bowel syndrome (IBS-D). The patients were randomized to receive a mixture of Lactobacillus, Bifidobacterium, and Streptococcus thermophilus strains or placebo for eight weeks. Primary endpoints included changes in symptom severity and improvement assessed with the IBS Severity Scoring System (IBS-SSS) and Global Improvement Scale (IBS-GIS). The probiotic in comparison with placebo significantly improved the IBS symptom severity (the change of total IBS-SSS score from baseline −165.8 ± 78.9 in the probiotic group and −105.6 ± 60.2 in the placebo group, p = 0.005) and in the specific scores related to the severity of pain (p = 0.015) and the quality of life (p = 0.016) after eight weeks of intervention. The probiotic group indicated an improvement in symptoms with the use of the IBS-GIS compared with the placebo group after four (p = 0.04) and eight weeks (p = 0.003). The occurrence of adverse events did not differ between study groups. In conclusion, the multi-strain probiotic intervention resulted in a significant improvement in IBS symptoms evaluated with the use of both IBS-SSS and IBS-GIS scales. The results suggest that the studied probiotic preparation is well tolerated and safe and can offer benefits for patients with IBS-D. (registration number in Clinicaltrials.gov NCT 04662957).

Antioxidant Effect of a Probiotic Product on a Model of Oxidative Stress Induced by High-Intensity and Duration Physical Exercise

This randomized double-blind and controlled single-center clinical trial was designed to evaluate the effect of a 6-week intake of a probiotic product (1 capsule/day) vs. a placebo on an oxidative stress model of physical exercise (high intensity and duration) in male cyclists (probiotic group, n = 22; placebo, n = 21). This probiotic included three lyophilized strains (Bifidobacterium longum CECT 7347, Lactobacillus casei CECT 9104, and Lactobacillus rhamnosus CECT 8361). Study variables were urinary isoprostane, serum malondialdehyde (MDA), serum oxidized low-density lipoprotein (Ox-LDL), urinary 8-hydroxy-2′-deoxiguanosine (8-OHdG), serum protein carbonyl, serum glutathione peroxidase (GPx), and serum superoxide dismutase (SOD). At 6 weeks, as compared with baseline, significant differences in 8-OHdG (Δ mean difference −10.9 (95% CI −14.5 to −7.3); p < 0.001), MDA (Δ mean difference −207.6 (95% CI −349.1 to −66.1; p < 0.05), and Ox-LDL (Δ mean difference −122.5 (95% CI −240 to −4.5); p < 0.05) were found in the probiotic group only. Serum GPx did not increase in the probiotic group, whereas the mean difference was significant in the placebo group (477.8 (95% CI 112.5 to 843.2); p < 0.05). These findings suggest an antioxidant effect of this probiotic on underlying interacting oxidative stress mechanisms and their modulation in healthy subjects. The study was registered in ClinicalTrials.gov (NCT03798821).

Effects of Dietary Intake and Supplementation of Indigenous Probiotic Lactobacillus Plantarum Dad-13 on Body Mass Index, Faecal Short-Chain Fatty Acid, and Gut Microbiota of Undernourished Children in East Lombok, Indonesia

Malnutrition has been a global public health problem, jeopardizing children growth and constituting a major cause of death in children in developing countries, including Indonesia. Malnourished person tends to have abnormal gut microbiota. Probiotics supplementation can be considered as one of preventative measures against imbalanced gut microbiota and pathogenic bacteria to enable optimum nutrition absorption. This study aimed to investigate the effects of dietary intake and supplementation of powder of indigenous probiotic Lactobacillus plantarum Dad-13 to undernourished children in East Lombok, Indonesia on their body mass index (BMI), faecal short-chain fatty acids and gut microbiota. This study was performed in a Randomized Double-Blind Placebo-Controlled design, involving 40 children aged 10-12 years old, with BMI/age ratio ≤ -2 standard deviation (SD). Subjects were randomly divided into two groups namely placebo and probiotic group. The placebo group consumed 1 gram of skimmed milk daily while the probiotic group consumed 1 gram of skimmed milk containing 1x109 CFU/gram of L. plantarum Dad-13 daily, with consumption period of 60 days for both groups. The result showed that dietary intakes of both groups were below recommended value (<70%). Lactobacillus plantarum and Bifidobacterium significantly increased after probiotic consumption while Enterobacteriaceae and Klebsiella pneumonia significantly reduced. Short-chain fatty acid (acetate, propionate, butyrate) significantly increased in probiotic group, which consequently lowered pH level. Subsequently, a significant increase was observed in body weight and height in both groups at the end of the study. Only BMI of probiotic group increased after consumption of probiotics.