{"publication_id":"45ba1bda-6940-4338-babd-4c360db9ad4d","content_hash":"sha256:6431f38cad3c72b99eaa2d469fdf8f9366a434990a973dc02b1bf0d8e43d93ba","nodes":[{"id":"45ba1bda-6940-4338-babd-4c360db9ad4d","type":"publication","title":"Adjacent Evidence Brief: Probiotic Supplementation Effects — full paper"},{"id":"claim_1","type":"claim","text":"Evidence-honesty note: 36/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims. Probiotic supplementation has attracted intense interest as a low-cost adjunct to influence cardiometabolic, immune, musculoskeletal, and clinical-infection outcomes, yet the literature spans dozens of meta-analyses with non-overlapping conclusions and a long tail of single-site RCTs whose results have not always replicated (Liang 2022; Aparicio-Pascual 2025; Prokopidis 2022). We applied an AI-assisted structured evidence-synthesis framework that ingests curated reference sources, enforces direct-vs-indirect outcome stratification, and produces an audit trail linking every quantitative claim to its primary source, while keeping the analytic reasoning in clinical domain language. Pediatric and cognitively-oriented RCTs (Chen 2026, Kim 2020) and a positive bariatric/inflammation trial (Potrykus 2025, P < 0.001 for several biomarkers) round out a pattern in which short-chain-fatty-acid-linked, inflammation-modulating mechanisms are biologically coherent but clinically bounded. **Evidence-abstraction note."},{"id":"claim_2","type":"claim","text":"Evidence-honesty note: 36/46 retained sources are indirect, review-level, adjacent, or mechanistic and are used only to bound interpretation. The conclusion therefore does not support broad causal, clinical, or policy claims."},{"id":"claim_3","type":"claim","text":"We applied an AI-assisted structured evidence-synthesis framework that ingests curated reference sources, enforces direct-vs-indirect outcome stratification, and produces an audit trail linking every quantitative claim to its primary source, while keeping the analytic reasoning in clinical domain language."},{"id":"claim_4","type":"claim","text":"Evidence-abstraction note.** The 46 retained reference papers are not 46 independent primary clinical trials: 36 are review, indirect, mechanistic, or registered-protocol source-level summaries, and 10 are classified as direct interventional evidence. Interpretation below therefore separates primary clinical-trial evidence from review-level, preclinical, and other indirect evidence."},{"id":"claim_5","type":"claim","text":"This synthesis evaluates evidence on probiotic supplementation effects across 46 included source papers and 2077 high-confidence extracted claims. The review is organized around the distinction between direct interventional hard-endpoint evidence, adjacent/review/context evidence, and mechanistic evidence so that biological plausibility is not confused with clinical certainty."},{"id":"claim_6","type":"claim","text":"The corpus contains 10 direct clinical sources, 36 adjacent, review, or context sources, and no sources classified primarily as mechanistic or model-system evidence. That distribution makes the synthesis appropriate for evaluating convergence, boundary conditions, and trial-design implications, while requiring caution around any conclusion that would exceed the direct human evidence."},{"id":"claim_7","type":"claim","text":"The introductory frame therefore treats the corpus as a set of evidence roles rather than a single directional verdict. Direct sources define the applied boundary, adjacent sources locate comparable clinical contexts, and mechanistic sources identify plausible bridges that still require endpoint-level confirmation."},{"id":"claim_8","type":"claim","text":"This distinction matters for publication because it makes the paper falsifiable. A future source can strengthen, weaken, or reverse the synthesis by changing the evidence tier, direction, or outcome-class balance."},{"id":"claim_9","type":"claim","text":"The mechanistic layer is most useful when it explains why a trial signal might appear or fail to appear. It is weaker when it is used as a replacement for outcome data, so this synthesis treats it as interpretive support rather than independent clinical proof."},{"id":"claim_10","type":"claim","text":"Null findings have a specific role in this evidence model. They do not erase mechanistic plausibility, but they do narrow the set of claims that can be made about effect consistency, target population, and endpoint selection."},{"id":"claim_11","type":"claim","text":"Adverse or negative signals are likewise retained in the main interpretation. For an aging intervention, the risk profile is part of the efficacy question because a plausible mechanism is not sufficient if the same corpus shows offsetting harm or tolerability constraints."},{"id":"claim_12","type":"claim","text":"The evidence base also distinguishes breadth from certainty. A broad corpus can cover many biological domains while still leaving the clinically decisive question unresolved if direct evidence is limited, heterogeneous, or endpoint-specific."},{"id":"claim_13","type":"claim","text":"For that reason, the manuscript does not collapse every source into a single recommendation. It presents the intervention as a set of linked claims whose strength depends on the evidence tier and the match between mechanism, population, and endpoint."},{"id":"claim_14","type":"claim","text":"The research value of the synthesis lies in making these boundaries explicit. It identifies which evidence streams are already aligned, which ones remain discordant, and which future studies would most directly test the unresolved bridge."},{"id":"claim_15","type":"claim","text":"The background evidence for probiotic supplementation effects is heterogeneous rather than uniformly confirmatory. Direct clinical sources such as Noorwali 2026, Moschonis 2026, Potrykus 2025 are interpreted separately from mechanistic studies such as the retained evidence base, because these evidence roles answer different questions about aging biology and clinical translation."},{"id":"claim_16","type":"claim","text":"The direct evidence establishes what has been observed in human or adjacent clinical settings. The mechanistic evidence helps explain why an effect might be plausible, but it does not by itself establish the size, durability, or safety of a human healthspan effect."},{"id":"claim_17","type":"claim","text":"Across the retained sources, positive signals cluster around the contextual adjacent evidence, immune and inflammation, cardiometabolic outcome classes; null signals around the immune and inflammation, contextual adjacent evidence outcome classes; and negative or adverse signals around the cardiometabolic, muscle function and longevity outcome classes. This pattern motivates a synthesis that keeps outcome domains separate before drawing cross-domain interpretation."},{"id":"claim_18","type":"claim","text":"The study-level structure also prevents selective emphasis. Supportive, null, mixed, and adverse findings remain visible in the same manuscript, allowing the reader to distinguish evidential breadth from evidential certainty."},{"id":"claim_19","type":"claim","text":"The resulting paper is therefore a calibrated synthesis: it can identify plausible mechanisms, observed direct signals when present, unresolved tensions, and trial-design priorities without converting them into claims stronger than the retained corpus can support."},{"id":"claim_20","type":"claim","text":"The following fields were extracted from each included source: study design, population / cohort, intervention or exposure, comparator, outcome class, effect direction, effect size, confidence interval or credible interval, p-value, sample size, follow-up duration, risk-of-bias rating. Under the calibration rule, source verification in the public bundle is limited to reference-level metadata; exact statistics and effect directions are drawn from these structured extraction artifacts (the synthesis manifest, risk-of-bias sidecar when populated, and claim registry) rather than from re-parsed full text."},{"id":"claim_21","type":"claim","text":"Risk-of-bias framework assignment follows study design (RoB-2 for RCTs, ROBINS-I for non-randomised studies, AMSTAR-2 for systematic reviews / meta-analyses). Public appraisal claims are limited to populated `risk_of_bias.json` rows; when no populated ratings are present, interpretation remains bounded by source tier and directness rather than formal RoB certification."},{"id":"claim_22","type":"claim","text":"Evidence-tension synthesis: claims grouped by outcome class (cardiometabolic, contextual adjacent evidence, deficiency prevalence, dosing and pharmacokinetics, immune and inflammation, longevity, muscle function, safety and comorbidity, skeletal, fracture, and bone); within-class agreement, disagreement, and directness gaps surfaced explicitly. Quantitative pooling applied only where ≥3 sources reported a comparable endpoint with extractable effect estimates."},{"id":"claim_23","type":"claim","text":"Source retrieval, claim extraction, evidence routing, and prose drafting were assisted by large language models under a deterministic audit-trail protocol. Every manuscript claim is traceable to a source record in the supplementary `manifest.json`. Final eligibility and interpretation decisions are author-verified."},{"id":"claim_24","type":"claim","text":"Outcome-class note:** Contextual Adjacent Evidence denotes background, boundary-condition, or adjacent-outcome sources. It is not pooled with direct outcome evidence; these sources bound scope, safety, methods, and translation rather than serving as equal-weight support for the main efficacy claim."},{"id":"claim_25","type":"claim","text":"| Evidence domain | Corpus slice | Strongest signal | Directness | Main limitation |"},{"id":"claim_26","type":"claim","text":"| Probiotic Supplementation Effects / Contextual Adjacent Evidence | n=14; claims=547 | significant source statistic in 12/14 sources; receipt-level direction coded unclear | 3 direct; 5 indirect; 6 review | limited corpus depth in this outcome class |"},{"id":"claim_27","type":"claim","text":"Contextual Adjacent Evidence: n=14; claims=547; mixed signal in 8/14 sources | directness: 3 direct; 5 indirect; 6 review; main limitation: directionally heterogeneous."},{"id":"claim_28","type":"claim","text":"Six curated reviews and meta-analyses comprise the cardiometabolic evidence base, spanning populations with type 2 diabetes, prediabetes, overweight/obesity, and polycystic ovary syndrome, as well as generally healthy adults and exercise-recovery cohorts. The dominant designs are systematic reviews with pooled analyses, with one observational synthesis, Shirkoohi 2025, contributing indirect data on body composition. Durations and dosing regimens were heterogeneous across the underlying trials, but endpoints were uniformly cardiometabolic: glycemic indices (HbA1c, fasting glucose, HOMA-IR, HOMA-β), lipid fractions, body weight, and islet β-cell function. The integrated thesis positions probiotic supplementation as context-dependent rather than uniformly favorable or unfavorable in this outcome class."},{"id":"claim_29","type":"claim","text":"Quantitative signals within the cardiometabolic class are mixed and outcome-specific. Tabrizi 2022, in PCOS, reported several glycemic, lipid, and inflammatory contrasts reaching P = 0.01, P = 0.02, P < 0.001, P < 0.01, and P = 0.04. Across the class, the per-study p-value tuples are catalogued in the evidence synthesis."},{"id":"claim_30","type":"claim","text":"Within-corpus tensions in the cardiometabolic class are pronounced. A plausible reconciling frame is that effect direction is conditional on baseline metabolic status, trial duration, and strain-specific formulations, but the corpus as currently constituted does not resolve which boundary condition drives the divergence. The same pattern recurs for body composition, where Shirkoohi 2025 reports predominantly null body-weight contrasts while Liang 2022 reports significant glycemic improvements, suggesting that probiotics decouple across cardiometabolic sub-domains within the same class."},{"id":"source_1","type":"source","study":"Comparative analysis of the efficacies of probiotic supplementation and glucose-lowering drugs for the treatment of type 2 diabetes: A systematic review and meta-analysis","year":2022,"doi":"10.3389/fnut.2022.825897","url":"https://doi.org/10.3389/fnut.2022.825897","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liang 2022","excerpt":"The aim of this systematic review and meta-analysis was to evaluate the effects of probiotics and glucose-lowering drugs (thiazolidinedione [TZD], glucagon-like pep-tide-1 receptor agonists [GLP-1 RA], dipeptidyl peptidase IV inhibitors, and sodium glucose co-transporter 2 inhibitors [SGLT-2i]) in patients with type 2 diabetes from randomized con-trolled trials (RCTs). The PubMed, Web of science, Embase, and Cochrane Library databases were searched on the treatment effects of probiotics and glucose-lowering drugs on glycemia, lipids, and blood pressure metabolism published between Jan 2015 and April 2021. We performed meta-analyses using the random-effects model. We included 25 RCTs (2,843 participants). Overall, GLP-1RA, SGLT-2i, and TZD significantly reduce fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), whereas GLP-1 RA increased the risk of hypoglycaemia. Multispecies probiotics decrease FBS, total cholesterol (TC), and systolic and diastolic blood pressure (SBP, DBP)."},{"id":"source_2","type":"source","study":"Impact of probiotics on muscle mass, muscle strength and lean mass: a systematic review and meta‐analysis of randomized controlled trials","year":2022,"doi":"10.1002/jcsm.13132","url":"https://doi.org/10.1002/jcsm.13132","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Prokopidis 2022","excerpt":"Probiotics have shown potential to counteract sarcopenia, although the extent to which they can influence domains of sarcopenia such as muscle mass and strength in humans is unclear. The aim of this systematic review and meta-analysis was to explore the impact of probiotic supplementation on muscle mass, total lean mass and muscle strength in human adults. A literature search of randomized controlled trials (RCTs) was conducted through PubMed, Scopus, Web of Science and Cochrane Library from inception until June 2022. Eligible RCTs compared the effect of probiotic supplementation versus placebo on muscle and total lean mass and global muscle strength (composite score of all muscle strength outcomes) in adults (>18 years). To evaluate the differences between groups, a meta-analysis was conducted using the random effects inverse-variance model by utilizing standardized mean differences. Twenty-four studies were included in the systematic review and meta-analysis exploring the effects of probiotics on muscle mass, total lean mass and global muscle strength. Our main analysis (k = 10) revealed that muscle mass was improved following probiotics compared with placebo (SMD: 0."},{"id":"source_3","type":"source","study":"The Effect of Probiotic Supplementation on Cytokine Modulation in Athletes After a Bout of Exercise: A Systematic Review and Meta-Analysis","year":2025,"doi":"10.1186/s40798-025-00860-7","url":"https://doi.org/10.1186/s40798-025-00860-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Aparicio-Pascual 2025","excerpt":"BACKGROUND: Exercise-induced inflammation, especially after intense or prolonged physical activity, can hinder recovery in athletes. Probiotic supplementation has been suggested as a potential method to modulate this inflammatory response by influencing the gut microbiota. However, the effects of probiotics on cytokine profiles following exercise remain unclear. This systematic review and meta-analysis aimed to assess the impact of probiotic supplementation on cytokine modulation in athletes aged 18-50 years following exercise. METHODS: Randomized controlled trials (RCTs) that administered probiotic supplementation for at least one week to athletes were included. Studies comparing probiotics to a placebo or no supplementation, with post-exercise cytokine levels as the primary outcome, were analyzed. A systematic search was conducted across four databases (PubMed (Medline), Scopus, Web of Science (WOS) and Cochrane), up to June 2024. Risk of bias was assessed using the McMaster Critical Review Form, and random-effects meta-analyses were performed to determine the impact of probiotic supplementation."},{"id":"source_4","type":"source","study":"Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials","year":2022,"doi":"10.3390/medicina58091188","url":"https://doi.org/10.3390/medicina58091188","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Guo 2022","excerpt":"Background and Objectives : Probiotic supplementation can prevent and alleviate gastrointestinal and respiratory tract infections in healthy individuals. Markers released from the site of inflammation are involved in the response to infection or tissue injury. Therefore, we measured the pre-exercise and postexercise levels of inflammation-related markers-tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, IL-10, interferon (IFN)-γ, salivary immunoglobulin A (IgA), IL-1β, IL-2, IL-4, and C-reactive protein (CRP)-in probiotic versus placebo groups to investigate the effects of probiotics on these markers in athletes. Probiotics contained multiple species (e.g., Bacillus subtilis, Bifidobacterium bifidum , etc.). Materials and Methods : We performed a systematic search for studies published until May 2022 and included nine randomized clinical trials. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline. Fixed-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were conducted on the basis of the period of probiotic intervention and timing of postassessment blood sampling."},{"id":"source_5","type":"source","study":"Effects of probiotic supplementation on diabetic kidney disease: a systematic review and meta-analysis of randomized controlled trials","year":2026,"doi":"10.3389/fmicb.2026.1760954","url":"https://doi.org/10.3389/fmicb.2026.1760954","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Huang 2026","excerpt":"BACKGROUND: Diabetic kidney disease (DKD) is one of the leading causes of end-stage kidney disease worldwide, and microbiota-based interventions are considered potential preventive and therapeutic strategies to slow its progression. This study evaluated the efficacy of probiotic supplementation in patients with DKD through a systematic review and meta-analysis. METHODS: We searched seven databases, including PubMed, Embase, the Cochrane Library (CENTRAL), CNKI, Wanfang, VIP and SinoMed, to identify all relevant studies published from database inception to July 2025. Eligible studies were randomized controlled trials assessing probiotic interventions in DKD patients. Study quality was evaluated using the Cochrane Risk of Bias tool, and meta-analyses were performed using R. RESULTS: A total of 11 studies involving 726 participants were included. Probiotic supplementation significantly improved serum creatinine (MD - 0.17, -0.22 to -0.12, p < 0.0001) and estimated glomerular filtration rate (MD 9.62, 2.74 to 16.51, p < 0.0001). No significant effects were observed for blood urea nitrogen, urinary albumin-to-creatinine ratio, 24-h urinary protein or cystatin C."},{"id":"source_6","type":"source","study":"The effect of probiotic supplementation on perceived stress and bowel function in healthy young adults: evidence from a randomized controlled trial in Makkah","year":2026,"doi":"10.3389/fnut.2025.1717047","url":"https://doi.org/10.3389/fnut.2025.1717047","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Noorwali 2026","excerpt":"BACKGROUND: Young adults experience high, persistent stress due to academic, social, and financial pressures. Lactobacillus rhamnosus GG (LGG) may reduce stress via the gut-brain axis, yet evidence from Middle Eastern populations is limited. We tested whether LGG lowers perceived stress in Saudi young adults and improved bowel function. METHODS: In this randomized controlled trial, healthy adult participants with moderate-high Perceived Stress Scale (PSS) scores received LGG (6 × 10 9 CFU/day, capsule) for 30 days or no intervention. Validated PSS version, anthropometrics and bowel habits were assessed at baseline and endline. Analyses included paired, two-sample t tests, Wilcoxon rank-sum and multivariable linear regression adjusted for baseline PSS, age, sex, and BMI were conducted. RESULTS: Sixty-six participants completed the trial (37 probiotic; 29 controls; mean age 21.97 ± 2.59 vs. 20.83 ± 1.91 years). Post-intervention, stress score reductions were significantly greater in the probiotic group than controls ( p = 0.006). In sex-stratified analyses, males receiving probiotics showed larger reductions than male controls ( p = 0."},{"id":"source_7","type":"source","study":"Effect of Probiotic Supplementation on Intestinal Permeability in Overweight and Obesity: A Systematic Review of Randomized Controlled Trials and Animal Studies","year":2023,"doi":"10.1016/j.advnut.2023.100162","url":"https://doi.org/10.1016/j.advnut.2023.100162","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"DiMattia 2023","excerpt":"Overweight and obesity are associated with increased intestinal permeability, characterized by loss of gut epithelial integrity, resulting in unregulated passage of lipopolysaccharide (LPS) and other inflammatory triggers into circulation, i.e., metabolic endotoxemia. In obesity, shifts in the gut microbiome negatively impact intestinal permeability. Probiotics are an intervention that can target the gut microbiome by introducing beneficial microbial species, potentially restoring gut barrier integrity. Currently, the role of probiotic supplementation in ameliorating obesity- and overweight-associated increases in gut permeability has not been reviewed. This systematic review aimed to summarize findings from both animal and clinical studies that evaluated the effect of probiotic supplementation on obesity-induced impairment in intestinal permeability (International Prospective Register of Systematic Reviews, CRD42022363538). A literature search was conducted using PubMed (Medline), Web of Science, and CAB Direct from origin until August 2023 using keywords of intestinal permeability, overweight or obesity, and probiotic supplementation."},{"id":"source_8","type":"source","study":"The safety and efficacy of probiotic supplementation for critically ill adult patients: a systematic review and meta-analysis","year":2022,"doi":"10.1093/nutrit/nuac059","url":"https://doi.org/10.1093/nutrit/nuac059","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Alsuwaylihi 2022","excerpt":"CONTEXT: The safety and efficacy of probiotics during severe illness has been a subject of ongoing interest. The impact of probiotics can worsen nutritional status, which could potentially result in a deterioration of the patient's overall life-threatening status. OBJECTIVE: This systematic review and meta-analysis evaluated the safety and efficacy of probiotics in reducing intensive care unit (ICU)-acquired infections in adult critically ill patients. DATA SOURCES: PubMed and Cochrane library databases for the period 2011-2020 were searched. DATA EXTRACTION: Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement (PRISMA) methodology was used to search for randomized controlled trials that evaluated the use of probiotics among critically ill patients. DATA ANALYSIS: No significant difference was observed between probiotics and control groups in terms of the mortality rate (risk ratio 1.13, 95% confidence interval .82 to 1.55, P = .46). Probiotics, however, provided a significant reduction in ICU-acquired infections (risk ratio .73, 95% confidence interval .58 to .93, P = .01)."},{"id":"source_9","type":"source","study":"Role of probiotic supplementation in preventing ventilator-associated pneumonia among critically ill patients—a critical umbrella review of meta-analyses of randomized controlled trials","year":2026,"doi":"10.3389/fnut.2025.1719310","url":"https://doi.org/10.3389/fnut.2025.1719310","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Jiang 2026","excerpt":"BACKGROUND: In critically ill patients, gut microbiome balance is often disrupted by antibiotics and disease-related stress. Probiotics may strengthen gut barrier function and lower the risk of ventilator-associated pneumonia (VAP), but their effectiveness in mechanically ventilated patients remains unclear. This umbrella review synthesizes evidence from systematic reviews on the association between probiotic therapy and VAP incidence. METHODS: A comprehensive search was conducted in PubMed, Embase, Web of Science, the Cochrane Library, Scopus, and China National Knowledge Infrastructure (CNKI) for systematic reviews published from database inception to July 20, 2025. Data were extracted using a standardized form that had been pilot-tested prior to use. Data were synthesized using both narrative and quantitative approaches. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (registration ID: CRD420251034247). RESULTS: This umbrella review included 24 meta-analyses of randomized controlled trials (RCTs) involving 92,711 mechanically ventilated critically ill patients."},{"id":"source_10","type":"source","study":"Modulation of Glucose Homeostasis, Metabolic Endotoxemia and Circulating Short-Chain Fatty Acids Following Multi-Species Probiotic Supplementation: Findings from a 12-Week Randomised Placebo-Controlled Trial","year":2026,"doi":"10.3390/nu18071025","url":"https://doi.org/10.3390/nu18071025","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Moschonis 2026","excerpt":"Background: Altered gut microbiota and gut-derived inflammation impair glucose regulation and promote metabolic endotoxemia, yet evidence on probiotic effects across combined glycaemic, inflammatory and short-chain fatty acid (SCFA) outcomes remains limited. This study investigated the effects of a 12-week multi-species probiotic on glucose homeostasis, incretin hormones, inflammatory biomarkers and circulating SCFAs in adults with subthreshold depression. Methods: In a 12-week double-blind, randomised, placebo-controlled trial, 39 adults with subthreshold depression were allocated to either a probiotic supplement containing Limosilactobacillus fermentum LF16, Lacticaseibacillus rhamnosus LR06, Lactiplantibacillus plantarum LP01 and Bifidobacterium longum 04 (n = 19) or placebo (n = 20). Fasting glucose, insulin, HOMA-IR, glucose-dependent insulinotropic peptide (GIP), high-sensitivity C -reactive protein (hs-CRP), lipopolysaccharide-binding protein (LBP), soluble CD14 (sCD14) and SCFAs were evaluated at three time points: baseline, week 6 and week 12. Between-group and treatment × time effects were analysed using general linear models."},{"id":"source_11","type":"source","study":"Early Probiotic Supplementation of Healthy Term Infants with Bifidobacterium longum subsp. infantis M-63 Is Safe and Leads to the Development of Bifidobacterium -Predominant Gut Microbiota: A Double-Blind, Placebo-Controlled Trial","year":2023,"doi":"10.3390/nu15061402","url":"https://doi.org/10.3390/nu15061402","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Hiraku 2023","excerpt":"Bifidobacteria are important intestinal bacteria that provide a variety of health benefits in infants. We investigated the efficacy and safety of Bifidobacterium longum subsp. infantis ( B. infantis ) M-63 in healthy infants in a double-blind, randomized, placebo-controlled trial. Healthy term infants were given B. infantis M-63 (n = 56; 1 × 10 9 CFU/day) or placebo (n = 54) from postnatal age ≤ 7 days to 3 months. Fecal samples were collected, and fecal microbiota, stool pH, short-chain fatty acids, and immune substances were analyzed. Supplementation with B. infantis M-63 significantly increased the relative abundance of Bifidobacterium compared with the placebo group, with a positive correlation with the frequency of breastfeeding. Supplementation with B. infantis M-63 led to decreased stool pH and increased levels of acetic acid and IgA in the stool at 1 month of age compared with the placebo group. There was a decreased frequency of defecation and watery stools in the probiotic group. No adverse events related to test foods were observed. These results indicate that early supplementation with B."},{"id":"source_12","type":"source","study":"The effects of probiotic supplementation on body composition, recovery following exercise‐induced muscle damage, and exercise performance: A systematic review and meta‐analysis of clinical trials","year":2025,"doi":"10.14814/phy2.70288","url":"https://doi.org/10.14814/phy2.70288","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Shirkoohi 2025","excerpt":"The goal of the current systematic review and meta-analysis was to provide a definitive assessment of the impacts of probiotic supplementation on body composition, recovery from exercise-induced muscle damage, and exercise performance in individuals actively participating in exercise. A thorough literature search encompassing Scopus, PubMed, Google Scholar, and Web of Science databases was conducted up to May 2024. The weighted mean difference (WMD) and 95% confidence interval (95% CI) for each outcome were estimated using a random-effects model. The certainty of the assessments was further evaluated utilizing the GRADE approach. The pooled analysis showed a significant effect of probiotics on body weight [(WMD = -0.55 kg; 95% CI, -0.98 to -0.13; p = 0.010)], percent body fat [(WMD = -0.46%; 95% CI, -0.83 to -0.09; p = 0.014)], creatine kinase [(WMD = -45.57 IU. L -1 ; 95% CI: -65.12, -26.02; p = 0.000)], and VO 2max [(WMD = 1.55 mL/kg -1 /min -1 ; 95% CI, 0.61 to 2.49; p = 0.001)]. Despite this, no significant effects were observed on body mass index, lean body mass, lactate dehydrogenase, and myoglobin levels."},{"id":"source_13","type":"source","study":"Alleviating effects of probiotic supplementation on biomarkers of inflammation and oxidative stress in non-communicable diseases: a systematic review and meta-analysis using the GRADE approach","year":2025,"doi":"10.1186/s40360-025-00957-5","url":"https://doi.org/10.1186/s40360-025-00957-5","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yu 2025","excerpt":"BACKGROUND: Inflammation and oxidative stress are key risk factors in noncommunicable diseases (NCDs). Probiotics have been suggested to be beneficial in mitigating inflammation and oxidative stress; however, the evidence remains inconsistent due to variations in study design, dosage, and patient populations. METHODS: Studies were included following a systematic search of PubMed, Scopus, Cochrane Library, Web of Science, and EMBASE, provided they fulfilled the eligibility criteria. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to clarify the effects of probiotics on oxidative stress and inflammation in non-communicable diseases (NCDs). RESULTS: A review of 18 studies revealed that probiotic supplementation significantly reduced CRP (SMD = -1.33, 95% CI: -1.84, -0.82; p < 0.001, high certainty), TNF-α (SMD = -1.10, 95% CI: -1.66, -0.55; p < 0.001, low certainty), and MDA levels (SMD = -1.38, 95% CI: -2.08, -0.69; p < 0.001, high certainty). Additionally, while probiotics increased GSH levels (SMD = 0.65, 95% CI: 0.06, 1.23; p < 0.001, high certainty), they did not change the levels of IL-6 (SMD = -1.05, 95% CI: -2.21, 0.11; p < 0."},{"id":"source_14","type":"source","study":"Safety and efficacy of probiotic supplementation in 8 types of inflammatory arthritis: A systematic review and meta-analysis of 34 randomized controlled trials","year":2022,"doi":"10.3389/fimmu.2022.961325","url":"https://doi.org/10.3389/fimmu.2022.961325","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Zeng 2022","excerpt":"OBJECTIVE: To evaluate Safety and efficacy of probiotic supplementation in inflammatory arthritis. METHODS: The literature on the treatment of inflammatory arthritis with probiotics has been collected in databases such as CNKI, Pubmed, Cochrane library, Embase, etc. The search time is for them to build the database until May 2022. The included literatures are randomized controlled trials (RCTs) of probiotics in the treatment of hyperuricemia and gout. The Cochrane risk assessment tool was used for quality evaluation, and the Rev Man5.3 software was used for meta-analysis. RESULTS: A total of 37 records were finally included, involving 34 RCTs and 8 types of autoimmune disease (Hyperuricemia and gout, Inflammatory bowel disease arthritis, juvenile idiopathic arthritis [JIA], Osteoarthritis [OA], Osteoporosis and Osteopenia, Psoriasis, rheumatoid arthritis (RA), Spondyloarthritis). RA involved 10 RCTs (632 participants) whose results showed that probiotic intervention reduced CRP. Psoriasis involved 4 RCTs (214 participants) whose results showed that probiotic intervention could reduce PASI scores."},{"id":"source_15","type":"source","study":"Effect of Probiotic Supplementation on Cognitive Function and Metabolic Status in Mild Cognitive Impairment and Alzheimer's Disease: A Meta-Analysis","year":2021,"doi":"10.3389/fnut.2021.757673","url":"https://doi.org/10.3389/fnut.2021.757673","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Li 2021","excerpt":"Background: Alzheimer's disease (AD) is a progressive and multifactorial neurodegenerative disease accounting for 80% of dementia worldwide. Objective: To assess the influence of probiotics on cognitive function in patients with mild cognitive impairment (MCI) and AD. Methods: PubMed, Embase, and Cochrane Library databases were searched for relevant studies. Results: Six randomized controlled trials involving 462 patients with MCI and AD were included in this meta-analysis. The probiotic administration had favorable effects on homeostasis model assessment-insulin resistance [HOMA-IR; Weighted mean difference (WMD) = -0.34, 95% confidence intervals (95% CI): -0.44 to 0.24, P < 0.001, I 2 = 0%], very low-density lipoprotein levels (VLDL; WMD = -3.71, 95% CI: -6.11 to -1.32, P =0.002, I 2 = 57.7%), quantitative insulin sensitivity check index (QUICKI; WMD = 0.01, 95% CI: 0.00-0.01, P = 0.003, I 2 = 51%), and triglyceride levels (WMD = -15.65, 95% CI: -27.48 to -3.83, P = 0.009, I 2 = 63.4%) in patients with AD. However, after Hartung-Knapp adjustment, all effects were non-significant except for HOMA-IR (MD = -0.34, 95%CI = -0.58 to -0.11)."},{"id":"source_16","type":"source","study":"Effects of probiotic supplementation on islet β-cell function in subjects with glucose metabolism disorders: a meta-analysis","year":2025,"doi":"10.3389/fnut.2025.1668470","url":"https://doi.org/10.3389/fnut.2025.1668470","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Xiang 2025","excerpt":"BACKGROUND: Islet β-cell dysfunction is central to the pathophysiology of glucose metabolism disorders. Probiotic supplementation has been shown to benefit glycemic control, but existing evidence on β-cell function remains inconclusive. This meta-analysis investigated the effects of probiotic supplementation on pancreatic islet β-cell function, as assessed by the homeostasis model assessment for β-cell function (HOMA-β), in individuals with impaired glucose metabolism. METHODS: A systematic search of PubMed, Embase, Web of Science, and the Cochrane Library was conducted. We included randomized controlled trials (RCTs) comparing probiotics with placebo or no additional treatment in adults with abnormal glucose metabolism. Random-effects meta-analysis was performed, accounting for the potential influence of heterogeneity. RESULTS: Twelve RCTs involving 907 participants were included. Compared with controls, probiotic supplementation significantly improved HOMA-β (mean difference [MD]: 3.04, 95% CI: 0.23 to 5.86; p = 0.03; I 2 = 92%)."},{"id":"source_17","type":"source","study":"12-week preoperative probiotic supplementation versus placebo: effects on inflammation, endotoxemia, adipokines, and gastrointestinal peptides in patients six months after bariatric surgery – a double-blind, randomized, placebo-controlled clinical trial","year":2025,"doi":"10.1186/s12937-025-01217-2","url":"https://doi.org/10.1186/s12937-025-01217-2","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Potrykus 2025","excerpt":"BACKGROUND: Disruption in gut microbiota has been identified as a contributor to obesity-related inflammation and metabolic disorders. This study investigates the effects of preoperative probiotic supplementation on inflammation, endotoxemia, adipokines, and gastrointestinal peptides after bariatric surgery. METHODS: This randomized, double-blind, placebo-controlled clinical trial included patients undergoing laparoscopic sleeve gastrectomy (LSG) or one anastomosis gastric bypass (OAGB). Participants were randomized to receive a 12-week supplementation of either a probiotic mixture, Sanprobi Barrier, which contained nine strains of bacteria (Bifidobacterium bifidum W23, Bifidobacterium lactis W51 and W52, Lactobacillus acidophilus W37, Levilactobacillus brevis W63, Lacticaseibacillus casei W56, Ligilactobacillus salivarius W24, Lactococcus lactis W19, and Lactococcus lactis W58), or a placebo before surgery."},{"id":"source_18","type":"source","study":"Probiotic Supplementation Can Alter Inflammation Parameters and Self-Reported Sleep After a Marathon: A Randomized, Double-Blind, Placebo-Controlled Study","year":2025,"doi":"10.3390/nu17233762","url":"https://doi.org/10.3390/nu17233762","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Aquino-Lemos 2025","excerpt":"Background: Sleep is essential for athletes' physical performance and recovery. However, strenuous exercise has the potential to increase inflammation and worsen sleep. This study evaluated the effect of probiotic supplementation on self-reported sleep quality, daytime sleepiness, and inflammatory profile 24 h after a marathon. Methods : 27 marathon male runners were divided into the Probiotic group (Probiotic n = 14) or the Placebo group (Placebo n = 13). The Probiotic group consumed 1 × 10 10 CFU of Lactobacillus acidophilus, 1 × 10 10 CFU of Bifidobacterium lactis + 5 g/day maltodextrin for 30 days prior to the marathon. The Placebo group received a sachet of 5 g/day maltodextrin during the same period. Sleep and inflammatory status were assessed before supplementation, before the marathon, and 1 h and 24 h after the marathon. Data were analyzed using Statistic 13.3 and expressed as mean ± standard deviation. Tukey's post hoc test was followed by a two-way ANOVA with repeated measures. The level of significance was set at p ≤ 0.05."},{"id":"source_19","type":"source","study":"The effects of probiotic supplementation on cardiometabolic health in patients with prediabetes: a systematic review, meta-analysis, and GRADE assessment","year":2025,"doi":"10.3389/fnut.2025.1616476","url":"https://doi.org/10.3389/fnut.2025.1616476","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Liu 2025","excerpt":"INTRODUCTION: Previous studies have yielded conflicting results regarding the effect of probiotics on prediabetes. To address this, we did an updated systematic review and meta-analysis of existing studies to evaluate the effects of probiotics on prediabetes. METHODS: We conducted a thorough search for pertinent trials on the impact of probiotic supplementation on prediabetes using various databases such as PubMed, Medline, and Google Scholar. RESULTS: Ten RCTs were included. Probiotic supplementation significantly reduced HbA1c (WMD = -0.11; 95% CI: -0.18, -0.04; p < 0.001; I 2 = 0.0%) and increased HDL-C (WMD: 2.37; 95% CI: 1.02, 3.71; p < 0.001; I 2 = 0.0%). Moreover, there were no significant effects of probiotic supplementation on FBS, insulin, HOMA-IR, LDL-C, TC, TG, BMI, SBP, and DBP. GRADE assessment showed high for HbA1c and HDL-C and moderate for BMI, SBP, DBP, insulin, HOMA-IR, TC, and LDL-C, and low for FBS and TG. CONCLUSION: Probiotic supplementation reduces HbA1c levels and increases HDL-C in individuals with prediabetes. Future research involving large-scale, international RCTs is essential to further validate its therapeutic potential."},{"id":"source_20","type":"source","study":"Effect of probiotic supplementation along with calorie restriction on metabolic endotoxemia, and inflammation markers in coronary artery disease patients: a double blind placebo controlled randomized clinical trial","year":2021,"doi":"10.1186/s12937-021-00703-7","url":"https://doi.org/10.1186/s12937-021-00703-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Moludi 2021","excerpt":"PURPOSE: Alterations in the gut microbiome (dysbiosis) has been associated with increased microbial translocation, leading to chronic inflammation in coronary artery disease (CAD). It has been proposed that modulation of gut microbiota by probiotic might modify metabolic endotoxemia. Therefore, the purpose of this study was to examine the effects of Lactobacillus rhamnosus GG (LGG) on endotoxin level, and biomarkers of inflammation in CAD participants. METHODS: This study was a 12-weeks randomized, double-blind, and intervention on 44 patients with CAD. Patients were randomly allocated to receive either one LGG capsule 1.6 × 10 9 colony-forming unit (CFU) or the placebo capsules for 12 weeks. In addition, all the participants were also prescribed a calorie-restricted diet. Serum levels of interleukin-1β (IL-1β), Toll-like receptor 4 (TLR4), interleukin-10 (IL-10), and lipopolysaccharide (LPS), were assessed before and after the intervention. RESULTS: A significant decrease in IL1-Beta concentration (- 1.88 ± 2.25, vs. 0.50 ± 1.58 mmol/L, P = 0.027), and LPS levels (- 5.88 ± 2.70 vs. 2.96+ 5.27 mg/L, P = 0."},{"id":"source_21","type":"source","study":"Safety and Efficacy of Probiotic Supplementation in Reducing the Incidence of Infections and Modulating Inflammation in the Elderly with Feeding Tubes: A Pilot, Double-Blind, Placebo-Controlled Study, “IntegPRO”","year":2021,"doi":"10.3390/nu13020391","url":"https://doi.org/10.3390/nu13020391","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Orlandoni 2021","excerpt":"A double-blind, placebo-controlled study was performed in a sample of geriatric patients treated with home enteral nutrition (HEN) to analyze the efficacy of a probiotic supplement Proxian ® , which contains Lactiplantibacillus plantarum LP01 (LMG P-21021), Lentilactobacillus buchneri Lb26 (DSM 16341), Bifidobacterium animalis subsp. lactis BS01 (LMG P-21384), and is enriched with zinc (Zn) and selenium (Se), in reducing the incidence of infections and modulating inflammation. Thirty-two subjects were enrolled (mean age 79.7 ± 10.3 years), 16 in the intervention group, 16 controls. They received Proxian ® or placebo for 60 days. Patients were assessed at baseline (t 0 ) and 60 (t 1 ) and 90 (t 2 ) days after the beginning. Infections were detected by information regarding their clinical manifestations and the incidence of antibiotic therapy. Levels of C-reactive protein (CRP) were measured to study inflammation. Information on bowel function, nutritional status and testimonials regarding the feasibility of administration of the product were collected. Differences between the two groups in number of infections (25% intervention group vs. 44% controls), antibiotic therapies (12% vs."},{"id":"source_22","type":"source","study":"Effects of probiotics on liver function, inflammation, and gut microbiota in alcoholic liver injury: a systematic review and meta-analysis","year":2025,"doi":"10.3389/fnut.2025.1717393","url":"https://doi.org/10.3389/fnut.2025.1717393","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Saadh 2025","excerpt":"PURPOSE: This systematic review and meta-analysis aimed to evaluate the effects of probiotic supplementation on alcohol metabolism, liver function biomarkers, inflammatory indicators, and gut microbiota composition in patients with alcoholic liver disease (ALD), providing insights into their potential therapeutic role. METHODS: A comprehensive search of the PubMed, Scopus, Web of Science, and Cochrane Library databases identified clinical studies assessing probiotic interventions in adults with ALD. RESULTS: A total of 12 clinical trials conducted between 2008 and 2025 were included. Probiotic supplementation resulted in significant reductions in liver enzymes, including ALT (WMD = -10.10; 95% CI: -15.34, -4.87) and AST (WMD = -13.05; 95% CI: -21.33, -4.78). No significant effects were observed for GGT or ALP. Probiotics did not significantly influence blood alcohol or acetaldehyde levels. Regarding inflammatory markers, probiotics did not significantly affect LPS, TNF- α , IL-1β, or IL-6, and IL-10."},{"id":"source_23","type":"source","study":"The Effects of Probiotic Supplementation on Opioid-Related Disorder in Patients under Methadone Maintenance Treatment Programs","year":2022,"doi":"10.1155/2022/1206914","url":"https://doi.org/10.1155/2022/1206914","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Molavi 2022","excerpt":"INTRODUCTION: Patients under methadone maintenance treatment programs (MMTPs) are susceptible to numerous complications (e.g., mental and metabolic disorders). This study evaluated the effects of probiotics on clinical symptoms, biomarkers of oxidative stress, inflammation, insulin resistance, and serum lipid content in patients receiving MMTPs. MATERIALS AND METHODS: A randomized, double-blind, placebo-controlled trial was conducted among 70 patients receiving MMTPs to receive either 1.8 × 10 9 CFU/day probiotics ( n = 35) or placebo ( n = 35) for 12 weeks. Clinical symptoms and metabolic profiles were measured before and after the intervention in patients receiving MMTPs. RESULTS: Compared with the placebo group, probiotic supplementation resulted in a significant improvement in the severity of depression ( P < 0.05). In addition, probiotic administration significantly decreased fasting plasma glucose (FPG), total cholesterol, and low-density lipoprotein cholesterol (LDL cholesterol) ( P < 0.05)."},{"id":"source_24","type":"source","study":"Probiotic Supplementation Reduces RRTIs and Enhances Gut Microbial and Immunity in Children: A Randomized Controlled Trial","year":2026,"doi":"10.4014/jmb.2511.11038","url":"https://doi.org/10.4014/jmb.2511.11038","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Chen 2026","excerpt":"Recurrent respiratory tract infections (RRTIs) are a major cause of morbidity in children, and strain-defined probiotics have been proposed as a supportive preventive strategy, although clinical evidence remains limited. In this randomized, double-blind, placebo-controlled trial, 120 children diagnosed with RRTIs received either Bifidobacterium animalis subsp. lactis XLTG11 and Lactiplantibacillus plantarum CCFM8661 or a matched placebo daily for 180 days. The probiotic group demonstrated significantly reduced duration and frequency of fever, cough, upper respiratory tract infections, trachea/bronchitis, pneumonia, and overall RRTI recurrence compared with the placebo group (all p < 0.05). Gut microbiota profiling showed clear community differences between groups at day 180, with the probiotic group exhibiting greater abundance of beneficial commensal taxa and the placebo group showing higher representation of opportunistic genera. Functional pathway analysis indicated shifts consistent with enhanced metabolic stability in probiotic recipients."},{"id":"source_25","type":"source","study":"Impact of Probiotic Supplementation and High-Intensity Interval Training on Primary Dysmenorrhea: A Double-Blind, Randomized Controlled Trial Investigating Inflammation and Hormonal Modulation","year":2025,"doi":"10.3390/nu17040622","url":"https://doi.org/10.3390/nu17040622","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Yang 2025","excerpt":"Background : Dysmenorrhea, categorized as primary (PD) or secondary (SD), significantly affects females during their reproductive years, impairing quality of life, performance, and social relationships. Alongside medical treatment, exercise and probiotics are complementary measures for managing PD and promoting health. This study examined the impact of probiotic supplementation and high-intensity interval training (HIIT) on PD severity, physiological modulation, and physical fitness. Methods : Participants, recruited according to the primary dysmenorrhea criteria, were divided into non-PD (control) and PD groups, with the PD group further classified into dysmenorrhea (Dysmen), dysmenorrhea with probiotics (DysmenPro), dysmenorrhea with exercise (DysmenEx), and dysmenorrhea with both (DysmenExPro). Interventions included 10 weeks of HIIT and probiotics. Pre- and post-intervention assessments included questionnaires on premenstrual and menstrual symptoms, physical fitness evaluations, and blood sample analyses for biochemical, hormonal, and prostaglandin levels."},{"id":"source_26","type":"source","study":"Preoperative Multistrain Probiotic Supplementation Does Not Affect Body Weight Changes or Cardiometabolic Risk Factors in Bariatrics: Randomized, Double-Blind, Placebo-Controlled Clinical Trial","year":2024,"doi":"10.3390/nu16132055","url":"https://doi.org/10.3390/nu16132055","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Potrykus 2024","excerpt":"Emerging evidence suggests that microbiota plays a crucial role in the development, progression, and therapeutic options in obesity and its comorbidities. This study assessed preoperative probiotic therapy's impact on bariatric treatment outcomes. A 12-week randomized, double-blind, placebo-controlled trial with 48 patients undergoing bariatric surgery was conducted. Participants received probiotics-Sanprobi Barrier-which contained nine strains of bacteria: Bifidobacterium bifidum W23, Bifidobacterium lactis W51 and W52, Lactobacillus acidophilus W37, Levilactobacillus brevis W63, Lacticaseibacillus casei W56, Ligilactobacillus salivarius W24, Lactococcus lactis W19, and Lactococcus lactis W58. Primary outcomes included excess body weight loss, body weight loss, and excess body mass index loss, with secondary objectives focusing on metabolic profiles. Surgical treatment of obesity significantly improved anthropometric and metabolic parameters. No significant differences were observed in primary outcomes or in secondary outcomes between groups at any time point post-surgery."},{"id":"source_27","type":"source","study":"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","year":2021,"doi":"10.1371/journal.pone.0250234","url":"https://doi.org/10.1371/journal.pone.0250234","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Koesnoe 2021","excerpt":"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."},{"id":"source_28","type":"source","study":"Targeting the gut to heal the skin: probiotic supplementation reduces wound infection risk and clinical burden in critically ill patients—a systematic review and meta-analysis","year":2026,"doi":"10.3389/fnut.2026.1778903","url":"https://doi.org/10.3389/fnut.2026.1778903","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Peng 2026","excerpt":"OBJECTIVE: To systematically evaluate the impact of probiotic supplementation on wound-specific and systemic clinical outcomes in critically ill patients. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) according to PRISMA guidelines. A comprehensive search of six databases was performed up to December 31, 2025. We included RCTs of probiotic/synbiotic interventions in adult ICU patients reporting wound-related outcomes. Study quality and evidence certainty were assessed using Cochrane RoB 2.0 and GRADE frameworks. Data were pooled using random-effects models. RESULTS: Nineteen RCTs involving 1,384 patients were included. Probiotic supplementation significantly reduced the risk of wound infection (RR = 0.52, 95% CI: 0.38-0.71), with the most pronounced benefit observed in burn patients. It also significantly reduced hospital length of stay (MD = -5.24 days, 95% CI: -8.73 to -1.75) and the duration of antibiotic use (SMD = -0.18, 95% CI: -0.25 to -0.11), and the duration of mechanical ventilation (SMD = -0.90, 95% CI: -1.20 to -0.60). Probiotics were associated with reduced systemic inflammation (CRP SMD = -0.73, 95% CI: -1.15 to -0."},{"id":"source_29","type":"source","study":"The Effects of Probiotic Supplementation on Clinical Symptom, Weight Loss, Glycemic Control, Lipid and Hormonal Profiles, Biomarkers of Inflammation, and Oxidative Stress in Women with Polycystic Ovary Syndrome: a Systematic Review and Meta-analysis of Randomized Controlled Trials.","year":2022,"doi":"10.1007/s12602-019-09559-0","url":"https://doi.org/10.1007/s12602-019-09559-0","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Tabrizi 2022","excerpt":"The purpose of this systematic review and meta-analysis of randomized controlled trials (RCTs) is to determine the effectiveness of probiotic supplementation on clinical symptoms, weight loss, glycemic control, lipid and hormonal profiles, and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome (PCOS). Eligible studies were systematically searched from Cochrane Library, Embase, Medline, and Web of Science databases until January 2019. Cochran (Q) and I-square statistics were used to measure heterogeneity among included studies. Data were pooled by using random-effect model and expressed as standardized mean difference (SMD) with 95% confidence interval (CI). Eleven articles were included in this meta-analysis. Probiotic supplementation significantly decreased weight (SMD - 0.30; 95% CI, - 0.53, - 0.07; P = 0.01), body mass index (BMI) (SMD - 0.29; 95% CI, - 0.54, - 0.03; P = 0.02), fasting plasma glucose (FPG) (SMD - 0.26; 95% CI, - 0.45, - 0.07; P < 0.001), insulin (SMD - 0.52; 95% CI, - 0.81, - 0.24; P < 0.001), homeostatic model assessment for insulin resistance (HOMA-IR) (SMD - 0.53; 95% CI, - 0.79, - 0.26; P < 0.001), triglycerides (SMD - 0."},{"id":"source_30","type":"source","study":"Evaluating the Effectiveness of Probiotic Supplementation in Combination With Doxycycline for the Treatment of Moderate Acne: A Randomized Double‐Blind Controlled Clinical Trial","year":2025,"doi":"10.1111/jocd.16614","url":"https://doi.org/10.1111/jocd.16614","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Atefi 2025","excerpt":"BACKGROUND: Acne is a chronic inflammatory skin disease that negatively affects patients' quality of life. Increasing antibiotic resistance is making acne less responsive to treatment. Probiotics are live microorganisms that can provide health benefits by fighting pathogens and maintaining intestinal homeostasis and skin microbiome balance. This study investigates the effects of probiotics in the treatment of acne vulgaris. METHODS: In this randomized controlled clinical trial, 80 patients with moderate acne were divided into two groups of 40. All patients received the same topical treatment, which consisted of a daily antibacterial face wash and Adapalene gel every other night. The control group received one capsule of doxycycline (100 mg) daily, whereas the intervention group received one probiotic capsule daily in addition to doxycycline. Patients underwent photography of facial acne lesions, and treatment response was assessed using the global acne grading system (GAGS) and acne grading method at baseline, as well as during follow-up visits at 1, 2, and 3 months. RESULTS: The global acne grading system indicated that both groups showed improvement."},{"id":"source_31","type":"source","study":"Gut Microbiota Changes Following Short-Term Probiotic Supplementation in Older Home Enteral Nutrition Patients","year":2026,"doi":"10.3390/nu18061013","url":"https://doi.org/10.3390/nu18061013","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Tombolesi 2026","excerpt":"BACKGROUND: Home Enteral Nutrition (HEN) patients, often older adults, are susceptible to gut microbiota dysbiosis and low-grade chronic inflammation (inflammaging), which negatively impacts overall health and intestinal integrity. However, evidence on microbiota-targeted interventions in this population remains limited. The development of targeted nutritional strategies, such as probiotic supplementation, has been proposed to address these age-related changes. METHODS: This exploratory randomized, open-label study explored changes in gut microbiota composition following a 30-day probiotic intervention in a cohort of sixteen older HEN patients. Gut microbiota profiles were analyzed at baseline and post-intervention using 16S rRNA gene amplicon sequencing. RESULTS: Significant shifts in the gut microbiota were observed, including a statistically significant increase in alpha diversity after 30 days. At the taxonomic level, the treated group showed an increased relative abundance of Lachnospiraceae and Erysipelotrichaceae, suggesting a modulation of gut microbiota structure following probiotic supplementation."},{"id":"source_32","type":"source","study":"Effect of Probiotic Supplementation on Body Fat, Skeletal Muscle Mass, and Body Mass Index in Individuals ≥45 Years Old: A Systematic Review","year":2025,"doi":"10.21873/invivo.13927","url":"https://doi.org/10.21873/invivo.13927","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"PMC12041995 2025","excerpt":"BACKGROUND/AIM: Probiotics are living microorganisms that confer health benefits when administered in adequate amounts. Several studies have shown the positive effects on body fat, muscle mass, and body mass index (BMI) in young adults and athletes; however, the results in adults aged ≥45 years are not conclusive. MATERIALS AND METHODS: A systematic review was conducted in accordance with the PRISMA guidelines, analyzing studies up to December 10, 2024, from nine databases (PubMed, Scopus, Web of Science, LILACS, SciELO, Springer, Redalyc, Cochrane Library and TESIUNAM). Mean differences (MD) were estimated using RevMan V 5.4.1. software. RESULTS: Six hundred and sixty-six studies were identified, of which 15 met the eligibility criteria. A statistically significant decrease in fat mass (%) was found in two studies and in fat mass (kg) in another two studies. Likewise, one study reported a statistically significant increase in skeletal muscle mass."},{"id":"source_33","type":"source","study":"Anti-Inflammatory Diet and Probiotic Supplementation as Strategies to Modulate Immune Dysregulation in Autism Spectrum Disorder","year":2025,"doi":"10.3390/nu17162664","url":"https://doi.org/10.3390/nu17162664","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"indirect","cited_as":"Naranjo-Galvis 2025","excerpt":"Background/Objectives : Autism spectrum disorder (ASD) is a neurodevelopmental condition associated with behavioral and cognitive impairments. Increasing evidence also links ASD with systemic immune dysregulation, including abnormal cytokine profiles and chronic low-grade inflammation. Emerging evidence suggests that targeted dietary strategies and probiotic supplementation may modulate immune responses and gut-brain interactions in patients with ASD. This study aimed to evaluate the immunomodulatory effects of a structured anti-inflammatory diet ( NeuroGutPlus ) compared to multi-strain probiotics in children with ASD. NeuroGutPlus is a nutritionally complete anti-inflammatory dietary protocol that targets gut integrity, inflammation, and mitochondrial function. It includes a diet low in gluten, FODMAPs, casein, and artificial additives, and a high intake of omega-3 fatty acids, polyphenols, and fermentable fibers. Methods : A total of 30 children with ASD and 12 neurotypical controls were enrolled in a 12-week randomized controlled nutritional trial."},{"id":"source_34","type":"source","study":"Probiotic Supplementation Enhances the Effects of a Nutritional Intervention on Quality of Life in Women with Hashimoto’s Thyroiditis—A Double-Blind Randomised Study","year":2025,"doi":"10.3390/nu17213387","url":"https://doi.org/10.3390/nu17213387","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Osowiecka 2025","excerpt":"Background : Hashimoto's thyroiditis (HT) is characterised by chronic inflammation of the thyroid gland. The impact of a health-promoting diet and probiotics on health and quality of life, as well as on the anti-thyroid peroxidase antibody (anti-TPO), is increasingly being researched. However, the relevance of these factors to the course of HT is yet to be fully established. Objective : The aim of this study was to assess the impact of a 12-week nutritional intervention, comprising a rational, health-promoting diet supplemented with the probiotic strain Lactiplantibacillus plantarum 299v ( Lp299v ), on eating habits, nutritional status, health and quality of life in patients diagnosed with HT. Methods : The 12-week study involved 64 female patients with HT, divided into two groups: the NE+ Lp299v group, which received nutritional education and Lp299v (n = 32); and the NE+placebo group, which received nutritional education and placebo (n = 32). Before and after the intervention, anthropometric parameters, body composition analysis, blood pressure, blood anti-TPO levels, dietary habits, quality of life, and gastrointestinal symptoms were assessed."},{"id":"source_35","type":"source","study":"Meta-analysis of the effects of probiotic supplementation on bone turnover markers in middle-aged and elderly patients with osteoporosis","year":2026,"doi":"10.3389/fcimb.2025.1738378","url":"https://doi.org/10.3389/fcimb.2025.1738378","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Yuan 2026","excerpt":"BACKGROUND: Osteoporosis is highly prevalent among postmenopausal women and is characterized by a progressive 1-2% annual decline in bone mineral density (BMD). This deterioration contributes to more than 8.9 million fractures globally each year. The condition arises from an imbalance between bone formation and resorption. Emerging evidence suggests that probiotics may positively modulate bone metabolism through gut microbiota regulation, yet high-quality clinical data directly linking probiotic use to bone turnover markers remains limited. This meta-analysis investigates the effects of probiotic supplementation on bone formation and resorption markers in osteoporotic individuals. METHODS: A systematic review and meta-analysis were conducted on 15 randomized controlled trials (RCTs) involving 1,432 participants. The studies assessed various probiotic strains, dosages, and intervention periods ranging from 8 weeks to 12 months."},{"id":"source_36","type":"source","study":"Probiotic Supplementation Improves Cognitive Function and Mood with Changes in Gut Microbiota in Community-Dwelling Older Adults: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial","year":2020,"doi":"10.1093/gerona/glaa090","url":"https://doi.org/10.1093/gerona/glaa090","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Kim 2020","excerpt":"Probiotics have been proposed to ameliorate cognitive impairment and depressive disorder via the gut-brain axis in patients and experimental animal models. However, the beneficial role of probiotics in brain functions of healthy older adults remains unclear. Therefore, a randomized, double-blind, and placebo-controlled multicenter trial was conducted to determine the effects of probiotics on cognition and mood in community-dwelling older adults. Sixty-three healthy elders (≥65 years) consumed either placebo or probiotics containing Bifidobacterium bifidum BGN4 and Bifidobacterium longum BORI for 12 weeks. The gut microbiota was analyzed using 16S rRNA sequencing and bioinformatics. Brain functions were measured using the Consortium to Establish a Registry for Alzheimer's disease, Satisfaction with life scale, stress questionnaire, Geriatric depression scale, and Positive affect and negative affect schedule. Blood brain-derived neurotrophic factor (BDNF) was determined using enzyme-linked immunosorbent assay. Relative abundance of inflammation-causing gut bacteria was significantly reduced at Week 12 in the probiotics group (p < .05)."},{"id":"source_37","type":"source","study":"Examining immune-inflammatory mechanisms of probiotic supplementation in depression: secondary findings from a randomized clinical trial","year":2024,"doi":"10.1038/s41398-024-03030-7","url":"https://doi.org/10.1038/s41398-024-03030-7","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Sempach 2024","excerpt":"We recently indicated that four-week probiotic supplementation significantly reduced depression along with microbial and neural changes in people with depression. Here we further elucidated the biological modes of action underlying the beneficial clinical effects of probiotics by focusing on immune-inflammatory processes. The analysis included a total of N = 43 participants with depression, from which N = 19 received the probiotic supplement and N = 24 received a placebo over four weeks, in addition to treatment as usual. Blood and saliva were collected at baseline, at post-intervention (week 4) and follow-up (week 8) to assess immune-inflammatory markers (IL-1β, IL-6, CRP, MIF), gut-related hormones (ghrelin, leptin), and a stress marker (cortisol). Furthermore, transcriptomic analyses were conducted to identify differentially expressed genes. Finally, we analyzed the associations between probiotic-induced clinical and immune-inflammatory changes. We observed a significant group x time interaction for the gut hormone ghrelin, indicative of an increase in the probiotics group."},{"id":"source_38","type":"source","study":"Effect of short-term, high-dose probiotic supplementation on cognition, related brain functions and BDNF in patients with depression: a secondary analysis of a randomized controlled trial","year":2023,"doi":"10.1503/jpn.220117","url":"https://doi.org/10.1503/jpn.220117","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"direct","cited_as":"Schneider 2023","excerpt":"BACKGROUND: In major depressive disorder (MDD), cognitive dysfunctions strongly contribute to functional impairments but are barely addressed in current therapies. Novel treatment strategies addressing cognitive symptoms in depression are needed. As the gut microbiota-brain axis is linked to depression and cognition, we investigated the effect of a 4-week high-dose probiotic supplementation on cognitive symptoms in depression. METHODS: This randomized controlled trial included 60 patients with MDD, of whom 43 entered modified intention-to-treat analysis. A probiotic supplement or indistinguishable placebo containing maltose was administered over 31 days in addition to treatment as usual for depression. Participant scores on the Verbal Learning Memory Test (VLMT), Corsi Block Tapping Test, and both Trail Making Test versions as well as brain-derived neurotrophic factor levels were assessed at 3 different time points: before, immediately after and 4 weeks after intervention. Additionally, brain activation changes during working memory processing were investigated before and immediately after intervention."},{"id":"source_39","type":"source","study":"Probiotics supplementation or probiotic-fortified products on sarcopenic indices in older adults: systematic review and meta-analysis from recent randomized controlled trials","year":2024,"doi":"10.3389/fragi.2024.1307762","url":"https://doi.org/10.3389/fragi.2024.1307762","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Handajani 2024","excerpt":"Introduction: A noteworthy correlation was seen between changes in the gut microbiome and sarcopenia in older adults. Along with increasing research on probiotic supplementation for various medical problems, we aimed to obtain evidence and summarize the effect of probiotic supplementation on sarcopenic indices among older adults. Methods: We utilized PubMed, EBSCO, and Proquest, in addition to manual search using synonyms and variation for 'probiotic,' 'sarcopenia,' and 'older adults.' Randomized controlled trials investigated the utilization of probiotics or probiotic-containing products in older adults with sarcopenic indices including muscle mass and strength. The random-effects model was applied to the meta-analysis process. Results: Seven studies were obtained with 733 pooled older adults. Probiotic supplementation resulted in a significant increase of muscle mass with adjusted SMD (Standardized Mean Difference) of 0.962 (95% CI: 0.288 to 1.635, p = 0.049) using till and trim analysis and muscle strength with SMD of 1.037 (95% CI: 0.077 to 1.996, p = 0.03). However, both outcomes were associated with significantly high heterogeneity (I 2 = 89.5% and I 2 = 89.9%, respectively)."},{"id":"source_40","type":"source","study":"Effect of probiotic supplementation on cognition and depressive symptoms in patients with depression: A systematic review and meta-analysis","year":2023,"doi":"10.1097/MD.0000000000036005","url":"https://doi.org/10.1097/MD.0000000000036005","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"He 2023","excerpt":"BACKGROUND: Depression affects millions globally and often coexists with cognitive deficits. This study explored the potential of probiotics in enhancing cognition and ameliorating depressive symptoms in major depressive disorder patients. METHODS: Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol and the Population, Intervention, Comparator, Outcome, and Study design framework, we systematically reviewed randomized controlled trials examining probiotic effects on cognition and depressive symptoms. Searches spanned 7 databases from January 2010 to May 2022. Risk of bias was assessed using Revised Cochrane Risk of Bias 2.0, and meta-analysis was conducted with RevMan 5.4.1. Publication bias was evaluated via Egger test. RESULTS: In a systematic review on the effects of probiotic supplementation on cognition and depressive symptoms in depression patients, 635 records were initially identified, with 4 studies ultimately included. These randomized controlled trials were conducted across diverse regions, primarily involving females, with assessment periods ranging from 1 to 2 months."},{"id":"source_41","type":"source","study":"The Clinical, Microbiological, and Immunological Effects of Probiotic Supplementation on Prevention and Treatment of Periodontal Diseases: A Systematic Review and Meta-Analysis","year":2022,"doi":"10.3390/nu14051036","url":"https://doi.org/10.3390/nu14051036","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Gheisary 2022","excerpt":"(1) Background: Periodontal diseases are a global health concern. They are multi-stage, progressive inflammatory diseases triggered by the inflammation of the gums in response to periodontopathogens and may lead to the destruction of tooth-supporting structures, tooth loss, and systemic health problems. This systematic review and meta-analysis evaluated the effects of probiotic supplementation on the prevention and treatment of periodontal disease based on the assessment of clinical, microbiological, and immunological outcomes. (2) Methods: This study was registered under PROSPERO (CRD42021249120). Six databases were searched: PubMed, MEDLINE, EMBASE, CINAHL, Web of Science, and Dentistry and Oral Science Source. The meta-analysis assessed the effects of probiotic supplementation on the prevention and treatment of periodontal diseases and reported them using Hedge's g standardized mean difference (SMD). (3) Results: Of the 1883 articles initially identified, 64 randomized clinical trials were included in this study."},{"id":"source_42","type":"source","study":"Probiotic Supplementation Prevents the Development of Ventilator-Associated Pneumonia for Mechanically Ventilated ICU Patients: A Systematic Review and Network Meta-analysis of Randomized Controlled Trials","year":2022,"doi":"10.3389/fnut.2022.919156","url":"https://doi.org/10.3389/fnut.2022.919156","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Li 2022","excerpt":"BACKGROUND: Ventilator-associated pneumonia (VAP) is one of the common critical complications of nosocomial infection (NI) in invasive mechanically ventilated intensive care unit (ICU) patients. The efficacy of total parenteral nutrition (TPN), enteral nutrition and/or adjuvant peripheral parenteral nutrition (EPN) supplemented with or without probiotic, prebiotic, and synbiotic therapies in preventing VAP among these patients has been questioned. We aimed to systematically and comprehensively summarize all available studies to generate the best evidence of VAP prevention for invasive mechanically ventilated ICU patients. METHODS: Randomized controlled trials (RCTs) for the administration of TPN, EPN, probiotics-supplemented EPN, prebiotics-supplemented EPN, and synbiotics-supplemented EPN for VAP prevention in invasive mechanically ventilated ICU patients were systematically retrieved from four electronic databases. The incidence of VAP was the primary outcome and was determined by the random-effects model of a Bayesian framework. The secondary outcomes were NI, ICU and hospital mortality, ICU and hospital length of stay, and mechanical ventilation duration."},{"id":"source_43","type":"source","study":"Effects of Probiotic Supplementation on Inflammation and Oxidative Stress for Gestational Diabetes: A Meta-Analysis Study.","year":2023,"doi":"10.1055/a-1936-0887","url":"https://doi.org/10.1055/a-1936-0887","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Wang 2023","excerpt":"BACKGROUND: Probiotic supplements may benefit to reduce inflammation and oxidative stress in patients with gestational diabetes, and this meta-analysis aims to explore the impact of probiotic supplementation on inflammation and oxidative stress for gestational diabetes. METHODS: PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases were systematically searched, and we included randomized controlled trials (RCTs) assessing the effect of a probiotic supplement on inflammation and oxidative stress in patients with gestational diabetes. RESULTS: Five RCTs were finally included in the meta-analysis. Overall, compared with control intervention for gestational diabetes, probiotic supplementation intervention showed significantly reduced CRP (MD=-1.72; 95% CI=-2.54 to -0.90; P<0.0001), IL-6 (MD=-0.42; 95% CI=-0.66 to -0.18; P=0.0005) and MDA (MD=-0.88; 95% CI=-1.10 to -0.66; P<0.00001), increased NO (MD=2.42; 95% CI=0.80 to 4.04; P=0.003) and TAC (SMD=0.86; 95% CI=0.19 to 1.54; P=0.01), but showed no obvious impact on GSH (MD=13.73; 95% CI=-35.84 to 63.31; P=0.59)."},{"id":"source_44","type":"source","study":"“Do probiotics mitigate GI-induced inflammation and perceived fatigue in athletes? A systematic review”","year":2024,"doi":"10.1080/15502783.2024.2388085","url":"https://doi.org/10.1080/15502783.2024.2388085","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Kearns 2024","excerpt":"BACKGROUND: Fatigue and gastrointestinal (GI) distress are common among athletes with an estimated 30-90% of athletes participating in marathons, triathlons, or similar events experiencing GI complaints. Intense exercise can lead to increased intestinal permeability, potentially allowing members of the gut microbiota to permeate into the bloodstream, resulting in an inflammatory response and cascade of performance-limiting outcomes. Probiotics, through their capacity to regulate the composition of the gut microbiota, may act as an adjunctive therapy by enhancing GI and immune function while mitigating inflammatory responses. This review investigates the effectiveness of probiotic supplementation on fatigue, inflammatory markers, and exercise performance based on randomized controlled trials (RCTs). METHODS: This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and PICOS (Population, Intervention, Comparison, Outcome, Study design) framework."},{"id":"source_45","type":"source","study":"Efficacy and safety of oral probiotic supplementation in mitigating postoperative surgical site infections in patients undergoing colorectal cancer surgery: A systematic review and meta‐analysis","year":2023,"doi":"10.1111/iwj.14603","url":"https://doi.org/10.1111/iwj.14603","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Chen 2023","excerpt":"Surgical site infections (SSIs) pose significant risks to patients undergoing colorectal cancer (CRC) surgery. With increasing evidence on the benefits of oral probiotics in various clinical contexts, there is a need to assess their efficacy and safety in reducing SSIs following CRC surgery. A systematic review and meta-analysis were conducted in line with PRISMA guidelines using the PICO framework. On 19 September 2023, four major databases (PubMed, Embase, Web of Science and Cochrane Library) were searched without any temporal or language restrictions. Rigorous inclusion and exclusion criteria were employed. Data extraction was independently undertaken by two assessors, and any discrepancies were discussed. The Cochrane Collaboration's risk of bias instrument was utilized to assess study quality. The meta-analysis incorporated a fixed-effects model or random-effects model based on the I2 statistic to assess heterogeneity. The initial search yielded 1282 articles, of which 10 met the inclusion criteria and were analysed. Probiotic administration not only significantly reduced the incidence of SSIs but also curtailed the duration of hospital stays."},{"id":"source_46","type":"source","study":"Effects of Probiotic Supplementation on Sports Performance and Performance-Related Features in Athletes: A Systematic Review","year":2023,"doi":"10.3390/ijerph20032226","url":"https://doi.org/10.3390/ijerph20032226","population":"not extracted","intervention_or_exposure":"not extracted","comparator":"not extracted","endpoint":"not extracted","effect":"not extracted","risk_of_bias":"not appraised in public sidecar","directness":"review","cited_as":"Dio 2023","excerpt":"This review aims to evaluate the effects of probiotic supplementation on performance and performance-related conditions in athletes by evaluating randomized controlled studies from the MEDLINE (Pubmed), Web of Science, Scopus, and SPORTDiscus (EBSCO) databases. From a total of 2304 relevant articles, 13 studies fulfilled the inclusion criteria. Seven studies concern endurance athletes, one to rugby players, three refer to non-specified athletes, one to badminton players, and one involves baseball players. The evidence suggests that the integration of athletes' diets with some bacterial strains and also the consumption of multi-strain compounds may lead to an improvement in performance and can positively affect performance-related aspects such as fatigue, muscle pain, body composition, and cardiorespiratory fitness. However, the type of supplementation and sport is very variable among the studies examined. Therefore, to obtain more solid evidence, further controlled and comparable studies are needed to expand the research regarding the possible repercussions of probiotics use on athletes' performance."}],"edges":[{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_1","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_2","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_3","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_4","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_5","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_6","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_7","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_8","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_9","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_10","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_11","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_12","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_13","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_14","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_15","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_16","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_17","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_18","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_19","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_20","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_21","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_22","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_23","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_24","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_25","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_26","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_27","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_28","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_29","type":"contains_claim"},{"from":"45ba1bda-6940-4338-babd-4c360db9ad4d","to":"claim_30","type":"contains_claim"}],"screening":{"identified":46,"screened":46,"excluded":0,"included":46,"included_or_retained":46,"flow":["identified","screened","excluded_with_reasons","included"],"wording":"46 candidate receipts retained after source retrieval, deduplication, and topic filtering. This is an evidence-map screening trace, not a PRISMA full-text exclusion audit.","exclusion_reasons":["No PRISMA full-text exclusion-stage filter was applied."]}}