In patients with relapse remitting multiple sclerosis (RRMS), supplementation with probiotics may be associated with slower disability progression, reduced depressive symptoms, and improvements in general health, according to findings from a meta-analysis published in the International Journal of Clinical Practice.
Past research has theorized an imbalance within the gut microbiome can trigger autoimmune diseases like MS. Researchers believe probiotic supplementation, which contains beneficial bacteria strains, could be a way to correct the gut microbiome and help MS treatment. Although the effect of probiotics on MS has been previously studied, most of these studies have had a small sample size and a short duration.
The objective of the current study was to perform analyze pooled data on probiotic supplementation in patients with RRMS to draw a more robust conclusion on its effect on clinical outcomes and general health.
The meta-analysis included 4 English-language clinical trials that included a pooled cohort of 213 patients (mean age range, 34-40 years) with RRMS who had a mean disease duration between 4.3 and 6.7 years. The researchers also identified another 6 studies that featured the same interventions but different outcomes and included these trials in a systematic review.
A total of 106 participants were randomly assigned to a probiotic supplementation group, while 107 were randomly assigned a control. Probiotic content in the meta-analyzed studies included Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium bifidum, and Lactobacillus fermentum, Bifidobacterium infantis, Bifidobacterium lactis, and Lactobacillus reuteri, among several other bacteria.
Across studies, the researchers found significant improvements following probiotic supplementation in the Expanded Disability Status Scale (weighted mean difference [WMD], −0.43; 95% CI, −0.65 to −0.20; P <.001), Beck Depression Inventory-II (WMD, −3.22; 95% CI, −4.38 to −2.06; P <.001), and General Health Questionnaire (WMD, −4.37; 95% CI, −6.43 to −2.31; P <.001). In contrast, there was no significant changes in body weight (WMD, 0.16; 95% CI, −3.01-3.33; P =.923) and body mass index (WMD, 0.04; 95% CI, −0.92-1.00; P =.939) following probiotic supplementation.
According to the researchers, the small number of trials as well as their relatively short treatment durations represent primary limitations of the meta-analysis.
The researchers “recommend that physicians and dietitians consider the confirmed probiotic supplements for managing the health-related concerns in MS.”
Mirashrafi S, Hejazi Taghanaki SZ, Sarlak F, et al. Effect of probiotics supplementation on disease progression, depression, general health, and anthropometric measurements in relapsing-remitting multiple sclerosis patients: A systematic review and meta-analysis of clinical trials. Int J Clin Pract. Published online August 11, 2021. doi:10.1111/ijcp.14724