title: Effects of Probiotic and Prebiotic Supplementation on Leptin, Adiponectin, and Glycemic Parameters in Non-alcoholic Fatty Liver Disease: A Randomized Clinical Trial Effects of probiotic therapy in critically ill patients: a randomized, double-blind, placebo-controlled trial. Probiotic Bifidobacterium longum NCC3001 Reduces Depression Scores and Alters Brain Activity: A Pilot Study in Patients With Irritable Bowel Syndrome. Effects of Lactobacillus acidophilus NCFM on insulin sensitivity and the systemic inflammatory response in human subjects. Effect of multi-strain probiotics (multi-strain microbial cell preparation) on glycemic control and other diabetes-related outcomes in people with type 2 diabetes: a randomized controlled trial Bifidobacterium infantis 35624 modulates host inflammatory processes beyond the gut Dietary therapy with Lactobacillus GG, bovine colostrum or bovine immune colostrum in patients with juvenile chronic arthritis: Evaluation of effect on gut defence mechanisms Probiotic supplementation improves inflammatory status in patients with rheumatoid arthritis. Effects of probiotics (cultured Lactobacillus subtilis/Streptococcus faecium) in the treatment of alcoholic hepatitis: randomized-controlled multicenter study Effect of Probiotic (VSL#3) and Omega-3 on Lipid Profile, Insulin Sensitivity, Inflammatory Markers, and Gut Colonization in Overweight Adults: A Randomized, Controlled Trial Randomized Controlled Trial of Strain-Specific Probiotic Formulation (Renadyl) in Dialysis Patients Effect of a probiotic preparation (VSL#3) in critically ill patients: A randomized, double-blind, placebo-controlled trial (Pilot Study) A randomized, double-blinded, placebo-controlled pilot study of probiotics in active rheumatoid arthritis Cholesterol lowering and inhibition of sterol absorption by Lactobacillus reuteri NCIMB 30242: a randomized controlled trial The additional effects of a probiotic mix on abdominal adiposity and antioxidant Status: A double-blind, randomized trial. Improvements in Seasonal Allergic Disease with Lactobacillus plantarum No. 14 The effect of orally administered probiotic Lactobacillus reuteri-containing tablets in peri-implant mucositis: a double-blind randomized controlled trial. Probiotic Therapy for the Treatment of Spondyloarthritis: A Randomized Controlled Trial Effects of probiotic therapy on the activity and activation of mild rheumatoid arthritis – a pilot study Effect of probiotic Bifidobacterium longum BB536 [corrected] in relieving clinical symptoms and modulating plasma cytokine levels of Japanese cedar pollinosis during the pollen season. A randomized double-blind, placebo-controlled trial. Effects of Probiotic Supplementation on Pancreatic β-cell Function and C-reactive Protein in Women with Polycystic Ovary Syndrome: A Randomized Double-blind Placebo-controlled Clinical Trial Effects of Multistrain Probiotic Supplementation on Glycemic and Inflammatory Indices in Patients with Nonalcoholic Fatty Liver Disease: A Double-Blind Randomized Clinical Trial The effects of probiotic supplement on hemoglobin in chronic renal failure patients under hemodialysis: A randomized clinical trial Impact of probiotic Saccharomyces boulardii on the gut microbiome composition in HIV-treated patients: A double-blind, randomised, placebo-controlled trial Role of Probiotics on Gut Permeability and Endotoxemia in Patients With Acute Pancreatitis: A Double-Blind Randomized Controlled Trial Effects of a Multispecies Probiotic Supplement on Bone Health in Osteopenic Postmenopausal Women: A Randomized, Double-blind, Controlled Trial The effect of probiotics on serum levels of cytokine and endotoxin in peritoneal dialysis patients: a randomised, double-blind, placebo-controlled trial. Probiotic Supplementation in Chronic Kidney Disease: A Double-blind, Randomized, Placebo-controlled Trial. Evaluation of Lactobacillus coryniformis CECT5711 strain as a coadjuvant in a vaccination process: a randomised clinical trial in healthy adults Intestinal and immunological effects of daily oral administration of Lactobacillus salivarius CECT5713 to healthy adults. Effects of the adjunctive probiotic VSL#3 on portal haemodynamics in patients with cirrhosis and large varices: a randomized trial. Efficacy of probiotic supplementation on quality of life and pulmonary symptoms due to sulfur mustard exposure: a randomized double-blind placebo-controlled trial
abstract: BACKGROUND According to previous studies , probiotic and prebiotic supplementation have desirable effects on glycemic parameters . Thus far , the effect of supplementation on the glycemic parameters and adipokines in non-alcoholic fatty liver disease ( NAFLD ) has not been assessed . Therefore , the aim of this study was to determine the effects of supplementation with probiotic and prebiotic on adiokines and glycemic parameters in the patients with NAFLD . METHODS In the present r and omized , double-blind , placebo-controlled trial , 89 patients with NAFLD were r and omly divided into three groups to receive one probiotic capsule + 16 g/d maltodextrin ( probiotic group ) or 16 g/d oligofructose powder + one placebo capsule ( prebiotic group ) , and one placebo capsule + 16 g/d maltodextrin ( control group ) for 12 weeks . All the subjects in the study were advised to follow the weight loss diet and physical activity recommendations during the intervention . Fasting blood sample s were taken at baseline and after the intervention to measure leptin , adiponectin , insulin , and fasting blood sugar . RESULTS At the end of the study , serum concentrations of leptin , insulin , and HOMA-IR decreased significantly in the probiotic and prebiotic groups compared with the control group . Despite the changes within the groups , serum concentrations of adiponectin did not change significantly between the three groups . Also , fasting blood sugar did not change between the groups , but decreased in the prebiotic group . Quantitative insulin-sensitivity check index ( QUICKI ) increased significantly in probiotic and prebiotic groups compared with the control group . CONCLUSION Probiotic and prebiotic supplementation along with lifestyle intervention has a favorable impact on glycemic parameters and leptin levels compared with lifestyle intervention alone BACKGROUND Multiple organ dysfunction syndrome ( MODS ) is a major cause of mortality in intensive care units . A breakdown in gut barrier function and immune dysfunction are associated with the onset of MODS . Probiotic bacteria have been shown to modulate intestinal barrier and immune function . OBJECTIVE This study assessed the efficacy of a probiotic compound in a viable and nonviable formulation in modulating intestinal permeability and immune function and preventing the onset of MODS in patients in the intensive care unit . DESIGN A double-blind , r and omized controlled trial was conducted in the intensive care unit of a tertiary care teaching hospital . Twenty-eight critically ill patients admitted to the intensive care unit were r and omly assigned to receive 1 of 3 treatments daily for 7 d : 1 ) placebo , 2 ) viable probiotics , or 3 ) equivalent probiotic sonicates .  MODS scores and systemic concentrations of immunoglobulin ( Ig ) A and IgG were measured on days -1 , 4 , and 7 , and intestinal permeability measurements were taken daily . RESULTS The patients responded to viable probiotics with a significantly larger increase in systemic IgA and IgG concentrations than in the patients who received placebo or sonicates ( P < 0.05 ) . MODS scores were not significantly affected by probiotic treatment . Over the study period , intestinal permeability decreased in most patients . CONCLUSION Patients receiving viable probiotics show a greater enhancement in immune activity than do patients receiving either placebo or probiotic bacterial sonicates BACKGROUND & AIMS Probiotics can reduce symptoms of irritable bowel syndrome ( IBS ) , but little is known about their effects on psychiatric comorbidities . We performed a prospect i ve study to evaluate the effects of Bifidobacterium longum NCC3001 ( BL ) on anxiety and depression in patients with IBS . METHODS We performed a r and omized , double-blind , placebo-controlled study of 44 adults with IBS and diarrhea or a mixed-stool pattern ( based on Rome III criteria ) and mild to moderate anxiety and /or depression ( based on the Hospital Anxiety and Depression scale ) at McMaster University in Canada , from March 2011 to May 2014 . At the screening visit , clinical history and symptoms were assessed and blood sample s were collected . Patients were then r and omly assigned to groups and given daily BL ( n = 22 ) or placebo ( n = 22 ) for 6 weeks . At weeks 0 , 6 , and 10 , we determined patients ' levels of anxiety and depression , IBS symptoms , quality of life , and somatization using vali date d question naires . At weeks 0 and 6 , stool , urine and blood sample s were collected , and functional magnetic resonance imaging ( fMRI ) test was performed . We assessed brain activation patterns , fecal microbiota , urine metabolome profiles , serum markers of inflammation , neurotransmitters , and neurotrophin levels . RESULTS At week 6 , 14 of 22 patients in the BL group had reduction in depression scores of 2 points or more on the Hospital Anxiety and Depression scale , vs 7 of 22 patients in the placebo group ( P = .04 ) . BL had no significant effect on anxiety or IBS symptoms . Patients in the BL group had a mean increase in quality of life score compared with the placebo group . The fMRI analysis showed that BL reduced responses to negative emotional stimuli in multiple brain areas , including amygdala and fronto-limbic regions , compared with placebo . The groups had similar fecal microbiota profiles , serum markers of inflammation , and levels of neurotrophins and neurotransmitters , but the BL group had reduced urine levels of methylamines and aromatic amino acids metabolites . At week 10 , depression scores were reduced in patients given BL vs placebo . CONCLUSION In a placebo-controlled trial , we found that the probiotic BL reduces depression but not anxiety scores and increases quality of life in patients with IBS . These improvements were associated with changes in brain activation patterns that indicate that this probiotic reduces limbic reactivity . Clinical Trials.gov no. NCT01276626 According to animal studies , intake of probiotic bacteria may improve glucose homeostasis . We hypothesised that probiotic bacteria improve insulin sensitivity by attenuating systemic inflammation . Therefore , the effects of oral supplementation with the probiotic bacterium Lactobacillus acidophilus NCFM on insulin sensitivity and the inflammatory response were investigated in subjects with normal or impaired insulin sensitivity . In a double-blinded , r and omised fashion , forty-five males with type 2 diabetes , impaired or normal glucose tolerance were enrolled and allocated to a 4-week treatment course with either L. acidophilus NCFM or placebo . L. acidophilus was detected in stool sample s by denaturating gradient gel electrophoresis and real-time PCR . Separated by the 4-week intervention period , two hyperinsulinaemic-euglycaemic clamps were performed to estimate insulin sensitivity . Furthermore , the systemic inflammatory response was evaluated by subjecting the participants to Escherichia coli lipopolysaccharide injection ( 0·3 ng/kg ) before and after the treatment course . L. acidophilus NCFM was detected in 75 % of the faecal sample s after treatment with the probiotic bacterium . Insulin sensitivity was preserved among volunteers in the L. acidophilus NCFM group , whereas it decreased in the placebo group . Both baseline inflammatory markers and the systemic inflammatory response were , however , unaffected by the intervention . In conclusion , intake of L. acidophilus NCFM for 4 weeks preserved insulin sensitivity compared with placebo , but did not affect the systemic inflammatory response Aim Evidence of a possible connection between gut microbiota and several physiological processes linked to type 2 diabetes is increasing . However , the effect of multi-strain probiotics in people with type 2 diabetes remains unclear . This study investigated the effect of multi-strain microbial cell preparation — also refers to multi-strain probiotics — on glycemic control and other diabetes-related outcomes in people with type 2 diabetes . Design A r and omized , double-blind , parallel-group , controlled clinical trial . Setting Diabetes clinic of a teaching hospital in Kuala Lumpur , Malaysia . Participants A total of 136 participants with type 2 diabetes , aged 30–70 years , were recruited and r and omly assigned to receive either probiotics ( n = 68 ) or placebo ( n = 68 ) for 12 weeks . Outcomes Primary outcomes were glycemic control-related parameters , and secondary outcomes were anthropomorphic variables , lipid profile , blood pressure and high-sensitivity C-reactive protein . The Lactobacillus and Bifidobacterium quantities were measured before and after intervention as an indicator of successful passage of the supplement through gastrointestinal tract . Statistical analysis Intention-to-treat ( ITT ) analysis was performed on all participants , while per- protocol ( PP ) analysis was performed on those participants who had successfully completed the trial with good compliance rate . Results With respect to primary outcomes , glycated hemoglobin decreased by 0.14 % in the probiotics and increased by 0.02 % in the placebo group in PP analysis ( p < 0.05 , small effect size of 0.050 ) , while these changes were not significant in ITT analysis . Fasting insulin increased by 1.8 µU/mL in placebo group and decreased by 2.9 µU/mL in probiotics group in PP analysis . These changes were significant between groups at both analyses ( p < 0.05 , medium effect size of 0.062 in PP analysis and small effect size of 0.033 in ITT analysis ) . Secondary outcomes did not change  significantly . Probiotics successfully passed through the gastrointestinal tract . Conclusion Probiotics modestly improved HbA1c and fasting insulin in people with type 2 diabetes Certain therapeutic microbes , including Bifidobacteria infantis ( B. infantis ) 35624 exert beneficial immunoregulatory effects by mimicking commensal-immune interactions ; however , the value of these effects in patients with non-gastrointestinal inflammatory conditions remains unclear . In this study , we assessed the impact of oral administration of B. infantis 35624 , for 6‒8 weeks on inflammatory biomarker and plasma cytokine levels in patients with ulcerative colitis ( UC ) ( n = 22 ) , chronic fatigue syndrome ( CFS ) ( n = 48 ) and psoriasis ( n = 26 ) in three separate r and omized , double-blind , placebo-controlled interventions . Additionally , the effect of B. infantis 35624 on immunological biomarkers in healthy subjects ( n = 22 ) was assessed . At baseline , both gastrointestinal ( UC ) and non-gastrointestinal ( CFS and psoriasis ) patients had significantly increased plasma levels of C-reactive protein ( CRP ) and the pro-inflammatory cytokines tumor necrosis factor α ( TNF-α ) and interleukin-6 ( IL-6 ) compared with healthy volunteers . B. infantis 35624 feeding result ed in reduced plasma CRP levels in all three inflammatory disorders compared with placebo . Interestingly , plasma TNF-α was reduced in CFS and psoriasis while IL-6 was reduced in UC and CFS . Furthermore , in healthy subjects , LPS-stimulated TNF-α and IL-6 secretion by peripheral blood mononuclear cells ( P BMC s ) was significantly reduced in the B. infantis 35624-treated groups compared with placebo following eight weeks of feeding . These results demonstrate the ability of this microbe to reduce systemic pro-inflammatory biomarkers in both gastrointestinal and non-gastrointestinal conditions . In conclusion , these data show that the immunomodulatory effects of the microbiota in humans are not limited to the mucosal immune system but extend to the systemic immune system The effect of dietary therapy with a human Lactobacillus strain GG ( ATCC 53103 ) , bovine colostrum , or bovine immune colostrum with specific antibodies against anaerobic intestinal bacteria on gut defence mechanisms were studied in juvenile chronic arthritis . Thirty patients with juvenile chronic arthritis were r and omly allocated to receive a freeze-dried powder of Lactobacillus GG , or bovine colostrum , or bovine immune colostrum , for a two-week period . Immunologic and non-immunologic gut defence mechanisms were indirectly investigated in blood and faecal sample s. In patients receiving Lactobacillus GG , the median ( interquartile range ) frequency of immunoglobulin-secreting cells , determined by enzyme-linked immunospot assay , increased in the IgA class from 1840 ( 690–2530 ) to 3480 ( 1030–13 170)/106 cells ; p=0.02 . Likewise the median ( interquartile range ) frequency of specific antibody-secreting cells against dietary antigens increased during the Lactobacillus GG therapy in the IgM class from 3.8 ( 1.4–5.0 ) to 11.2 (5.0–30.0)/106 cells ; p=0.02 . In addition , Lactobacillus GG therapy decreased the median ( interquartile range ) activity of faecal urease , which has been associated with mucosal tissue damage , from 40.3 ( 21.7–54.3 ) to 28.6 ( 24.5–49.4 ) nmol . min−1 ( mg protein)−1 ; p=0.10 , while , in patients receiving bovine colostrum , faecal urease activity increased ( from 42.2 to 80.6 ; p=0.04 ) . All findings were transient . We suggest that gut defence mechanisms are disturbed in juvenile chronic arthritis and we further suggest that orally administered Lactobacillus GG has a potential to reinforce the mucosal barrier mechanisms in juvenile chronic arthritis OBJECTIVES Rheumatoid arthritis ( RA ) is an inflammatory autoimmune disease in which the gut microbiota is altered . Probiotics are microorganisms that can normalize gut microbiota ; thus , they may help to alleviate RA symptoms . The objective of the present clinical trial was to assess the effects of probiotic supplementation on disease activity and inflammatory cytokines in patients with RA . METHODS Forty-six patients with RA were assigned into two groups in this r and omized , double-blind , placebo-controlled clinical trial . The patients in the probiotic group received a daily capsule that contained a minimum of 10(8 ) colony-forming units of Lactobacillus casei 01 for 8 wk . The placebo group took capsules filled with maltodextrin for the same time period . Question naires , anthropometric measurements , and fasting blood sample s were collected , and the participants were assessed by a rheumatologist at baseline and at the end of the trial . RESULTS Disease activity score was significantly decreased by the intervention , and there was a significant difference between the two groups at the end of the study ( P < 0.01 ) . Three of the assessed serum proinflammatory cytokines ( tumor necrosis factor-α , interleukin-6 , and interleukin-12 ) significantly decreased in the probiotic group ( P < 0.05 ) ; however , serum levels of interleukin-1 β were not significantly affected by the probiotic ( P = 0.22 ) . The serum level of regulatory cytokine ( interleukin-10 ) was increased by the supplementation ( P < 0.05 ) . The proportion of interleukin-10 to interleukin-12 was significantly increased in the probiotic group as well . CONCLUSIONS L. casei 01 supplementation improved the disease activity and inflammatory status of patients with RA . Further studies are warranted to confirm these results , and such confirmation may lead to the introduction of probiotics as adjunctive therapy for this population Background Probiotics might reduce gut-derived microbial lipopolysaccharide ( LPS ) by restoring bowel flora in patients with alcoholic hepatitis ( AH ) . We evaluated the therapeutic effects of probiotics in patients with AH . Patients and methods Between September 2010 and April 2012 , 117 patients ( probiotics 60 and placebo 57 ) were prospect ively r and omized to receive the 7 days of cultured Lactobacillus subtilis/Streptococcus faecium ( 1500 mg/day ) or placebo .  All patients were hospitalized and were not permitted to consume alcohol for the 7 days of the study . Liver function test , proinflammatory cytokines , LPS , and colony-forming units by stool culture were examined and compared after therapy . Results In both groups , the mean levels of aspartate aminotransferase/alanine aminotransferase , alkaline phosphatase , & ggr;-glutamyl transpeptidase , bilirubin , and prothrombin time were significantly improved after 7 days of abstinence . In the probiotics group ( baseline and after ) , albumin ( 3.5±0.7 and 3.7±0.6 g/dl , P=0.038 ) and tumor necrosis factor-&agr ; ( 121±244 and 71±123 pg/ml , P=0.047 ) showed differences . In addition , the number of colony-forming units of Escherichia coli was significantly reduced ( 435±287 and 168±210 , P=0.002 ) . In the placebo group , the level of LPS ( 1.7±2.8 and 2.0±2.7 EU/ml ) was significantly increased . In the intergroup comparison , significant differences in the levels of tumor necrosis factor-&agr ; ( P=0.042 ) and LPS ( P=0.028 ) were observed between the groups . Conclusion Immediate abstinence is the most important treatment for patients with AH . In addition , 7 days of oral supplementation with cultured L. subtilis/S. faecium was associated with restoration of bowel flora and improvement of LPS in patients with AH To evaluate the effects of probiotic ( VSL#3 ) and omega-3 fatty acid on insulin sensitivity , blood lipids , and inflammation , we conducted a clinical trial in 60 overweight ( BMI > 25 ) , healthy adults , aged 40–60 years . After initial screening the subjects were r and omized into four groups with 15 per group . The four groups received , respectively , placebo , omega-3 fatty acid , probiotic VSL#3 , or both omega-3 and probiotic , for 6 weeks . Blood and fecal sample s were collected at baseline and after 6 weeks . The probiotic ( VSL#3 ) supplemented group had significant reduction in total cholesterol , triglyceride , LDL , and VLDL and had increased HDL ( P < 0.05 ) value . VSL#3 improved insulin sensitivity ( P < 0.01 ) , decreased hsCRP , and favorably affected the composition of gut microbiota . Omega-3 had significant effect on insulin sensitivity and hsCRP but had no effect on gut microbiota . Addition of omega-3 fatty acid with VSL#3 had more pronounced effect on HDL , insulin sensitivity and hsCRP .  Subjects with low HDL , insulin resistance , and high hsCRP had significantly lower total lactobacilli and bifidobacteria count and higher E. coli and bacteroides count Background . Primary goal of this r and omized , double-blind , placebo-controlled crossover study of Renadyl in end-stage renal disease patients was to assess the safety and efficacy of Renadyl measured through improvement in quality of life or reduction in levels of known uremic toxins . Secondary goal was to investigate the effects on several biomarkers of inflammation and oxidative stress . Methods . Two 2-month treatment periods separated by 2-month washout and crossover , with physical examinations , venous blood testing , and quality of life question naires completed at each visit . Data were analyzed with SAS V9.2 . Results . 22 subjects ( 79 % ) completed the study . Observed trends were as follows ( none reaching statistical significance ): decline in WBC count ( −0.51 × 109/L , P = 0.057 ) and reductions in levels of C-reactive protein ( −8.61 mg/L , P = 0.071 ) and total indoxyl glucuronide ( −0.11 mg% , P = 0.058 ) . No statistically significant changes were observed in other uremic toxin levels or measures of QOL . Conclusions . Renadyl appeared to be safe to administer to ESRD patients on hemodialysis . Stability in QOL assessment is an encouraging result for a patient cohort in such advanced stage of kidney disease . Efficacy could not be confirmed definitively , primarily due to small sample size and low statistical power — further studies are warranted Objective : Reactive oxygen species ( ROS ) are a major contributing factor in diseases pathophysiology in critically ill patients . Oxidative stress usually occurs in critical illnesses , specifically during sepsis , and organ dysfunction . The anti-oxidative properties of probiotics may serve as a defense in intestine and overcome various oxidative stresses . The aim of this trial was to determine the effect of probiotics on inflammation , antioxidant capacity and lipid peroxidation in critically ill patients . Methodology : Forty patients admitted to the intensive care unit were enrolled in this double-blind , r and omized controlled trial . They were r and omized to receive placebo or probiotic for 7 days . Serum levels of Total Antioxidant Capacity ( TAC ) , Malodialdehyde ( MDA ) , C-Reactive Protein ( CRP ) and Acute Physiology and Chronic Health Evaluation ( APACHE II ) score were measured before initiation of the study and on the 7th day . Results : There was a significant difference in CRP levels and APACHE II score between two groups at the end of the study ( P= 0.003 and 0.001 , respectively ) . There was not a significant difference in levels of TAC and MDA between two groups . Conclusions : Administration of  probiotics to critically ill patients caused reduction in inflammation and improvement of clinical outcome . However , there were not significant changes in markers of oxidative stress Summary Background To examine the effect of probiotics as adjunctive therapy for the treatment of rheumatoid arthritis ( RA ) . A sample size of 30 subjects was calculated to determine a moderate effect . Material / Methods A three month double-blind , placebo-controlled study was performed using probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 capsules administered orally . Inclusion criteria required at least 4 swollen and 4 tender joints and stable medications with no steroids for at least 1 month prior to and during the study . Twenty-nine patients with RA were r and omized to treatment .  ACR20 responses , serum cytokine levels and safety parameters were assessed . Results Fifteen patients were r and omized to the probiotic group , and 14 to placebo .  Three subjects in the probiotic ( 20 % ) and one in the placebo group ( 7 % ) achieved an ACR20 response ( p= 0.33 ) . There was no statistically significant difference between individual components of the ACR20 criteria . Changes in cytokines favored placebo over probiotic . There was a significant improvement in the Health Assessment Question naire ( HAQ ) score in the probiotic group from visit 1 to visit 3 ( p=0.02 ) but no between-group differences . Conclusions Due to inclusion criteria , patients selected for the study had stable RA with chronic synovitis , and thus it may have been difficult for an adjunctive therapy to demonstrate improvement within 3 months . Although probiotics did not clinical ly improve RA as measured by the ACR20 , it is interesting that there was functional improvement seen within the probiotic group compared to placebo Background / Objectives : The percentage of hypercholesterolemic individuals not reaching their LDL-cholesterol ( LDL-C ) goal remains high and additional therapeutic strategies should be evaluated . The objective of this study was to evaluate the cholesterol-lowering efficacy and mechanism of action of bile salt hydrolase-active Lactobacillus reuteri NCIMB 30242 capsules in hypercholesterolemic adults . Subjects/ Methods : A total of 127 subjects completed a r and omized , double-blind , placebo-controlled , parallel-arm , multicenter study . Subjects were r and omized to consume L. reuteri NCIMB 30242 capsules or placebo capsules over a 9-week intervention period . The primary outcome was LDL-C relative to placebo at the study end point . Results : L. reuteri NCIMB 30242 capsules reduced LDL-C by 11.64 % ( P<0.001 ) , total cholesterol by 9.14 % , ( P<0.001 ) , non-HDL-cholesterol ( non-HDL-C ) by 11.30 % ( P<0.001 ) and apoB-100 by 8.41 % ( P=0.002 ) relative to placebo . The ratios of LDL-C/HDL-cholesterol ( HDL-C ) and apoB-100/apoA-1 were reduced by 13.39 % ( P=0.006 ) and 9.00 % ( P=0.026 ) , respectively , relative to placebo . Triglycerides and HDL-C were unchanged . High-sensitivity C-reactive protein and fibrinogen were reduced by 1.05 mg/l ( P=0.005 ) and 14.25 % ( P=0.004 ) relative to placebo , respectively . Mean plasma deconjugated bile acids were increased by 1.00 nmol/l ( P=0.025 ) relative to placebo , whereas plasma campesterol , sitosterol and stigmasterol were decreased by 41.5 % , 34.2 % and 40.7 % , respectively . Conclusions : The present results suggest that the deconjugation of intraluminal bile acids results in reduced absorption of non-cholesterol sterols and indicate that L. reuteri NCIMB 30242 capsules may be useful as an adjunctive therapy for treating hypercholesterolemia OBJECTIVE To investigate whether a probiotic mix has additional effects when compared with an isolated dietary intervention on the body composition , lipid profile , endotoxemia , inflammation , and antioxidant profile . METHODS Women who had excess weight or obesity were recruited to a r and omized , double-blind trial and received a probiotic mix ( Lactobacillus acidophilus and casei ; Lactococcus lactis ; Bifidobacterium bifidum and lactis ; 2 × 1010 colony-forming units/day ) ( n = 21 ) or placebo ( n = 22 ) for 8 weeks . Both groups received a dietary prescription . Body composition was assessed by anthropometry and dual-energy X-ray absorptiometry . The lipid profile , lipid accumulation product , plasma fatty acids , lipopolysaccharide , interleukin-6 , interleukin-10 , tumor necrosis factor-α , adiponectin , and the antioxidant enzymes activities were analyzed . RESULTS In comparison with the dietary intervention group , the dietary intervention + probiotic mix group showed a greater reduction in the waist circumference ( -3.40 % vs. -5.48 % , P = 0.03 ) , waist-height ratio ( -3.27 % vs. -5.00 % , P = 0.02 ) , conicity index ( -2.43 % vs. -4.09 % P = 0.03 ) , and plasma polyunsaturated fatty acids ( 5.65 % vs. -18.63 % , P = 0.04 ) and an increase in the activity of glutathione peroxidase ( -16.67 % vs. 15.62 % , P < 0.01 ) . CONCLUSIONS Supplementation of a probiotic mix reduced abdominal adiposity and increased antioxidant enzyme activity in a more effective way than an isolated dietary intervention We conducted two r and omized , placebo-controlled , double-blind studies of Lactobacillus plantarum No. 14 ( LP14 ) in female students with seasonal allergic diseases . We also examined the mitogenic activity and cytokine inducibility of LP14 using Peyer ’s patch cells and mesenteric lymph node cells of swine . For subjects who took 8.7 × 108 of LP14  , a significant improvement in ocular symptom-medication score was observed . In the placebo group , the T helper type 1 (Th1)/T helper type 2 ( Th2 ) ratio tended to decrease after a 6-week intake period , while in the LP14 group , the percentage of Th1 cells significantly increased . Post-intake eosinophil counts significantly increased in comparison to those at intake cessation in the placebo group , but it appeared to be suppressed in the LP14 group . There were no changes in fecal microflora .  LP14  strongly induced the gene expression of Th1-type cytokines . This study indicates the clinical effects of LP14 on seasonal allergic diseases BACKGROUND AND OBJECTIVES Probiotics create a biofilm and protect the oral tissues against the action of periodontal pathogenic bacteria . The aim of this study was to evaluate the effects of the oral probiotic Lactobacillus reuteri Prodentis upon the peri-implant health of edentulous patients with dental implants and peri-implant mucositis , establishing comparisons vs implants without peri-implant disease . MATERIAL AND METHODS A double-blind , placebo-controlled , prospect i ve cross-over study was made . The patients were all edentulous and were divided into two groups , ( A ) no peri-implant disease , and ( B ) peri-implant mucositis affecting one or more implants . Patients with peri-implantitis were excluded . The dosage was one tablet every 24 h over 30 d. All patients in both groups initially received the oral probiotic Lactobacillus reuteri Prodentis , followed by placebo . Patients started with probiotic treatment during 30 d , followed by a 6 mo washout period and the administration of placebo for the same period . The following parameters were studied : crevicular fluid volume , modified plaque index , probing depth , modified gingival index , and concentrations of interleukin 1β , interleukin 6 and interleukin 8 . RESULTS A total of 77 implants were evaluated in 34 patients . Group A involved 22 patients with 54 implants without peri-implant alterations , and group B , 12 patients with mucositis affecting one or more implants ( 23 implants ) . After treatment with the probiotic , both the patients with mucositis and the patients without peri-implant disease showed improvements in the clinical parameters , with reductions in cytokine levels . In contrast , no such changes were observed with placebo . CONCLUSIONS After treatment with the probiotic Lactobacillus reuteri in patients with implants presenting mucositis , the clinical parameters improved , and the cytokine levels decreased - in contraposition to the observations in the placebo group . Probiotic administration may be regarded as a good alternative for both the treatment of peri-implant mucositis and its prevention , as it also improved clinical parameters in the healthy individuals . Further studies involving larger patient series are needed regarding the effects of probiotics upon peri-implant health Objective . To investigate the effect of an orally administered probiotic on disease activity , fatigue , quality of life , and intestinal symptoms in patients with active spondyloarthritis . Methods . Patients with active spondyloarthritis [ defined as Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) ≥ 3 , Bath Ankylosing Spondylitis Functional Index ( BASFI ) ≥ 3 , Maastricht Ankylosing Spondylitis Enthesitis Score ( MASES ) ≥ 2 , or peripheral joint count ≥ 2 ] were r and omized to oral probiotic or placebo for 12 weeks . Patients and assessors were blinded to treatment allocation . The primary outcome measure was 10 % improvement in the BASFI . Additional outcome measures were improvements in the ASsessment s in Ankylosing Spondylitis (ASAS)-endorsed core domains : pain , spinal mobility , patient global , peripheral joint and entheseal scores , stiffness , C-reactive protein , and fatigue . The ASAS20 criteria , a composite measure of response , were also applied . Quality of life and bowel symptoms were quantified using the Ankylosing Spondylitis Quality of Life Question naire ( ASQoL ) and Dudley Inflammatory Bowel Symptom Question naire ( DISQ ) . Results . Sixty-three patients were r and omized to oral probiotic ( n = 32 ) or placebo ( n = 31 ) . All patients completed the trial . No significant difference was noted between groups in any of the core domains . The mean BASFI fell from 3.5 ± 2.0 to 2.9 ± 1.9 in the probiotic group and from 3.6 ± 1.9 to 3.1 ± 2.2 in the placebo group ( p = 0.839 ) . The mean BASDAI fell from 4.2 ± 2.2 to 3.2 ± 2.1 in the probiotic group and 4.5 ± 2.0 to 3.9 ± 2.2 in the placebo group ( p = 0.182 ) . No significant adverse events were recorded in the probiotic-treated group . Conclusion . In this r and omized controlled trial , the probiotic combination administered did not demonstrate significant benefit over placebo , despite a theoretical rationale for this therapy Objective : To study the effects of Lactobacillus rhamnosus GG ( LGG ) on rheumatoid arthritis ( RA ) . Methods : Twenty‐one RA patients were r and omised to receive 2 capsules of LGG or a placebo twice daily in double‐blind fashion for 12 months . Arthritis activity was evaluated by clinical examination , HAQ index , and laboratory tests ( e.g. ESR , CRP , pro‐ and anti‐inflammatory cytokines ) . Results : There were no statistical differences in the clinical parameters , biochemical variables and HAQ index between the study groups over the intervention period . The mean number of tender and swollen joints decreased from 8.3 to 4.6 in the Lactobacillus group and from 5.5 to 4.8 in the placebo group ( p=0.41 ) . According to the global assessment the RA activity was reduced in 71 % ( LGG group ) vs. 30 % ( controls ) ( p=0.15 ) . Serum IL‐1β increased slightly in the LGG group ( p=0.07 ) , but no differences were seen in IL‐6 , TNF‐α , MPO , IL‐10 or 1L‐12 . Conclusions : Although there were no statistical significant differences in the activity of RA , more subjects in the LGG group reported subjective well being . More studies on the effects of probiotic bacteria in RA are needed Probiotic microorganisms have been shown to be effective in the treatment of allergic inflammation and food allergy , but their efficacy remains controversial . This study tested the effect of a yogurt supplemented with a probiotic strain Bifidobacterium longum BB536 in the treatment of Japanese cedar pollinosis ( JCPsis ) . Forty subjects with a clinical history of JCPsis were given yoghurt either containing BB536 ( BB536 yoghurt ) or without BB536 ( placebo yoghurt ) at 2 X 100 g per day for 14 weeks , in a r and omized , double-blind , placebo-controlled trial . Subjective symptoms and self-care measures were recorded daily and blood sample s were taken before and during the intervention ( at weeks 4 , 9 , and 14 ) to measure the blood parameter levels related to JCPsis . Yoghurt supplemented with BB536 significantly alleviated eye symptoms compared with placebo yoghurt ( odds ratio 0.31 ; 95 % confidence interval 0.10 - 0.97 ; p = 0.044 ) . Although no statistically significant differences were detected , nasal symptoms such as itching , rhinorrhea , and blockage , as well as throat symptoms tended to be relieved with the BB536 yoghurt . BB536 tended to suppress the decreasing blood levels of interferon-gamma ( IFN-y ) and the increasing blood eosinophil rates ; a significantly higher IFN-gamma level was observed for the difference from baseline at week 4 . A decreased trend in the difference from baseline levels of JCP-specific IgE levels was also observed at week 4 in the BB536 group compared with the placebo group . In conclusion , these results suggest that intake of BB536-supplemented yoghurt may relieve JCPsis symptoms , probably through a modulating effect on Th balance Background : Polycystic ovary syndrome ( PCOS ) is a polygenic endocrine disorder in women of reproductive age that lead to infertility . The aim of this study was to investigate the effects of probiotic on pancreatic β-cell function and C-reactive protein ( CRP ) in PCOS patients . Methods : This r and omized double-blind placebo-controlled clinical trial was conducted among 72 women aged 15–40 years old diagnosed with PCOS . Participants were r and omly assigned to two groups receiving : ( 1 ) Probiotic supplements ( n = 36 ) , ( 2 ) placebo ( n = 36 ) for 8-week . Fasting blood sample s were taken at baseline and after 8-week of intervention . Results : Probiotic supplementation , compare with placebo , reduced fasting blood sugar ( −4.15 ± 2.87 vs. 2.57 ± 5.66 mg/dL , respectively P = 0.7 ) , serum insulin levels in crude model ( −0.49 ± 0.67 vs. 0.34 ± 0.82 μIU/mL , respectively , P = 0.09 ) , homeostasis model of assessment -insulin resistance score ( −0.25 ± 0.18 vs. −0.05 ± 0.18 , respectively , P = 0.14 ) nonsignificantly . Serum insulin levels after adjustment with covariates reduced significantly in probiotic group ( P = 0.02 ) . We did not found any significant differences in mean changes of CRP between groups ( −0.25 ± 0.18 vs. −0.05 ± 0.18 , respectively , P = 0.14 ) . Conclusions : A 8-week multispecies probiotics supplementation had nonsignificantly beneficial effect on pancreatic β-cell function and CRP in PCOS patients . After adjustment for some covariates , serum insulin changes were significantly different between groups Objective : Nonalcoholic fatty liver disease ( NAFLD ) is a condition defined by exceeding triglycerides accumulation in the liver . The condition can develop into fibrosis , cirrhosis , and hepatocellular carcinoma . Considering the ever-increasing prevalence of NAFLD , the aim of the present study was to investigate the effects of probiotic supplementation on glycemic and inflammatory indices in patients with NAFLD . Methods : This r and omized clinical trial was conducted on 42 patients with NAFLD who had been referred to a gastroenterology clinic . Subjects in the intervention and control groups consumed 2 capsules/day probiotic or placebo , respectively , for 8 weeks . Fasting blood sugar ( FBS ) , insulin , insulin resistance , tumor necrosis factor alpha ( TNF-α ) , and interleukin 6 ( IL-6 ) were measured at baseline and at the end of the study . Results : Means of FBS , insulin , insulin resistance , and IL-6 were significantly different between groups after intervention ( p < 0.05 ) , whereas TNF-α was not significantly modified ( p > 0.05 ) . In the probiotic group , insulin , insulin resistance , TNF-α , and IL-6 decreased significantly at the end of the study compared to the beginning of study . Conclusion : Considering the effects of probiotic supplementation on the reduction of glycemic and inflammatory indices in patients with NAFLD , consumption of probiotics is recommended as a complementary therapy in these patients Background : Chronic inflammation is one of the causes of anemia in chronic renal failure patients under hemodialysis . Probiotics probably establish a balance between pro- and anti-inflammatory cytokines . The study was conducted to determine the effects of probiotic supplementation on hemoglobin ( Hb ) in hemodialysis patients . Material s and Methods : A parallel clinical trial was conducted in which patients were r and omly allocated into two groups . The intervention group ( n = 18 ) was given a 500 mg probiotic supplement ( a capsule ) every day whereas the  control group ( n = 18 ) received placebo ( a capsule ) , both for 3 months . Hb levels and C-reactive protein ( CRP ) levels were measured for three periods . The data were analyzed in SPSS-16 using statistical tests including the t-test and repeated- measures ANOVA . Results : In the probiotic supplementation group , the mean Hb was 9.22 ± 1.04 mg/dl before the intervention and reached 10.85 ± 1.177 mg/dl afterward , while in the placebo group , the mean Hb level was 9.38 ± 0.97 mg/dl before the intervention and reached 10.03 ± 1.97 mg/dl afterward ( P > 0.05 ) . During the study , the placebo caused to increase of Hb temporary , but in longer term , the effect of probiotic was more manifested . Hb levels increased in both groups although the change was not statistically significant ( P > 0.05 ) . The findings showed no significant differences between the two groups in either the pre- or post-intervention CRP levels ( P = 0.239 ) . Conclusion : Probiotic supplementation  decreased Hb fluctuations in hemodialysis patients but did not result in a significant increase in Hb levels . Similar studies are therefore recommended to be conducted with a prolonged duration of the study or an increased probiotic dose with larger sample size to complete the results of the present study Dysbalance in gut microbiota has been linked to increased microbial translocation , leading to chronic inflammation in HIV- patients , even under effective HAART . Moreover , microbial translocation is associated with insufficient reconstitution of CD4+T cells , and contributes to the pathogenesis of immunologic non-response . In a double-blind , r and omised , placebo-controlled trial , we recently showed that , compared to placebo , 12 weeks treatment with probiotic Saccharomyces boulardii significantly reduced plasma levels of bacterial translocation ( Lipopolysaccharide-binding protein or LBP ) and systemic inflammation ( IL-6 ) in 44 HIV virologically suppressed patients , half of whom ( n = 22 ) had immunologic non-response to antiretroviral therapy ( < 270 CD4+Tcells/μL despite long-term suppressed viral load ) . The aim of the present study was to investigate if this beneficial effect of the probiotic Saccharomyces boulardii is due to modified gut microbiome composition , with a decrease of some species associated with higher systemic levels of microbial translocation and inflammation . In this study , we used 16S rDNA gene amplification and parallel sequencing to analyze the probiotic impact on the composition of the gut microbiome ( faecal sample s ) in these 44 patients r and omized to receive oral supplementation with probiotic or placebo for 12 weeks . Compared to the placebo group , in individuals treated with probiotic we observed lower concentrations of some gut species , such as those of the Clostridiaceae family , which were correlated with systemic levels of bacterial translocation and inflammation markers . In a sub- study of these patients , we observed significantly higher parameters of microbial translocation ( LBP , soluble CD14 ) and systemic inflammation in immunologic non-responders than in immunologic responders , which was correlated with a relative abundance of specific gut bacterial groups ( Lachnospiraceae genus and Proteobacteria ) . Thus , in this work , we propose a new therapeutic strategy using the probiotic yeast S. boulardii to modify gut microbiome composition . Identifying pro-inflammatory species in the gut microbiome could also be a useful new marker of poor immune response and a new therapeutic target Goals To study the role of probiotics on gut permeability and endotoxemia in patients with acute pancreatitis ( AP ) . Background Bacterial translocation has been implicated in infective complications in AP , which has been shown to be prevented by probiotics . Study A double-blind , r and omized placebo-controlled trial was conducted . Consecutive patients with AP presenting within 72 hours after the onset of abdominal pain or who had been nil orally at the time of presentation for up to 5 days were included in the study . The probiotic group received 4 sachets of Probiotics ( 2.5 billion bacteria per sachet ) whereas the placebo group received 4 sachets of placebo for 7 days . Primary outcome measures were effect on gut permeability [ assessed by lactulose/mannitol ( L/M ) excretion in urine ] and endotoxemia assessed by endotoxin-core antibody types IgG and IgM ( EndoCab IgG and IgM ) . Secondary outcome measures were mortality , total hospital/intensive care unit stay , abdominal discomfort , organ failure , C-reactive protein , and prealbumin levels . The study was prematurely stopped after the publication of probiotic prophylaxis in patients with predicted severe acute pancreatitis trial . Results From March 2007 to May 2008 , 50 patients with AP were included in the study ( 26 in placebo group and 24 in probiotic group ) . There was no difference after intervention in gut permeability , whereas values of C-reactive protein and immunoglobulins decreased significantly [ IgG : 140 ( 20–920 ) to 90 ( 20–600 ) GGU/mL and IgM : 65 ( 13–230 ) to 51 ( 9–240 ) GMU/mL ] in the probiotic group . No difference was observed in prealbumin values , duration of hospital/intensive care unit stay , and mortality in both the groups . Conclusions No significant trend was identified for an effect of probiotics on gut permeability or endotoxemia in AP . However , the study was underpowered owing to premature study termination ABSTRACT Objective : The development of alternative approaches to prevent and /or treat osteoporosis , as a chronic progressive bone disease , is being considered currently . Among dietary supplements , probiotics may have favorable effects on bone metabolism . Therefore , the aim of this study was to evaluate the effects of a multispecies probiotic supplementation on bone biomarkers and bone density in osteopenic postmenopausal women . Methods : This r and omized double-blind placebo-controlled clinical trial was performed on 50 patients with osteopenia aged 50–72 years . Participants were r and omly assigned to take either a multispecies probiotic supplement ( GeriLact ; n = 25 ) or placebo ( n = 25 ) for 6 months . GeriLact contains 7 probiotic bacteria species . Participants received 500 mg Ca plus 200 IU vitamin D  daily . Bone mineral density ( BMD ) of lumbar spine and total hip and blood biomarkers including bone-specific alkaline phosphatase ( BALP ) , osteocalcin ( OC ) , collagen type 1 cross-linked C-telopeptide ( CTX ) , deoxypyridinoline ( DPD ) , parathyroid hormone ( PTH ) , 25-OH vitamin D , and serum pro-inflammatory cytokines ( tumor necrosis factor [TNF]-α and interleukin [IL]-1β ) were assessed at baseline and at the end of the study . Results : The multispecies probiotic significantly decreased BALP ( p = 0.03 ) and CTX ( p = 0.04 ) levels in comparison with the control group but had no effect on BMD of the spine and total hip . Moreover , there was a statistically significant decrease in serum PTH ( p = 0.01 ) and TNF-α ( p = 0.02 ) in the intervention group compared to the placebo group . Conclusions : These results may suggest the favorable effects of the multispecies probiotic supplementation for 6 months on bone health in postmenopausal women due to slowing down the rate of bone turnover Inflammatory markers such as interleukin (IL)-6 and tumour necrosis factor-alpha ( TNF-α ) are elevated in dialysis patients and can predict cardiovascular events and all-cause mortality . Endotoxin is an important source and also another marker of inflammation in patients with chronic kidney disease . The aim of this study was to evaluate the impact of oral probiotics on serum levels of endotoxemia and cytokines in peritoneal dialysis ( PD ) patients . The decline of residual renal function , peritonitis episodes , and cardiovascular events were also recorded . From July 2011 to June 2012 , a r and omised , double-blind , placebo-controlled trial was conducted in PD patients . The intervention group received one capsule of probiotics containing 10(9 ) cfu Bifobacterium bifidum A218 , 10(9 ) cfu Bifidobacterium catenulatum A302 , 10(9 ) cfu Bifidobacterium longum A101 , and 10(9 ) cfu Lactobacillus plantarum A87 daily for six months , while the placebo group received similar capsules containing maltodextrin for the same duration . Levels of serum TNF-α , interferon gamma , IL-5 , IL-6 , IL-10 , IL-17 , and endotoxin were measured before and six months after intervention . 39 patients completed the study ( 21 in the probiotics group and 18 in the placebo group ) . In patients receiving probiotics , levels of serum TNF-α , IL-5 , IL-6 , and endotoxin significantly decreased after six months of treatment , while levels of serum IL-10 significantly increased . In contrast , there were no significant changes in levels of serum cytokines and endotoxin in the placebo group after six months . In addition , the residual renal function was preserved in patients receiving probiotics . In conclusion , probiotics could significantly reduce the serum levels of endotoxin , pro-inflammatory cytokines ( TNF-α and IL-6 ) , IL-5 , increase the serum levels of anti-inflammatory cytokine ( IL-10 ) , and preserve residual renal function in PD patients OBJECTIVE The objective of the study was to evaluate the effects of probiotic supplementation on the gut microbiota profile and inflammatory markers in chronic kidney disease patients undergoing maintenance hemodialysis ( HD ) . DESIGN AND METHODS This was a r and omized , double-blind , placebo-controlled study . Forty-six HD patients were assigned to receive 1 of 2 treatments : probiotic ( n = 23 ; Streptococcus thermophilus , Lactobacillus acidophilus e Bifidobacterialongum , 90 billion colony-forming units per day ) or placebo ( n = 23 ) daily for 3 months . Blood and feces were collected at baseline and after intervention . The inflammatory markers ( C-reactive protein and interleukin-6 ) were analyzed by immunoenzymatic assay ( enzyme-linked immunosorbent assay ) . Uremic toxins plasma levels ( indoxyl sulfate , p-cresyl sulfate , and indole-3-acetic acid ) were obtained by Reversed-Phase High-Performance Liquid Chromatography . Routine laboratory parameters were measured by st and ard techniques . Fecal pH was measured by the colorimetric method , and the gut microbiota profile was assessed by Denaturing Gradient Gel Electrophoresis analysis . RESULTS Sixteen patients remained in the probiotic group ( 11 men , 53.6 ± 11.0 year old , 25.3 ± 4.6 kg/m2 ) and 17 in the placebo group ( 10 men , 50.3 ± 8.5 year old , 25.2 ± 5.7 kg/m2 ) . After probiotic supplementation there was a significant increase in serum urea ( from 149.6 ± 34.2 mg/dL to 172.6 ± 45.0 mg/dL , P = .02 ) , potassium ( from 4.4 ± 0.4 mmol/L to 4.8 ± 0.4 mmol/L , P = .02 ) , and indoxyl sulfate ( from 31.2 ± 15.9 to 36.5 ± 15.0 mg/dL , P = .02 ) . The fecal pH was reduced from 7.2 ± 0.8 to 6.5 ± 0.5 ( P = .01 ) . These parameters did not change significantly in placebo group . Changes in the percentage delta ( Δ ) between groups were exhibited with no statistical differences observed . The inflammatory markers and gut profile were not altered by supplementation . CONCLUSIONS Aprobiotic supplementation failed to reduce uremic toxins and inflammatory markers . Therefore , probiotic therapy should be chosen with caution in HD patients . Further studies addressing probiotic therapy in chronic kidney disease patients are needed Background Although the effects of probiotics on the immune system have been extensively evaluated under disease states , their role in healthy situations remains unclear , since changes are hardly expected under immunological homeostasis . EFSA indicates that vaccination protocol s could be used to evaluate the potential role of probiotics to improve the immune response against antigen challenges . The aim of the study was to evaluate the effect of Lactobacillus coryniformis CECT5711 ( Lc ) on the specific immunity of healthy volunteers undergoing vaccination with Hepatitis A virus ( HAV ) . Methods One hundred twenty-three healthy adults were r and omised into three groups to follow a 6-week ( wk ) intervention and all received an intramuscular HAV vaccine 2 weeks after starting the intervention : 1 ) PRO1 received Lc for 2weeks ( 1 capsule/day ; 3 × 109 CFU/capsule ) and placebo capsules after vaccination ; 2 ) PRO2 received a daily capsule of Lc ( 3 × 109 cfu/day ) before and after the challenge ; 3 ) Control group ( C ) received a daily placebo capsule before and after the vaccine .  Blood sample s were collected at the beginning ( visit 1 ; V1 ) and after 2 ( V2 ) and 6 weeks ( V3 ) of the intervention . At each visit , lymphocyte subset counts and cytokine levels were analysed . Specific HAV antibodies were analysed at V1 and V3 . To evaluate differences between groups , one-way ANOVA with Bonferroni post-hoc test were used regarding lymphocyte subset counts and specific HAV antibodies production , and Friedman test of related sample s and Kendall concordance coefficient for cytokines production . Chi square test was used to analyse seroconversion rates . Results Specific HAV antibodies were significantly higher in PRO1 ( 50.54 ± 29.57 ) compared to C ( 36.23 ± 16.45 ) ( P = 0.017 ) and showed an intermediate value in PRO2 ( 41.61 ± 15.74 ) . Seroconversion rates were similar in the three groups ( 97.3 , 92.3 and 97.4 % in C , PRO1 and PRO2 respectively ) . Memory T-helper lymphocytes increased in V3 vs. V1 ( P = 0.032 ) in PRO2 . No differences were found in cytokine concentrations . Conclusion Mixed results have been found regarding the usefulness of Lc supplementation to increase the antigen-specific antibody response to an immune challenge . Clinical trial registration number : EudraCT Number 2016 - 000183 - 42 . Registered 19 January 2016 . Retrospectively registered There is an increasing interest in the intestinal and immunological effects of probiotics . The aim of the present study is to evaluate the tolerance and beneficial effects in healthy adults of the strain , Lactobacillus salivarius CECT5713 isolated from breast milk .  A phase II , r and omized , double-blinded , placebo-controlled human clinical trial was carried out in 40 healthy adults . The Probiotic group received a daily dose of 2 x 10(8 ) CFU of L. salivarius CECT5713 in capsules during 4 weeks while volunteers of the control received only a placebo . Gastrointestinal and immunological parameters were analyzed . Results showed that L. salivarius CECT5713 was well tolerated and no adverse effects were detected . Consumption of the probiotic strain increased fecal lactobacilli counts ( 7.9+/-0.1 vs. 7.05+/-0.2 CFU/g feces , P=0.001 ) . Also , an improvement in the frequency of defecation ( P=0.04 ) was observed . Probiotic treatment induced significantly the percentage of NK cells and monocytes , as well as the plasmatic levels of immunoglobulins M , A and G , and the regulatory cytokine IL-10 ( 72.3+/-11.7 in probiotic group vs. 27.3+/-6.4 pg/mL in control group , P<0.01 ) . Thus , it can be concluded that daily administration of L. salivarius CECT5713 to healthy adults is safe and improve gut microbiota and different parameters related to immune response BACKGROUND Probiotics , by altering gut flora , may favourably alter portal haemodynamics in patients with cirrhosis . AIM To investigate the effect of probiotics on portal pressure in patients with cirrhosis . METHODS R and omized double-blind placebo-controlled trial conducted in G.B. Pant Hospital , New Delhi . A total of 94 cirrhotic patients having large oesophageal varices without history of variceal bleeding were r and omized to three treatment groups and given 2 months ' treatment with propranolol plus placebo , propranolol plus antibiotics ( norfloxacin 400 mg BD ) or propranolol plus probiotic ( VSL#3 , 900 billion/day ) r and omly assigned in 1:1:1 ratio . Outcome measures were change in Hepatic venous pressure gradient ( HVPG ) : Response rate ( Percentage of patients having a decrease from baseline of ≥20 % or to ≤12 mm Hg ) and changes from baseline ; biochemical markers of inflammation : changes from baseline . RESULTS Adjunctive probiotics  increased the response rate compared with propranolol alone ( 58 % vs. 31 % , P = 0.046 ) , similar to adjunctive antibiotics ( 54 % ) . The mean fall in HVPG was greater with either adjunctive probiotics ( 3.7 mm Hg vs. 2.1 mm Hg , P = 0.061 ) or adjunctive antibiotics ( 3.4 mm Hg ) than with propranolol alone . Both adjunctive therapies were associated with greater decreases in TNF-α levels ( in both peripheral and hepatic venous blood ) that result ed from propranolol-only treatment . No clinical ly relevant between-group differences were observed in the type or frequency of adverse events . CONCLUSIONS Adjunctive probiotic ( VSL#3 ) improved the response  rate to propranolol therapy and was safe and well tolerated in patients with cirrhosis .  Adjunctive probiotic therapy merits further study for reduction in portal pressure Abstract Objective : This study investigated the efficacy and safety of supplementation with probiotics in improving chronic pulmonary symptoms due to sulfur mustard ( SM ) exposure . Methods : In a r and omized double-blind placebo-controlled study , 65 subjects suffering from chronic pulmonary complications of SM were assigned to one probiotic capsule ( 1 × 109 CFU containing seven strains of lactic acid-producing bacteria ) every 12 h or an identical placebo for six weeks . Serum high-sensitivity C-reactive protein ( CRP ) concentrations , pulmonary function tests ( FEV1 , FEV1/FVC and MMEF 25–75 % ) and COPD assessment test ( CAT ) were assessed at baseline and at the end of trial . Results : The groups were comparable in baseline characteristics . There were significant improvements in FEV1/FVC in the probiotic but not in placebo group . CAT scores were decreased in both study groups . However , between-group comparison of changes in the assessed parameters reached statistical significance only for CAT score ( p < 0.001 ) . There was no report of adverse events during the course of trial . Conclusions : Findings of the present trial favor the efficacy of probiotic supplementation in improving the pulmonary symptoms of SM-exposed subjects
target: Conclusions Probiotic supplementation significantly reduced serum concentrations of pro-inflammatory cytokines including , hs-CRP , TNF-a , IL-6 , IL-12 , and IL-4 , but it did not influence IL-1B , IL-8 , IFN-g , and IL-17 concentrations .
  A significant increase in serum concentrations of IL-10 , as a anti-inflammatory cytokine was also documented after probiotic supplementation
background: Purpose No study has summarized earlier findings on the effect of probiotic supplementation on  inflammatory biomarkers .
  This systematic review and meta- analysis was conducted to systematic ally review the available placebo-controlled clinical trials about the effect of probiotic supplementation  on several inflammatory biomarkers in adults .