Efficacy of probiotics in multiple sclerosis: a systematic review of preclinical trials and meta-analysis of randomized controlled trials
Jiang J, et al
Published in Food & Function
Methodology
Systematic review of preclinical trials plus meta-analysis of randomised controlled trials, searching PubMed, Web of Science, Cochrane CENTRAL, EMBASE, Clinical Trials and Google Scholar to November 2020; 3 RCTs and 22 preclinical studies included, pooled as standardised mean differences.
Key Findings
This review pooled 3 randomised controlled trials in 173 people with multiple sclerosis alongside 22 animal studies. Probiotic supplementation improved Expanded Disability Status Scale scores (SMD -1.22, 95% CI -2.40 to -0.03, I-squared 92%), Beck Depression Inventory scores (SMD -1.58, 95% CI -3.03 to -0.12, I-squared 94%), General Health Questionnaire scores (SMD -0.71, 95% CI -1.02 to -0.40) and Depression Anxiety Stress Scale scores (SMD -0.72, 95% CI -1.12 to -0.33), all rated very low certainty, plus improvements in insulin resistance and inflammatory and oxidative stress markers. In animal models probiotics reduced incidence and severity and delayed progression (15 studies) and improved motor impairment (3 studies).
Conclusions
Probiotics showed beneficial effects on mental health outcomes in MS, with very low certainty of evidence.
Limitations
Only three human trials with 173 participants in total, with extreme heterogeneity (I-squared above 90%) on the main outcomes and certainty of evidence graded very low; much of the supporting evidence is from animal models that may not translate.
Supplements Studied
Meta-analysis of RCTs enrolling 173 patients with MS receiving probiotics revealed significant beneficial effects of probiotic supplementation on mental health, with very low certainty of evidence.
Related Health Concerns
Study Details
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