Effect of prebiotic and probiotic supplementation on reduced pain in patients with fibromyalgia syndrome: a double-blind, placebo-controlled randomized clinical trial

Fibromyalgia syndrome (FMS) is a chronic, idiopathic condition with symptoms such as widespread musculoskeletal pain, stiffness, general fatigue, sleep disturbances, and cognitive dysfunction. Recent studies have observed that patients with FMS have low levels of bifidobacteria and high levels of aerobic bacteria in their gut microbiota, showing a relationship between the gastrointestinal (GI) system and central nervous system, referred to as the ‘brain-gut axis’. A double-blind, randomized, placebo-controlled clinical study was conducted to determine the effects of prebiotic and probiotic treatment on pain, sleep, quality of life, depression, and anxiety. Fifty-three female participants with FMS were randomized into three groups: 1) a probiotic group that received 4×10¹⁰ colony forming units (CFUs)/day of Lactobacillus acidophilus L1, Lactobacillus rhamnosus liobif, Bifidobacterium longum, and Saccharomyces boulardii; 2) a prebiotic group that received a 10 g dose inulin/day; and 3) a placebo group that received fructooligosaccharides (FOS) and magnesium stearate capsules for eight weeks. Participants who received prebiotic and probiotic treatment presented a significantly reduced Visual Analogue Scale (VAS) score compared with those who received placebo treatment after eight weeks of intervention. The probiotic supplementation significantly improved sleep quality, depression, anxiety, and pain scores compared to those at baseline in FMS patients, while prebiotic supplementation significantly improved pain scores and sleep quality. Moreover, probiotic supplementation significantly decreased the Beck Depression Index (BDI), Beck Anxiety Index (BAI), and Pittsburgh Sleep Quality Index (PSQI) scores compared to baseline; meanwhile, prebiotic supplementation only significantly decreased PSQI scores. As such, the current study provides supporting results on the potential benefits of prebiotic and probiotic supplementation for FMS management.

Key takeaways:

• Patients with FMS experience low quality of life and high levels of disability.
• Prebiotic supplementation improved pain scores and sleep quality in patients with FMS.
• Probiotic intake may positively affect sleep quality, depression, anxiety, and pain scores in subjects with FMS.

Access to the study: https://pubmed.ncbi.nlm.nih.gov/37224267/

Reference: Aslan Çİn, N. N., Açik, M., Tertemİz, O. F., Aktan, Ç., Akçali, D. T., Çakiroğlu, F. P., & Özçelİk, A. Ö. (2024). Effect of prebiotic and probiotic supplementation on reduced pain in patients with fibromyalgia syndrome: a double-blind, placebo-controlled randomized clinical trial. Psychology, health & medicine, 29(3), 528–541. https://doi.org/10.1080/13548506.2023.2216464

Efficacy of probiotics or synbiotics in critically ill patients: A systematic review and meta-analysis

Ventilation-associated pneumonia (VAP) is a common infection that occurs in patients undergoing mechanical ventilation in medical facilities. The development of VAP is related to a longer duration of mechanical ventilation, longer hospital days, higher hospitalization costs, and increased mortality rates. Due to various factors such as weakened gastrointestinal motility, disturbed hormone levels, and infections, intensive care unit (ICU) patients have a disrupted intestinal microbiota characterized by an overgrowth of pathogens, which can lead to VAP. Many studies have reported on the use of probiotics and synbiotics in reducing the incidence of VAP and improving the prognosis of critically ill patients. Four databases were searched for relevant publications (i.e., PubMed, Embase, Cochrane Database, and Web of Science) to examine the effects of probiotic and synbiotic supplementation in preventing VAP in critically ill patients. Thirty-three studies with 4065 patients who received probiotics or synbiotics (treatment group) and 3821 patients who received standard care or placebo (control group) were included in this systemic review and meta-analysis. The analyzed data, which was pooled and expressed as relative risk (RR) and standardized mean difference (SMD) with a 95% confidence interval (CI), demonstrated that the treatment group had a significantly reduced incidence of VAP and sepsis as well as duration of mechanical exploitation, ICU mobility, ICU stay, and hospital stay than the control group. However, there were no significant differences in diarrhea, Clostridium difficile infection (CDI), incidence of acquired pneumonia, and in-hospital mortality observed between the two groups. Therefore, this study highlights the potential benefits of probiotic and synbiotic supplementation for VAP reduction in critically ill patients.

Key takeaways:

• VAP is a common infection originated in-hospital, and its prevention is critical.
• Probiotics or synbiotics used for ICU patients may prevent VAP and sepsis.
• Probiotics and synbiotics positively affect the duration of mechanical exploitation, ICU mobility, ICU stay, and hospital stay.

Access to the study: https://pubmed.ncbi.nlm.nih.gov/38220407/

Reference: Lou, J., Cui, S., Huang, N., Jin, G., Chen, C., Fan, Y., Zhang, C., & Li, J. (2024). Efficacy of probiotics or synbiotics in critically ill patients: A systematic review and meta-analysis. Clinical nutrition ESPEN, 59, 48–62. https://doi.org/10.1016/j.clnesp.2023.11.003

Exploring the underlying correlation between microbiota, immune system, hormones, and inflammation with breast cancer and the role of probiotics, prebiotics and postbiotics

Breast cancer is one of the most prevalent cancers diagnosed in women around the world. Recent research has reported that bacterial imbalance in the gut microbiota and breast tissue may be connected to the development of breast cancer. The gut bacteria play a crucial role in regulating the metabolism of steroid hormones like estrogen, which can increase the risk of breast cancer, especially in menopausal women. The microbiota can influence mucosal and systemic immune responses, which in turn affects the interactions between cancer cells and their environment in the breast and gut. Studies reported that prebiotics and probiotics may have a positive effect on cancer treatment and prevention. However, further mechanistic-based research is required to find the effective strains of bacteria against breast cancer as well as the appropriate dosages, treatment plans, safety measures, and selectivity required for optimal results.

Key takeaways:

• Breast cancer is a common type of cancer that affects women worldwide.
• Bacterial imbalance in the gut and breast tissue may be connected to the development of breast cancer.
• Prebiotics and probiotics may positively affect cancer prevention and treatment.

Access the study: https://link.springer.com/article/10.1007/s00203-024-03868-x#citeas

Reference: Summer, M., Sajjad, A., Ali, S. et al. Exploring the underlying correlation between microbiota, immune system, hormones, and inflammation with breast cancer and the role of probiotics, prebiotics and postbiotics. Arch Microbiol 206, 145 (2024). https://doi.org/10.1007/s00203-024-03868-x

A randomized, double-blind, placebo-controlled trial: efficacy of Opuntia ficus-indica prebiotic supplementation in subjects with gut dysbiosis

An imbalance in the composition and function of the gut microbiota is termed gut dysbiosis, which is associated with an overgrowth of pathobionts or a decrease in beneficial bacterial species. Gut dysbiosis can be caused by various factors like genetics, health status (infections, chronic inflammation), lifestyle habits, environmental factors such as diet (high simple sugars, low fiber content), and xenobiotics (antibiotics, drugs, and food additives). The most prevalent symptoms of this condition include digestive issues (bloating, gas, and abdominal pain), changes in bowel habits, GI distress (indigestion, pyrosis, and nausea), fatigue, skin issues, mood changes (emotional and psychological symptoms), and weight changes. Gut dysbiosis has been involved in the development or exacerbation of different conditions such as irritable bowel syndrome, inflammatory bowel disease, GI infections, as well as autoimmune, metabolic, and neurologic disorders. Opuntia ficus-indica (L.) Mill is a tropical or subtropical perennial plant belonging to the Cactaceae family and originating in Mexico. Its anthocyanins-containing fruits modulate gut microbiota composition and improve short-chain fatty acid (SCFA) production in mice. A randomized, double-blind, placebo-controlled study was conducted to evaluate the efficacy of Odilia^TM, a standardized extract from Opuntia ficus-indica (L.) Mill, on the overall health of 80 subjects experiencing gut dysbiosis. Subjects were randomized to receive either 300 mg of Odilia/day or placebo for eight weeks. The effect of the intervention was evaluated using 16S metagenomics and GIQLI/GSAS scores at baseline, 4, and 8 weeks. The study found that eight weeks of Odilia supplementation positively modulated gut microbiota composition and significantly reduced the Firmicutes to Bacteroidetes ratio (p = 0.0012). Relative abundance of beneficial bacteria (Bacteroides and Clostridium_XIVa) significantly increased (p < 0.001), in contrast to a significant reduction in pro-inflammatory bacteria (p < 0.001). Altogether, GIQLI and GSAS scores revealed successful improvement in GI discomfort.

Key takeaways:

• Gut dysbiosis is an imbalance in the composition and function of the gut microbiota.
• Opuntia ficus-indica (L.) Mill is a tropical or subtropical perennial plant that contains anthocyanins, which can modulate the gut microbiota composition, improving SCFA production in mice.
• Opuntia ficus-indica (L.) Mill extract may be an effective and well-tolerated treatment in subjects with gut dysbiosis.

Access the study: https://www.mdpi.com/2072-6643/16/5/586

Reference: Mellai M, Allesina M, Edoardo B, Cascella F, Nobile V, Spina A, Amone F, Zaccaria V, Insolia V, Perri A, Lofaro D, Puoci F. A Randomized, Double-Blind, Placebo-Controlled Trial: Efficacy of Opuntia ficus-indica Prebiotic Supplementation in Subjects with Gut Dysbiosis. Nutrients. 2024 Feb 21;16(5):586. doi: 10.3390/nu16050586. PMID: 38474715; PMCID: PMC10934938.