The correlation between gut microbes and epilepsy is a hot research topic. This review aims to summarize the effects of Ketogenic diet (KD) on gut microbes and the preclinical and clinical progress of the use of Fecal microbiota transplants (FMT) and Probiotics in the intervention of epilepsy to provide clinical reference. Gut microbes mediates the antiepileptic effect of KD. Many studies have found that bactericides decreased in epileptic patients, and KD can increase bactericides abundance, which may be one of its effective mechanisms. Both FMT and probiotics showed antiepileptic effects on epileptic model mice with different pathogenesis, suggesting that gut microbes is an important target for epilepsy treatment. Preliminary clinical studies of small samples suggest that the use of probiotics can effectively treat refractory epilepsy and autoimmune-associated epilepsy, and can improve comorbidities. No serious and long-term side effects of probiotics have been found in epileptic patients. In the future, more high-quality studies are needed to further clarify its efficacy and mechanisms, which could lead to new strategies for epilepsy treatment and refresh our understanding of the causes of epilepsy.
ObjectiveTo investigate the effect of Lactobacillus plantarum (LP) on the intestinal barrier function under inflammation. MethodsInterleukin-10 knockout (IL-10－/－) mice were used as the model of inflammatory bowel disease. IL-10－/－ and wild type (WT) mice received the LP or Ringer solutions for 4 weeks. Colitis was assessed by histological score and clinical manifestation was observed. The gut paracellular permeability was measured by Ussing chamber. The concentrations of tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ) were detected by the ELISA method. The expressions and distributions of tight junction proteins were determined by Western blot and immunofluorescence, respectively. ResultsCompared with the WT group, the diarrhea, rectal prolapse, and weight loss were obvious (Plt;0.01), the concentrations of TNF-α and IFN-γ significantly increased (Plt;0.01), the infiltration of numerous inflammatory cells, even transmural ulcers, and crypt abscess were observed, the ultrastructure of tight junction was damaged, the mannitol permeability significantly increased (Plt;0.001) and transepithelial resistance (TER) significantly decreased (Plt;0.001), and the expressions of tight junction proteins (ZO-1, occludin, and claudin-1) significantly decreased (Plt;0.01) in the IL-10－/－ group. Compared with the IL-10－/－ group, the clinical and pathological manifestations of colitis significantly improved (Plt;0.01), the ultrastructural damage of tight junction was prevented, the mannitol permeability significantly decreased (Plt;0.001) and the TER significantly increased (Plt;0.001), the concentrations of TNF-α and IFN-γ significantly decreased (Plt;0.01), and the expressions of tight junction proteins (ZO-1, occludin, and claudin-1) significantly increased (Plt;0.01) in the IL-10－/－+LP group. ConclusionTreatment with LP ameliorates colonic epithelial barrier dysfunction by promoting the expressions of tight junctional proteins in IL-10－/－ mice.
Objective To systematically assess the efficacy and safety of probiotics in prevention and treatment of bronchial asthma. Methods Randomized controlled trials (RCTs) of probiotics in prevention/treatment of asthma compared with placebo were searched in PubMed, EMbase, Web of Science, OVID and The Cochrane Library published before August 2011. The quality of the included RCTs was evaluated and the data were extracted by two assessors independently. Meta-analyses were performed with RevMan 5.1 software. Results Eleven RCTs on probiotics preventing asthma (n=3 656) and 5 RCTs on probiotics treating asthma (n=430) were identified. The Meta-analyses on preventing asthma showed that probiotics didn’t statistically decease the incidence of asthma (RR=0.76, 95%CI 0.47 to 1.22, P=0.25) and asthma-like wheezing (RR=0.92, 95%CI 0.62 to 1.39, P=0.71) compared with placebo. The Meta-analyses on treating asthma indicated that probiotics could prolong free episodes of asthma (RR=1.48, 95%CI 1.20 to 1.76, Plt;0.000 1) in comparison with placebo. No severe adverse events were found in all included studies. Conclusion The present evidence is not b enough to prove that probiotics is effective to prevent asthma, but it may prolong free episodes of asthma. Although it seems to have the effect on improving lung function, it fails to reduce the acute onset of asthma and has no have the advantage of improving immune function.
Objective To systematically evaluate the preventative effect of probiotics for infantile eczema and atopic eczema. Methods Databases including PubMed, EMbase, MEDLINE (Ovid), CENTRAL, CBM and CNKI were searched from inception to February 2012, so as to collect the randomized controlled trials (RCTs) on probiotics in preventing infantile eczema and atopic eczema. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, evaluated quality and cross-checked. Then the meta-analysis was conducted using RevMan 5.0 software. Result A total of 15 RCTs involving 3 179 infants were included. The results of meta-analyses on 8 high quality RCTs showed that: the incidence of infantile eczema was lower in the probiotics group than the placebo group, with a significant difference (RD=–0.06, 95%CI –0.10 to –0.03, Plt;0.05). Probiotics had no preventative effect on infantile atopic eczema (RD=–0.02, 95%CI –0.08 to 0.03, Pgt;0.05), and had preventative effects on both high risk population (RD=–0.09, 95%CI –0.15 to –0.03, Plt;0.05) and general population (RD=–0.05, 95%CI –0.10 to 0.00, Plt;0.05) of infantile eczema. Conclusion Probiotics have certain preventative effects on infantile eczema. Due to the differences of probiotics in the aspects such as probiotic strain, dosage, treatment course, etc., its specific effects on infantile eczema and atopic eczema should be further tested.
Objective To compare the clinical therapeutic effect of probiotic agents in treating irritable bowel syndrome (IBS) by Meta-analysis. Methods Such databases as MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Chinese Biomedical Literature Database were searched from January 2001 to October 2011, and the domestic conference proceedings and relevant papers published in recent 1 year were also searched manually. All domestic randomized controlled trials (RCTs) on probiotic agents in treating irritable bowel syndrome (IBS) were collected, which were then selected according to the inclusion and exclusion criteria. The data were extracted, the methodological quality of the included studies was assessed, and the Meta-analysis was performed with Revman5.0. Results A total of 11 RCTs involving 1 065 patients were included. The total effective rate of the probiotic agents plus conventional treatment group was superior to that of the conventional treatment (trimebutine meleate/ pinaverium bromide) group (RR=1.26, 95%CI 1.18 to 1.34, Plt;0.000 01), it could effectively relieve abdominal pain (RR=1.10, 95%CI 1.03 to 1.18, P=0.004) and diarrhea (RR=1.15, 95%CI 1.07 to 1.24, P=0.000 3). But there was no significant difference between the two groups in alleviating abdominal distention (RR=1.08, 95%CI 0.95 to 1.24, P=0.25). The effectiveness of probiotic agents used alone was similar to that of the conventional treatment used alone, without significant differences (RR=0.85, 95%CI 0.66 to 1.09, P=0.19). Conclusion Probiotic agents combined with conventional drugs can improve the total therapeutic effect of IBS, especially in alleviating abdominal pain, diarrhea and so on. But the effectiveness of probiotic agents used alone is similar to that of the conventional treatment used alone. For the possibility of bias due to the lower quality of the included studies and unclear implementation of RCTs, this conclusion should be verified with more large-scale and high-quality RCTs.
Slow wound healing has been a troublesome problem in clinic. In China, traditional methods such as antibiotics and silver sulfadiazine are used to treat skin wound, but the abuse use has many disadvantages, such as chronic wounds and pathogen resistance. Studies have shown that the microorganisms with symbiotic relationship with organisms have benefits on skin wound. Therefore, the way to develop and utilize probiotics to promote wound healing has become a new research direction. In this paper, we reviewed the studies on the bacteriotherapy in the world, described how the probiotics can play a role in promoting wound healing through local wound and intestine, and introduced some mature probiotics products and clinical trials, aiming to provide foundations for further development of bacteriotherapy and products.
Objective To study the effect of probiotics on the change of intestinal permeability and inflammatory reaction after surgery of colorectal cancer. Methods Sixty patients who underwent colonic surgery were randomly divided into two groups: probiotic group and control group, with 30 cases in each group. Each group received nutritional support of the same nitrogen and calorie from day 3 to day 7 after operation. The patients in probiotic group were orally administrated probiotic (2 g/d) from the first day after surgery for 7 days. Every patient’s body temperature and heart rate were observed after operation, and white blood cell counts were observed before operation and on day 1, 5, 8 after operation. The levels of microbial DNA in whole blood and plasma D-lactate, and urine lactulose/mannito (L/M) ratio were measured before operation and on day 1 and day 8 after operation, respectively. In addition, the occurrence of postoperative systemic inflammatory response syndrome (SIRS) and complications of inflammation were closely observed. Results The average heart rate in postoperative 5 days was significantly lower in probiotics group than that in control group (P＜0.01). The duration of fever and the recovery time for white blood cell counts decreasing to normal were significantly less in probiotics group than those in control group (P＜0.01) as well. There was no significant difference of positive rate of microbial DNA in peripheral blood on day 1 after operation between two groups. However, the number of patients that showed positive result of microbial DNA PCR test in probiotic group （1 case, 3.3%） was significantly less than that of control group (7 cases, 23.3%）on day 8 after operation (P＜0.05). The level of plasma D-lactate in probiotic group 〔decreasing from (6.90±1.41) ng/ml on day 1 to (0.56±0.18) ng/ml on day 8〕 was also significantly lower than that in control group 〔decreasing from (6.63±1.29) ng/ml on day 1 to (0.95±0.83) ng/ml on day 8〕 on day 8 after operation (P＜0.05). Urine L/M ratio increased from 0.053±0.019 on day 1 to 0.063±0.016 on day 8 after operation in control group; while in probiotic group, the ratio decreased from 0.047±0.012 on day 1 to 0.031±0.008 on day 8 after operation, and there was significantly statistical difference of the ratio between two groups on day 8 (P＜0.01). There was no significant difference of the occurrence rate of SIRS and complications of inflammation between two groups (Pgt;0.05). Conclusion Probiotics can decrease intestinal permeability and maintain the intestinal barrier function after operation. It may be helpful for the recovery of patients with early inflammatory response after surgery of colorectal cancer.
ObjectiveTo systematically review the efficacy and safety of probiotics-containing rescue regimen for the eradication of Helicobacter pylori (Hp) infection. MethodsWe electronically searched PubMed, EMbase, Cochrane Central Register of Controlled Trials (CENTRAL), CBM, CNKI, WanFang Data and VIP databases, and Chinese Clinical Trial Register (ChiCTR) and ClinicalTrial.gov from inception to December 2015, to collect randomized controlled trials (RCTs) about probiotics-containing rescue regimen for the eradication of Hp infection. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsEleven RCTs involving 1888 patients were finally included. The results of meta-analysis showed that: Compared with the control group, probiotics-containing rescue regimen could significantly increase the eradication rate (ITT analysis: 80.3% vs. 69.3%, RR =1.15, 95%CI 1.10 to 1.22, P<0.00001; PP analysis: 86.5% vs. 74.3%, RR=1.16, 95%CI 1.11 to 1.22, P<0.00001), and decrease the incidence of total adverse reaction (ITT analysis: 19% vs. 29.2%, RR=0.60, 95%CI 0.40 to 0.91, P=0.02). Sensitivity analysis showed that the result was relatively stable. Publication bias test showed no evidence of substantial publication bias. ConclusionCurrent evidence indicates that probiotics-containing rescue regimen may contribute to improve eradication rate of Hp infection patients, and may reduce the occurrence of major gastrointestinal associated adverse reaction. Due to the limited quality and quantity of included studies, more high-quality RCTs are needed to verify the above conclusion.
Epilepsy is a common neurological disorder that affect patients' cognitive function and their mental health, imposing a huge burden on families and society. There are approximately 50 million epilepsy patients worldwide, with a prevalence rate of 4‰~7‰ in China, including about 6 million active epilepsy patients. Although scientists have been devoted to the research and exploration of epilepsy, the causes and pathological mechanisms of epilepsy are still poorly understood. The effectiveness of anti-seizure drugs is limited, and more effective methods is needed. With the deepening of microbiological research, many studies have found significant differences in the composition of the intestinal microbiota of epilepsy patients compared to healthy individuals. Analysis of the intestinal microbiota of epilepsy patients through sequencing has shown significantly lower abundances of Bacteroidetes and Firmicutes compared to the normal population. Many related clinical studies have found that adopting a ketogenic diet, taking probiotics orally, using antibiotics, or fecal microbiota transplantation (FMT) can effectively control epilepsy by normalizing the intestinal microbiota. Various studies suggest a possible connection between the intestinal microbiota and epilepsy, recognizing that the intestinal microbiota can have an impact on the central nervous system. As a result, gut-brain axisis gradually recognized by scientists. Therefore, the role of the intestinal microbiota in epilepsy is gradually being recognized, and recent clinical studies have confirmed that supplementing probiotics can effectively reduce seizure frequency and improve comorbidities, which may become a new method for treating epilepsy.
ObjectiveTo systematically review the efficacy and safety of probiotics for the treatment of Helicobacter pylori (H.pylori) infection in children. MethodsWe electronically searched The Cochrane Library, PubMed, EMbase, CNKI, VIP and WanFang Data databases to collect randomized controlled trials (RCTs) about probiotics for the treatment of H.pylori infection in children from inception to January 2015. The references of included studies and conference proceedings were manually searched for additional studies. Two reviewers independently screened literature, extracted data and assessed the risk of bias of include studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of twelve RCTs were included, involving 1 227 patients. The result of meta-analysis showed that the probiotics adjuvant therapy group was superior to the control group in H.pylori eradication rates (OR=2.23, 95%CI 1.66 to 2.99, P<0.000 01) and the incidence of adverse effect (OR=0.31, 95%CI 0.18 to 0.53, P<0.000 1). ConclusionCurrent evidence shows that probiotics adjuvant therapy may be a new effective and safe solution in the treatment of H.pylori infections in children. Due to the limited quality and quantity of the included studies, more higher quality studies are needed to verify the above conclusion.