Effects Of Probiotics Research Articles

The role of probiotics on microvascular complications of type-2 diabetes: Nephropathy and retinopathy.

Diabetes is a multifactorial disorder that involves several molecular mechanisms and is still one of the key global health challenges with increasing prevalence and incidence. Gut microbiome dysbiosis could activate and recognize receptors that trigger the inflammation response and modulation of insulin sensitivity. In addition, the intricate role of gut microbiota dysbiosis in the onset and development of T2D (Type 2 diabetes mellitus) and associated microvascular complications was identified. These complications include diabetic nephropathy (DN) and diabetic retinopathy (DR), diabetic neuropathy, cerebrovascular disorders, and coronary heart disease. A recent interesting strategy to improve these complications is probiotics administration. The safety and health effects of probiotics against various diseases have been validated by various in vitro, in vivo and clinical studies. In this review, the related mechanisms between the gut microbiome, initiation, and progression of T2D and its common microvascular complications (DN and DR) have been discussed.

Carbon source competition within the wound microenvironment can significantly influence infection progression

It is becoming increasingly apparent that commensal skin bacteria have an important role in wound healing and infection progression. However, the precise mechanisms underpinning many of these probiotic interactions remain to be fully uncovered. In this work, we demonstrate that the common skin commensal Cutibacterium acnes can limit the pathogenicity of the prevalent wound pathogen Pseudomonas aeruginosa in vivo. We show that this impact on pathogenicity is independent of any effect on growth, but occurs through a significant downregulation of the Type Three Secretion System (T3SS), the primary toxin secretion system utilised by P. aeruginosa in eukaryotic infection. We also show a downregulation in glucose acquisition systems, a known regulator of the T3SS, suggesting that glucose availability in a wound can influence infection progression. C. acnes is well known as a glucose fermenting organism, and we demonstrate that topically supplementing a wound with glucose reverses the probiotic effects of C. acnes. This suggests that introducing carbon source competition within the wound microenvironment may be an effective way to prevent or limit wound infection.

Effect of probiotics on pain and ulceration in patients undergoing fixed orthodontic treatment.

Ulcers caused by mucosal irritation of fixed orthodontic appliances remain an unsolved problem, and more research is needed to improve the pain caused by orthodontic appliances to provide more comfortable treatment for these patients. This study investigated the effect of probiotic Lactogum on pain and ulceration in patients undergoing fixed orthodontic treatment. In this study, 64 patients over 12 years of age and candidates for fixed orthotic treatment were divided into case and control groups (n=32). The control group received orthodontic waxes, and the case group received the same orthodontic waxes and "Lactogum" probiotic lozenges from the beginning of the treatment. The number of ulcers, the amount of pain, and the location of the ulcer were recorded and compared between the two groups. An independent-sample t-test was used to compare the pain level and number of ulcers between the two groups. A significance level of 0.05 was considered for all tests. SPSS 17 was used for data analysis. The mean number of ulcers in the case group was significantly lower than the control group (P<0.001). The mean pain in the case group was significantly lower than in the control group (P<0.001). The most frequent location of ulcers was the buccal mucosa, followed by the labial mucosa. Lactogum probiotic lozenges can reduce traumatic oral ulcers and pain levels in patients undergoing fixed orthodontic treatment. However, larger clinical trials are encouraged to confirm these findings.

Effect of probiotics on children with autism spectrum disorders: a meta-analysis

BackgroundResearches have found that alteration of intestinal flora may be closely related to the development of autism spectrum disorder (ASD). However, whether probiotics supplementation has a protective effect on ASD remains controversial. This meta-analysis aimed to analyze the outcome of probiotics in the treatment of ASD children.MethodsThe Pubmed, Cochrane Library, Web of Science and Embase were searched until Sep 2022. Randomized controlled trials (RCTs) relevant to the probiotics and placebo treatment on ASD children were screened. Quality assessment of the included RCTs was evaluated by the Cochrane collaboration’s tool. The primary outcomes were ASD assessment scales, including ABC (aberrant behavior checklist) and CBCL (child behavior checklist) for evaluating the behavior improvement, SRS (social responsiveness scale) for social assessment, DQ (developmental quotient) for physical and mental development and CGI-I (clinical global impression improvement) for overall improvement. The secondary outcome was total 6-GSI (gastrointestinal severity index).ResultsIn total, 6 RCTs from 6 studies with 302 children were included in the systemic review. Total 6-GSI (MD=-0.59, 95%CI [-1.02,-0.17], P < 0.05) decreased significantly after oral administration of probiotics. Whereas, there was no statistical difference in ABC, CBCL, SRS, DQ and CGI-I between probiotics and placebo groups in ASD children.ConclusionProbiotics treatment could improve gastrointestinal symptoms, but there was no significant improvement in ASD.

Dietary Supplementation of Compound Probiotics Improves Intestinal Health by Modulated Microbiota and Its SCFA Products as Alternatives to In-Feed Antibiotics.

Enterococcus faecium, Bifidobacterium, and Pediococcus acidilactici, as intestinal probiotics, have been proved to play a positive role in treating intestinal diseases, promoting growth and immune regulation in poultry. The aim of this study was to evaluate the effect of compound probiotics on growth performance, digestive enzyme activity, intestinal microbiome characteristics, as well as intestinal morphology in broiler chickens. Treatment diets with chlortetracycline and compound probiotics were used for two groups of sixty broilers each throughout the feeding process. Another group was fed the basal diet. The BW (2589.41 ± 13.10g vs 2422.50 ± 19.08g) and ADG (60.57 ± 0.31g vs 56.60 ± 0.45g) of the compound probiotics added feed treatment group were significantly increased, and the FCR was significantly decreased (P < 0.05). The supplementation of a compound probiotics enhanced the abundance of beneficial bacteria such as Lactobacillus, Faecalibacterium, and norank_f_norank_o_Clostridia_vadinBB60_group (P < 0.05), and modulated the cecal microbiota structure, thereby promoting the production of short-chain fatty acids (SCFAs) and elevating their levels (P < 0.05), particularly propionic and butyric acids. Furthermore, the administration of the compound probiotics supplements significantly enhanced the villi height, V/C ratio, and reduced the crypt depth (P < 0.05). In addition, the activity of digestive enzymes in the duodenum and jejunum was elevated (P < 0.05). Collectively, the selected compound probiotics supplemented in this experiment have demonstrated efficacy, warranting further application in practical production settings as a viable alternative to antibiotics, thereby facilitating efficient production and promoting gastrointestinal health.

Integrative Analysis of the Microbiome and Metabolome of Broiler Intestine: Insights into the Mechanisms of Probiotic Action as an Antibiotic Substitute.

Antibiotic substitutes have become a research focus due to restrictions on antibiotic usage. Among the antibiotic substitutes on the market, probiotics have been extensively researched and used. However, the mechanism by which probiotics replace antibiotics remains unclear. In this study, we aimed to investigate this mechanism by comparing the effects of probiotics and antibiotics on broiler growth performance and intestinal microbiota composition. Results shown that both probiotics and antibiotics increased daily weight gain and reduced feed conversion rate in broilers. Analysis of ileum and cecum microorganisms via 16S rRNA gene sequencing revealed that both interventions decreased intestinal microbial diversity. Moreover, the abundance of Bacteroides increased in the mature ileum, while that of Erysipelatoclostridium decreased in the cecum in response to both probiotics and antibiotics. The main metabolites of probiotics and antibiotics in the intestine were found to be organic acids, amino acids, and sugars, which might play comparable roles in growth performance. Furthermore, disaccharides and trisaccharides may be essential components in the ileum that enable probiotics to replace antibiotics. These findings provide important insights into the mechanisms underlying the use of probiotics as antibiotic substitutes in broiler breeding.

A randomized double-blind controlled clinical trial demonstrating efficacy of different probiotic strains on serum lipids and glycemic biomarker.

the aim of this randomized placebo-controlled study was to investigate the effect of probiotics mainly on plasma lipids, homocysteine levels, glycemic biomarkers and inflammatory marker in people with hyperlipidemia, compared to a placebo. a randomized, double-blind placebo-controlled study was completed with a total of 51 men and women who have diagnosed with hyperlipidemia. The three study interventions were: 1) probiotic group I asked to take once a day 1 x 106 colony forming unit (CFU) Lactobacillus rhamnosus GG microorganism (n = 18) capsule; 2) probiotic group II asked to take once a day of a combined Lactobacillus acidophilus 1 x 109 CFU and Bifidobacterium animalis subsp.lactis 1 x 109 CFU probiotic capsule (n = 17); and 3) placebo group: emptied capsule (n = 16), plasma lipids, homocysteine, and glycemic biomarkers were were performed at baseline and week 8. Also, hs-CRP levels was assessed as inflammatory parameter. compared to baseline there was a significant decrease in triglyceride and total cholesterol levels of the both intervention groups compared to the placebo group. Regarding the glycemic biomarkers. both intervention groups significantly alter the HOMA-IR values compared to the placebo group (p < 0.05). When homocysteine values were evaluated. a statistically significant decrease was observed only in the group using the combined strain (p < 0.05). Results demonstrated that regular and strain-specific use of probiotics have effective and favorable consequences on plasma lipids and glycemic biomarkers. probiotics containing Lactobacillus or Bifidobacterium could be effective in hypercholesterolemic patients, reducing serum lipids as well as homocysteine and glycaemia.

Protective effects of probiotics against menopausal symptoms in ovariectomized mice

With growing interest in the role of the gut microbiome in the pathogenesis of menopausal disorders, probiotic supplementation is emerging as a novel therapeutic strategy for postmenopausal women. In this study, we investigated the protective effects of several probiotic strains against menopausal symptoms using an ovariectomized (OVX) mouse model fed a high-fat diet, in comparison with the effects of 17β-estradiol (E2) replacement. Among the eight tested probiotic strains, we selected four (Limosilactobacillus fermentum MG901, Lactiplantibacillus plantarum MG4604, Ligilactobacillus salivarius MG4679, and Lacticaseibacillus reuteri MG5463) that showed superior estrogen-like activity in an uterotrophic assay. We then examined their effects in OVX mice. The probiotic MG4679 was tested in combination with MG5463. During the 12-week experimental period, oral administration of the four probiotics reduced blood glucose and body temperature and ameliorated depression-like behavior in OVX mice. In the Barnes maze test, MG901 and MG4604 improved the spatial memory deficits observed in OVX mice. Micro-CT analysis of mouse femurs revealed that MG5463 prevented the OVX-induced reduction in cortical bone mineral density and bone volume fraction. Importantly, similar to E2 replacement, most of the test probiotics increased Akt phosphorylation in skeletal muscle, estrogen receptor-α (ER-α) protein expression in the liver, and ERK phosphorylation in the brain of OVX mice. However, unlike E2 treatment, all probiotics did not affect uterine weight, uterine ER-α expression, and serum E2 concentration. These results indicated that the probiotics used in this study exhibited protective effects against menopausal symptoms, partly through estrogen-mimetic action, without unfavorable uterine stimulation in OVX mice.

Utilization of Probiotics in Relieving Post-Colonoscopy Gastrointestinal Symptoms: A Systematic Review and Meta-Analysis.

Colonoscopy is regarded as a safe diagnostic and therapeutic procedure, nevertheless, some patients may still encounter post-colonoscopy gastrointestinal symptoms. This study aimed to evaluate the utilization of probiotics before and after colonoscopy to relieve those symptoms. This study was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines. Included studies were all interventional studies examining the effects of probiotics use before and after colonoscopy. Articles were retrieved from MEDLINE, EBSCO-Host, Cochrane, ProQuest, and Google Scholar electronic databases, utilized specific keywords ( " Probiotic " OR " Probiotics ") AND (" Colonoscopy " OR " Colonoscopies "). The Cochrane Risk of Bias (RoB) 2 and Joanna Briggs Institute (JBI) Critical Appraisal tools were used for study quality assessment, as well as Review Manager (RevMan) 5.4 to perform the meta-analysis. A total of ten studies were included in this systematic review. Six studies assessed the effect of probiotics consumption after colonoscopy, three examined the impact before colonoscopy, and one study assessed both. The most common type of probiotics used were Lactobacillus and Bifidobacterium. Quantitative synthesis of probiotics before colonoscopy showed no significant differences among bloating, abdominal pain, nausea, and vomiting symptoms (p=0.49, p=0.14, p=0.30, and p=0.42, respectively). Similarly, quantitative synthesis of probiotics after colonoscopy showed no significant differences in bloating and abdominal pain (p=0.16 and p=0.63, respectively). Probiotic administration pre- and post-colonoscopy exhibited preliminary evidence for reducing gastrointestinal symptoms, but a quantitative synthesis revealed non-significant findings, necessitating further investigations.

Effect of millets and probiotics on cancer prevention:exploring its nutritional composition and health benefits

Effect of millets and probiotics on cancer prevention:exploring its nutritional composition and health benefits

Meta-analysis to predict the effects of probiotics on meat quality of broiler.

The demand for chicken meat has surged globally due to its status as a primary protein source in human diets. However, ensuring high-quality meat products has become an increasingly important subject to consumers. In this study, 21 articles from PubMed and Web of Science databases published between 2005 and 2023 were examined to assess the influence of probiotic supplementation on broiler meat quality. The meta-analysis revealed significant findings across various meat quality parameters. Specifically, probiotics were found to significantly affect meat colour parameters, including redness, yellowness, and lightness, in both breast and thigh meat samples. Moreover, significant differences were observed in parameters such as water-holding capacity (p < 0.001), cook loss (p = 0.047), and shear force (p = 0.025) between control and probiotic groups. However, it's essential to note the considerable heterogeneity among the studies, emphasising the need for a cautious interpretation of the results. Despite this variability, the study underscores the potential of probiotics to positively influence broiler meat quality, highlighting avenues for further research and standardisation in poultry production practices. These findings also contribute to a better understanding of probiotics' role in improving meat quality and meeting consumer preferences for nutritious and high-quality poultry products.

Screening Probiotics for Anti-Helicobacter pylori and Investigating the Effect of Probiotics on Patients with Helicobacter pylori Infection.

Probiotics are natural microbial agents with beneficial properties such as bacteriostatic and anti-infective properties. Lactobacillus plantarum Q21, Q25 and QA85, were isolated from the Chinese specialty fermented food "Jiangshui" and proved to be highly resistant to Helicobacter pylori (p < 0.0001). In vitro results showed that Q21, Q25 and QA85 strongly inhibited H. pylori and could specifically co-aggregate H. pylori in vitro (more than 56%). Strains have the potential to adhere to cells and hinder H. pylori colonization (p < 0.0001). To assess the anti-H. pylori efficacy of strains in vivo, volunteers were recruited and a self-controlled study of probiotic intervention was conducted. Compared to pre-probiotics, volunteers who took Q21, Q25 and QA85 for 1 month showed significant improvement in discomfort, a significant reduction in GSRS scores (p < 0.05), and modulation of inflammatory response (p < 0.05). Q21, Q25 and QA85 resulted in a decreasing trend of H. pylori load in volunteers (454.30 ± 327.00 vs. 328.35 ± 237.19, p = 0.06). However, the strains were not significantly effective in modulating the imbalance of the gut microbiota caused by H. pylori infection. In addition, strains affect metabolic pathways by increasing the levels of O-Phosphoethanolamine and other related metabolites, which may ameliorate associated symptoms. Therefore, Lactobacillus plantarum Q21, Q25 and QA85 can be regarded as a candidate probiotic preparation that exerts direct or indirect anti-H. pylori effects by inhibiting H. pylori activity and colonization, reducing inflammation and discomfort, maintaining homeostasis in the internal environment, affecting the metabolic pathways and repairing the body barrier. They can play a role in relieving H. pylori infection.

Effects of water additive mixed probiotics on water quality, growth performance, feed utilization, biochemical analyses and disease resistance against Aeromonas sobria of Nile tilapia

The present study examined the effects of water additive mixed probiotics on water quality, growth performance, feed utilization, biochemical analyses and disease resistance against Aeromonas sobria of Nile tilapia (Oreochromis niloticus). Triplicate groups of Nile tilapia fingerlings (46 g) were fed a commercial diet (ALLER AQUA FEED) in four water treatments control (0.0 g/m3), T1 (0.0010 gm m-3 day-1), T2 (0.0015 gm m-3 day-1), T3 (0.0020 gm m-3 day-1) of probiotic ( AquaStar® Pond) for 60 days. The water quality parameters particularly total ammonia nitrogen (TAN) and ammonia (NH3) decreased significantly (P ≤ 0.05) in all three water treatments when compared to the control treatment. The better values of growth performance, feed utilization and hematology recorded of probiotic groups. The results also showed that fish reared in three water treatments with additive probiotics had a lower mortality when challenged with Aeromonas sobria. Hence, the water additive probiotic used in this study is a promising solution as an alternative product to improve the water quality, growth, and health of O. niloticus.

Bacillus licheniformis-based intensive fermentation of Tibetan tea improved its bioactive compounds and reinforced the intestinal barrier in mice.

Tibetan tea changes during microorganism fermentation. Research on microorganisms in Tibetan tea has focused on their identification, while studies on the influence of specific microorganisms on the components and health functions of Tibetan tea are lacking. Bacillus licheniformis was inoculated into Tibetan tea for intensive fermentation, and the components of B. licheniformis-fermented tea (BLT) were detected by liquid chromatography with tandem mass spectrometry (UHPLC-TOF-MS), and then the effects of BLT on intestinal probiotic functions were investigated by experiments on mice. The results revealed the metabolites of BLT include polyphenols, alkaloids, terpenoids, amino acids, and lipids. Intensified fermentation also improved the antioxidant capacity in vivo and the protective effect on the intestinal barrier of Tibetan tea. In addition, the enhanced fermentation of Tibetan tea exerted intestinal probiotic effects by modulating the relative abundance of short-chain fatty acid-producing bacteria in the intestinal flora. Therefore, intensive fermentation with B. licheniformis can improve the health benefits of Tibetan tea.

Ameliorative effect of probiotics used in animals: A comprehensive review

Ameliorative effect of probiotics used in animals: A comprehensive review

Ameliorative effect of probiotics used in animals: A comprehensive review

Ameliorative effect of probiotics used in animals: A comprehensive review

Effects of Probiotics on Inflammatory Biomarkers and Its Associations With Cardiac Autonomic Function in Women With Arterial Hypertension: A Secondary Analysis of a Randomized Clinical Trial.

Preclinical evidence suggests that probiotic administration may exert an anti-inflammatory effect and reduce autonomic dysfunction and blood pressure. This study evaluated the effects of probiotic therapy on inflammatory biomarkers and characterized the correlations between inflammation and cardiac autonomic function in women with arterial hypertension. Women were randomized into probiotics (n = 20) or placebo (n = 20). The probiotic group received 109CFU/day of Lactobacillus (L.) paracasei LPC-37, L. rhamnosus HN001, L. acidophilus NCFM, and Bifidobacterium lactis HN019, and the placebo group received polydextrose. Clinical, electrocardiogram, heart rate variability (HRV) analysis, and cytokine levels were assessed at baseline and after 8weeks. Women who received probiotics for 8weeks had increased serum levels of IL-17A (p = 0.02) and decreased INF-γ (p = 0.02) compared to baseline. Probiotic supplementation increased serum levels of IL-10 compared to the placebo group (p = 0.03). Probiotic or placebo administration did not change serum levels of TNFα and IL-6. Serum levels of IL-2 (p = 0.001, and p = 0.001) and IL-4 (p = 0.001, and p = 0.001) were reduced in women receiving placebo or probiotics, respectively. Correlations between HRV indices and inflammatory variables showed that INF-γ was positively correlated with heart rate (HR) and sympathetic HRV indices and negatively correlated with vagal HRV indices. IL-10 was negatively correlated with HR and sympathetic HRV indices. IL-6 was negatively correlated with parasympathetic HRV indices and positively correlated with SD2/SD1 ratio. Probiotic therapy has a discreet anti-inflammatory effect in hypertensive women, and pro-inflammatory cytokines were negatively correlated with vagal modulation and positively correlated with sympathetic modulation of HRV.The clinical trial was registered in the Brazilian Registry of Clinical Trials (ReBEC) with the identification RBR-9mj2dt.

Effect of monensin and/or probiotics on feed intake, apparent digestibility, ruminal, serum and urinary variables, and nitrogen balance of steers

The objective of the present study was to evaluate the association of Bacillus toyonensis, Saccharomyces cerevisiae var. boulardii, and sodium monensin on feed intake, apparent digestibility, ruminal, urinary, and serum variables in the diet of steers. Four Angus × Nellore crossbred steers, with 403.0 ± 75.5 kg of BW, rumen cannulated and housed individually were used. The animals were submitted to a 4 ×4 Latin square design, receiving the following treatments: monensin only (MO); monensin + B. toyonensis (MBT); monensin + S. cerevisiae boulardii (MSB); and B. toyonensis + S. cerevisiae boulardii (BTSB). Treatments with monensin (MO, MBT and MSB) presented lower DM intake than BTSB, but similar apparent digestibility between treatments. No difference was observed between treatments for ruminal pH, but BTSB presented higher NH3-N concentration than MBT and MSB and did not differ from MO. All concentrations in the blood serum and urinary variables were found within the physiological range or close to normal, and no difference was observed in the retained nitrogen. The BTSB treatment showed potential as a feed additive for cattle, by controlling rumen pH and similar concentrations of NH3-N, total SCFA, and retained nitrogen to MO treatment, but when probiotics were combined with monensin no beneficial effect was observed under the studied conditions.

Probiotics relieve perioperative postoperative cognitive dysfunction induced by cardiopulmonary bypass through the kynurenine metabolic pathway

Postoperative cognitive dysfunction (POCD) has become the popular critical post-operative consequences, especially cardiopulmonary bypass surgery, leading to an increased risk of mortality. However, no therapeutic effect about POCD. Probiotics are beneficial bacteria living in the gut and help to reduce the risk of POCD. However, the detailed mechanism is still not entirely known. Therefore, our research aims to uncover the effect and mechanism of probiotics in relieving POCD and to figure out the possible relationship between kynurenine metabolic pathway. 36 rats were grouped into three groups: sham operated group (S group, n = 12), Cardiopulmonary bypass group (CPB group, n = 12), and probiotics+CPB (P group, n = 12). After CPB model preparation, water maze test and Garcia score scale was performed to identify the neurological function. Immunofluorescence and Hematoxylin and eosin staining has been used for hippocampal neurons detection. Brain injury related proteins, oxidative stress factors, and inflammatory factors were detected using enzyme-linked immunosorbent assays (ELISA). Neuronal apoptosis was detected by TdT-mediated dUTP nick end-labeling (TUNEL) staining and western blot. High-performance liquid chromatography/mass spectrometry (HPLC/MS) was performed to detect the key factors of the kynurenine metabolic pathway. Our results demonstrated that probiotics improved neurological function of post-CPB rats. The administration of probiotics ameliorated memory and learning in spatial terms CPB rats (P < 0.05). Hematoxylin and eosin (H&E) staining data, S‐100β and neuron-specific enolase (NSE) data convinced that probiotics agonists reduced brain damage in CPB rats (P < 0.05). Moreover, probiotics regulated inflammatory factors, meanwhile attenuated hippocampal neuronal apoptosis. Probiotics alleviated POCD in rats with CPB through regulation of kynurenine metabolic signaling pathway.

Association between the gut microbiota and diabetic nephropathy: a two-sample Mendelian randomization study

Numerous studies have revealed a correlation between the risk of developing diabetic nephropathy (DN) and the gut microbiota (GM) composition. However, it remains uncertain whether the GM composition causes DN. We aimed to explore any potential causal links between the GM composition and the risk of developing DN. A meta-analysis conducted by the MiBioGen consortium of the largest genome-wide association study (GWAS) provided aggregated data on the GM. DN data were obtained from the IEU database. The inverse-variance weighting (IVW) method was employed as the primary analytical approach. The IVW analysis indicated that genus Dialister (OR = 0.51, 95% CI: 0.34–0.77, p = 0.00118) was protective against DN. In addition, class Gammaproteobacteria (OR = 0.47, 95% CI: 0.27–0.83, p = 0.0096), class Lentisphaeria (OR =0.76, 95% CI: 0.68–0.99, p = 0.04), order Victivallales (OR = 0.76, 95% CI: 0.58–0.99, p = 0.04), and phylum Proteobacteria (OR = 0.53, 95% CI: 0.33–0.85, p = 0.00872) were negatively associated with the risk of developing DN. Genus LachnospiraceaeUCG008 (OR =1.45, 95% CI: 1.08–1.95, p = 0.01), order Bacteroidales (OR = 1.59, 95% CI: 1.02–2.49, p = 0.04), and genus Terrisporobacter (OR = 1.98, 95% CI: 1.14–3.45, p = 0.015) were positively associated with the risk of developing DN. In this study, we established a causal relationship between the genus Dialister and the risk of developing DN. Further trials are required to confirm the protective effects of probiotics on DN and to elucidate the precise protective mechanisms involving genus Dialister and DN.