Multi-strain Probiotics Research Articles

Efficacy and safety of oral probiotic supplementation in mitigating postoperative surgical site infections in patients undergoing colorectal cancer surgery: A systematic review and meta-analysis.

Surgical site infections (SSIs) pose significant risks to patients undergoing colorectal cancer (CRC) surgery. With increasing evidence on the benefits of oral probiotics in various clinical contexts, there is a need to assess their efficacy and safety in reducing SSIs following CRC surgery. A systematic review and meta-analysis were conducted in line with PRISMA guidelines using the PICO framework. On 19 September 2023, four major databases (PubMed, Embase, Web of Science and Cochrane Library) were searched without any temporal or language restrictions. Rigorous inclusion and exclusion criteria were employed. Data extraction was independently undertaken by two assessors, and any discrepancies were discussed. The Cochrane Collaboration's risk of bias instrument was utilized to assess study quality. The meta-analysis incorporated a fixed-effects model or random-effects model based on the I2 statistic to assess heterogeneity. The initial search yielded 1282 articles, of which 10 met the inclusion criteria and were analysed. Probiotic administration not only significantly reduced the incidence of SSIs but also curtailed the duration of hospital stays. Moreover, the subgroup analysis indicated that interventions employing multiple strains of probiotics were more effective in reducing postoperative infections than those utilizing a single strain. Probiotics effectively prevent postoperative infections and shorten hospital stays. Multi-strain probiotics outperform single strain in efficacy. Future studies should focus on their safety and optimal clinical use.

Improving the utilization efficiency of nitrogen source through co-culture of Lactobacillus strains with different nitrogen source metabolisms

The growth of lactic acid bacteria depends largely on a sufficient source of nitrogen as well as a wide variety of nitrogen sources. Nutrient dependence, especially in relation to nitrogen sources, plays a key role in controlling the positive interactions between microorganisms. However, little is known regarding the relationship between co-culture and nitrogen source dependence in current studies. This study aimed to obtain a higher proliferation of strains with the same nitrogen source content by co-cultivation of Lactobacillus. First, upon the detection of various commercial nitrogen sources, notable differences in peptide molecular weight distributions were observed. In addition, diverse Lactobacillus strains exhibit varying proficiencies in utilizing these nitrogen sources. Second, in the exploration of co-cultivation of distinct bacterial strains, three synergistic combinations were identified. These assemblies exhibited superior total viable cell counts, growth trajectories, and glucose consumption. Finally, strains possessing capsular proteinase genes adeptly hydrolyzed large peptides, yielding smaller peptides and amino acids for strains lacking analogous enzymatic and peptide transport mechanisms. This culminated in optimized utilization of the nitrogen source and provided a method for the direct production of multi-strain probiotics.

Comparison of Bioconversion Ability and Biological Activities of Single and Multi-Strain Probiotics for an Active Molecule in Roasted Tartary Buckwheat

Comparison of Bioconversion Ability and Biological Activities of Single and Multi-Strain Probiotics for an Active Molecule in Roasted Tartary Buckwheat

Dietary effect of multi-strain prebiotics and probiotics on growth, hemato-biochemical parameters, intestinal histomorphometry, and resistance to hypoxia in juvenile tambaqui (Colossoma macropomum).

This study evaluated the effects of a multi-strain prebiotics and probiotics on the diet of tambaqui Colossoma macropomum. One hundred and fifty juvenile tambaqui (20.2 ± 3.6 g and 10.32 ± 5.78 cm) were randomly distributed in 15 experimental units with a volume of 80 L and fed for 45 days with a diet containing the symbiotic additive at five inclusion levels (0, 2, 4, 6 and 8 g kg feed- 1). At the end of the period, growth performance, survival, hemato-biochemical and intestinal parameters, as well as the fish's resistance to stress were evaluated. The additive did not alter the growth performance, hemato-biochemical and intestinal parameters of the tambaqui. However, the hemato-biochemical parameters of aspartate aminotransferase (AST), plasma protein, hematocrit, glucose, triglycerides and cholesterol showed differences between treatments after the stress challenge. AST increased significantly during challenge and post-challenge. Plasma protein increased significantly during and after the challenge. The hematocrit was highest at 48 h after the challenge and lowest in the 2 g, 6 g and 8 g groups. Glucose was significantly reduced 24 h after the challenge, while triglycerides were lower 24 h and 48 h after the challenge. Cholesterol increased significantly in the challenge. There was an interaction between the factors sampling time and symbiotic concentration for hematocrit and glucose. In hypoxic stress situations, the 2 g concentration was more favorable for the fish. We recommend further studies with 2 g kg feed- 1 in trials lasting more than 45 days.

Multi-species probiotics enhance survival, growth, intestinal microbiota and disease resistance of rohu (Labeo rohita) larvae

Multi-strain probiotics provide the most dependable approaches to improve health, immune response, and disease resistance in farmed fishes. In the present study, we examined the effects of multi-species probiotics on the survival, growth, immune response, and disease resistance of rohu (Labeo rohita) larvae. Newly hatched larvae from the day of first feeding (average weight of 0.003 ​g) were reared with multi-species probiotics having a combination of Bacillus subtilis (109 colony forming units (cfu)/mL) and Lactobacillus spp. (Lactobacillus plantarum, Lactobacillus buchneri - 1011 ​cfu/mL) in water containing doses of 0 (control-C), 0.5 ​mL/L (treatment 1-T1), and 1.0 ​mL/L (treatment 2-T2) in triplicates for 90 days. After the experiment, a challenge test was performed to assess the fish's resistance to pathogenic Aeromonas veronii. Significantly higher survival was recorded in larvae of treated groups (87% in T2 and 79% in T1) compared to the control (62%). Significantly higher growth performance (weight gain and specific growth rate—SGR) was shown by the probiotic-treated larval groups compared to the control. Probiotic supplementation resulted in significantly higher counts of total viable colony (TVC) and lactic acid bacteria (LAB) in the intestine. Some immunological parameters (mucosal fold fattening, goblet cell abundance, expansion of lamina propria and enterocytes) of the gut were significantly better in probiotic-treated fish. The liver of treated fish showed irregular shape nuclei turning into regular shape and reducing spaces between the hepatic cells. Probiotic-treated fish had the highest post-challenge survival rate (90%) against A. veronii infection. The erythrocytes of challenged fish treated with probiotics had significantly lower frequencies of various nuclear and cellular abnormalities. These findings suggest that multi-species probiotic supplements could improve the survival, growth, health status, and immune response of rohu in the early stages of its development.

Novel Multi-Strain E3 Probiotic Formulation Improved Mental Health Symptoms and Sleep Quality in Hong Kong Chinese.

Mental health issues have emerged as a significant concern in public health, given their association with physical and psychological comorbidities and the resultant socioeconomic burdens. Recent studies have highlighted the interplay between gut microbes and brain functions through the gut-brain axis. To investigate this further, we conducted a targeted 16S rRNA sequencing and comprehensive bioinformatic analysis among Southern Chinese individuals to explore the role of the gut microbiome in depression, anxiety, and sleep disturbance. We analyzed the differences in the gut microbiome profile of 68 participants with sleep disturbance and mood symptoms before and after an 8-week course of a novel oral E3 multi-strain probiotics formula. The results revealed a significant improvement in subjective sleep quality (PSQI: mean 8.79 at baseline vs. 7.10 at week 8, p < 0.001), depressive symptoms (PHQ9: mean 6.17 at baseline vs. 4.76 at week 8, p < 0.001), and anxious symptoms (GAD7: mean 4.90 at baseline vs. 3.76 at week 8, p < 0.001). Additionally, there were notable differences in beta diversity (weighted UniFrac; p = 0.045) and increased Firmicutes/Bacteroidetes (F/B) ratio (p = 4 × 10-4) were observed in the gut microbiome analysis. Furthermore, the relative abundance of Bifidobacterium bifidum (p < 0.001), Lactobacillus acidophilus (p < 0.001), Lactobacillus helveticus (p < 0.001) and Lactobacillus plantarum (p < 0.001) were significantly increased after the 8-week probiotic supplementation. Our study suggests that the gut microbial landscape varies between responders and non-responders at multiple levels, including genera, species, functional, and network interaction. Notably, the use of probiotics in populations with depressive or anxious symptoms and poor sleeping quality remodeled the gut microbiome and demonstrated improved mood and sleep quality.

Multi-strain probiotic improved feed conversion ratio and selected health indicators in Japanese quail*

Abstract Use of multi-strain probiotics in poultry nutrition provides advantages, including promoting microbial diversity in the birds’ gut. Less investigated, as compared to broilers, is how application of probiotics affects performance and health of Japanese quails. Up to date effects of either probiotics based on a single microorganism or using a single dose of probiotic were investigated. The aim of the study was to investigate the effect of gradual levels of multi-strain probiotic applied in the Japanese quails’ diet on their performance, carcass, microbiological and immunological parameters. Total of 240 Japanese quail mixed sex chicks were randomly selected into four treatments: 0.15, 0.10, 0.05 g/l of the probiotic and control group not provided with probiotic. Body weight gain (BWG), feed intake (FI), feed conversion ratio (FCR), carcass characteristics, selected gut microbiome species and sheep red blood cell (SRBC) immunoglobulin IgT, IgG and IgM antibodies were determined. Repeated measures ANOVA was performed on parameters related to productive performance of the birds, while one-way ANOVA on all other parameters using SAS software v 9.4. FI was the highest in the control group (16.84±2.19) and did not differ significantly between other groups (from 16.53±2.12 to 15.18±1.86). FCR was the highest in the control and the lowest dose group (3.15±0.28 and 3.07±0.27), as compared to two other groups of birds which received multi-strain probiotic (2.8±0.23 and 2.77±0.24, respectively). Birds in the control group and birds which received the lowest dose of the probiotic had lower counts of IgT (5.63±0.26 and 5.75±0.25, respectively) and IgG (4.00±0.38 and 4.13±0.3, respectively), as compared to two other treatment groups which received the multi-strain probiotic. Birds which did not receive the multi-strain probiotic had significantly lower levels of Lactobacillus (6.98±0.01), as compared to other birds, while those in the control group and which received lowest amount of probiotic had significantly higher levels of E.Coli (6.67±0.01). Multi-strain probiotic had overall positive effect on the selected parameters of Japanese quails’ performance and health, while efficacy varied depending on dosage.

Biosurfactant potential and antiviral activity of multistrain probiotics

The COVID-19 caused by the SARS-CoV-2 has become a great threat to humans. However, there is no recommendation for an effective and safe drug to treat the disease. The strategy developed in this study is to utilize biosurfactant potential activity of Lactobacillus spp. and Rhodopseudomonas palustris probiotics to prevent the virus from entering human body. The outer membrane of the virus is comprising of phospholipid compounds. Biosurfactants, are known to have detergent-like properties (able to dissolve lipids) that are safe for in vivo use. Thus, the biosurfactant potential activity of the multistrain probiotics extract is expected to be able to disrupt the phospholipid membrane, resulting in the inactivity of the virus to infect human body. The biosurfactant potential activity of the probiotics extract was evaluated using oil spreading, drop collapse, and emulsification methods. The virus infectivity was evaluated on the SARS-CoV-2 of delta variant as a virus model. The results indicated that the probiotics extract has biosurfactant potential activity, able to inhibit virus growth up to 99.9 % within 48 h in the prevention platform, and up to 99.6 % within 48 h in the treatment platform. Therefore, the multistrain probiotics extract was identified to have potential as a promising antiviral agent.

Effect of Supplementing a Bacillus Multi-Strain Probiotic to a Post-Weaning Diet on Nutrient Utilisation and Nitrogen Retention of Piglets

Probiotics are suggested to improve pig health, nutrient utilisation, performance, and they may reduce nitrogen (N) pollution. However, the effectivity of a single strain might be different from that of a multi-strain. The study was conducted to investigate the effect of a novel Bacillus multi-strain on nutrient digestibility, energy utilisation, and N retention in weaned piglets using an European diet. The experiment consisted of a control diet (CD) and a supplemented diet (SD). The probiotic used for SD consisted of B. amyloliquefaciens—516 and B. subtilis—541. A total of eight boars/treatment were weaned (day 0; 8.5 kg body weight). Only boars were used to ease the collection of urine. Until day 10, piglets were fed ad libitum and were housed in pairs; from day 11, piglets were fed semi ad libitum (feeding level 3.2× metabolic body weight) and were housed individually. From day 14, faecal and urine were collected twice daily. Piglets were humanely euthanised at day 19 (15.0 kg bodyweight) after which the jejunum, ileum, and colon content were collected. In faeces, the apparent total tract digestibility (ATTD) of, amongst others, DM, organic matter (OM), crude protein (CP), non-starch polysaccharides (NSP), and subsequently net energy (NE) were calculated using titanium dioxide as an indigestible marker. In the jejunum and ileum, the apparent digestibility of CP was estimated, and in the ileum, the apparent AA digestibility was measured. In urine, the N content was measured to determine N retention. The volatile fatty acid (VFA), branched-chain fatty acid (BCFA), and lactic acid content were analysed in the colon and faeces. The apparent CP digestibility in the jejunum and ileum was not affected by treatment (p &gt; 0.05), and no effect was observed on the apparent ileal digestibility of AA (p &gt; 0.05). Supplementation with the multi-strain probiotic improved the ATTD of DM (p = 0.01; +1.3%) and OM (p = 0.02; +1.2%) and tended to improve the ATTD of CP (p = 0.10; +2.2%) and NSP (p = 0.07; +1.9%). The multi-strain probiotic also improved the NE value (p = 0.02; +0.2 MJ/kg DM) and improved N retention (p = 0.05; +1.6%). Supplementation did not influence the VFA, BCFA, and lactic acid content in the faeces (p &gt; 0.05). However, in the colon, supplementation did influence the lactic acid content (lower; p = 0.01) and tended to influence the valeric acid content (higher; p = 0.09). In conclusion, results from the current study suggest that the multi-strain probiotic has the potential to contribute to improve nutrient efficiency in weaned piglets. More research needs to be conducted to identify the impact of the improved nutrient utilisation on gut health in post-weaned pigs as well as environmental pollution.

PSV-19 Supplementation of a Multi-Strain Probiotic Increases the Expression of Biomarkers of Immunity in Savannah X Spanish Goat Blood

Abstract Probiotics are considered a safe, non-chemical alternative to antibiotics and have been shown to boost the host immune response of livestock. The present study investigated the effect of Gut Candy (GC), a multi-strain probiotic supplementation, on immune gene expression in Spanish X Savannah goats. Seven adult female Spanish X Savannah goats (n = 7) received a daily dose (28 g) of a GC (containing Lactobacillus acidophilus, Enterococcus faecium, Bacillus subtilis, Propioni bacterium freudenreichii, and Aspergillus oryza) for 60 days. The control group received no probiotics (n = 7). Blood (10 mL) was collected aseptically from the jugular vein on days 0 and 60. Total RNA was extracted from whole blood, reverse transcribed to cDNA, and quantitative real-time PCR (RT-PCR) was performed using specific primers for TLR2, TLR4, TNF-α, IL1B, IL10, and MPO. The fold changes (FC) in relative gene abundance were analyzed using Livak's method. β-actin and GAPDH were used as internal controls and for normalization. Fold changes (FC) were considered significant at -2 ≥ FC ≥ 2. After 60 days of GC supplementation, there was an increase in fold change in relative gene abundance in IL10 (FC = 3.66), TNF-α (FC = 11.7), IL1β (FC = 19.59), TLR4 (FC = 5.09), and MPO (FC = 2.05). GC also tended to increase the FC of TLR 2(FC = 1.86). The results from the study demonstrate that probiotic supplementation modulates the expression of immune genes in goats. Incorporating probiotics supplementation into the feed regimen of livestock could be beneficial to the animals' health and overall performance.

Irritable bowel syndrome in children and intestinal microbiota: pathogenetic aspects and clinical guidelines

Irritable bowel syndrome (IBS) is one of the most common functional conditions among children and adults. At the basis of IBS, as well as other functional disorders of the digestive system, is the disorder of brain-gut-microbiota axis. In recent years, the latter has been given particular importance not only in post-infectious IBS, but also in classic stress-induced IBS. The intestinal microflora determines the state of the enteric nervous system, visceral sensitivity, intestinal motility. In addition, the intestinal microbiota interacts through the transmitters it produces with the central nervous system, which also affects intestinal motility and the state of the microflora. Updated guidelines for the diagnosis and treatment of IBS in children of the Russian Society of Pediatric Gastroenterologists, Hepatologists and Nutritionists in the treatment section include psychotherapeutic correction, diet therapy and drug therapy. Correctors of intestinal motility (trimebutine), probiotics and antispasmodics have proven effectiveness. The efficacy and safety of use in IBS in children Lactobacillus rhamnosus GG, L. acidophilus LA­5, B. infantis, B. animalis, L. plantarum, L. casei, L. bulgaricus, Bifidobacterium lactis BВ­12, B. breve, B. longum, S. thermophilus, Saccharomyces boulardii CNCM I­745. In this case, it is advisable to use multi-strain probiotics. Thus, the intestinal microbiota is directly involved in the pathogenesis of IBS, and the need for the use of probiotics as part of complex therapy is beyond doubt. Their effectiveness has been proven in many serious studies, which was the reason for their inclusion in practical recommendations for the treatment of IBS in children and adults.

Mono- or multistrain probiotics? Comparative clinical study of different therapeutic strategies for infantile colic

Introduction. The highest level of evidence for the treatment of colic in breastfed infants is with L. reuteri monoprobiotic therapy. Recently multistrain probiotics have been used to treat colic.Аim. Is to evaluate the effectiveness of various strategies for the treatment of infantile colic, including monoand multistrain probiotics.Materials and methods. A total of 110 infants aged 1–5 months with colic and 20 healthy infants were examined. The effectiveness of treatment was assessed in three groups of infants with colic: Group 1 consisting of 30 children who received BioGaia Probiotic drops for baby (L. reuteri); Group 2 consisting of 40 children who received Bac-Set Baby multistrain probiotic, and Group 3 consisting of 40 children who received symptomatic therapy. The estimated parameters included duration of crying, fecal levels of zonulin measured by ELISA assays, and gut microbiota composition.Results. Children with colic had longer crying duration compared to healthy children, higher levels of zonulin in the stool and differences in the microbiota. In group 2, colic relief occurred on average within 5 days, which is significantly faster than in groups 1 and 3 (10 and 12 days, respectively). In group 2, colic relief occurred in the majority of children (87.5%), the differences with groups 1 and 3 were statistically significant (53.3% and 10% of children, respectively). Also in group 2 there was a decrease in the level of zonulin by 41.4% from the initial level, in group 1 – by 40.1%, in group 3 – by 10.8%. Group 2 has also showed positive changes in the microbiota.Discussion. The results confirm the effectiveness of multistrain probiotics in the treatment of colic.Conclusions. Bac-Set Baby multistrain probiotic proved to be more effective than BioGaia Probiotic drops for baby monostrain probiotic and symptomatic therapy in the relief of infantile colic. The effect of Bac-Set Baby is associated with its ability to normalize the intestinal microbiota and reduce the permeability of the intestinal wall.

Role of multi-strain probiotics in preventing severity and frequency of recurrent respiratory tract infections in children

BackgroundRespiratory tract infections are among the most common infections in the pediatric population throughout the globe. Globally around 20% of all deaths in children below 5 years of age are secondary to acute respiratory infections, mostly pneumonia. Probiotics are live microorganisms that when administered in adequate amounts confer a health benefit on the host. Their mechanism in preventing respiratory tract infections is not known but it is thought that probiotics act by modulating the immune system. This study was conducted to find out whether using probiotics is effective in decreasing the severity and frequency of recurrent respiratory tract infections or not.MethodsA Quasi-experimental study was conducted at the Pediatric Medicine Department of Abbassi Shaheed Hospital Karachi during 2021–2022. The study was approved by the institutional ethical review committee i.e. advanced studies and research board (ASRB). The sampling technique was non-probability consecutive sampling and the sample size was 70 patients with recurrent respiratory tract infections, aged six months to 12 years of age. All enrolled children were given probiotics containing Bifidobacterium, Lactobacillus Acidophilus for two weeks. Data were analyzed by using SPSS version 22. A p-value of < 0.05 was considered statistically significant.ResultsOut of 70 children with recurrent respiratory tract infections, 39 (55.71%) were male and 31 (44.29%) female. Around 75% of the children were below five years of age. The most common presenting complaint was fever (72.86%), followed by cough (68.57%), wheezes (45.71%) and nasal discharge/sneezing (32.86%), respectively. The most common RRTI was infectious rhinitis (30% of the cases), otitis media (24%) and pharyngitis/tonsillitis (21%). After giving probiotics for two weeks most significant decrease was found in recurrent infectious rhinitis (p-value 0.02), recurrent otitis media (p-value 0.03) and recurrent bronchiolitis (p-value 0.05) over the next six months.ConclusionThe results of our study indicate that the administration of probiotics reduces recurrent respiratory tract infections among children. This six months trial has demonstrated that there was a significant decline in respiratory symptoms among study participants. This study also observed a significant decrease in respiratory diseases during the follow-up.

Clinical Trial: Probiotics in Metformin Intolerant Patients with Type 2 Diabetes (ProGasMet)

BackgroundFor decades, metformin has been the drug of first choice in the management of type 2 diabetes. However, approximately 2–13% of patients do not tolerate metformin due to gastrointestinal (GI) side effects. Since metformin influences the gut microbiota, we hypothesized that a multi-strain probiotics supplementation would mitigate the gastrointestinal symptoms associated with metformin usage. Methods and analysisThis randomized, double-blind, placebo-controlled, single-center, cross-over trial (ProGasMet study) assessed the efficacy of a multi-strain probiotic in 37 patients with metformin intolerance. Patients were randomly allocated (1:1) to receive probiotic (PRO-PLA) or placebo (PLA-PRO) at baseline and, after 12 weeks (period 1), they crossed-over to the other treatment arm (period 2). The primary outcome was the reduction of GI adverse events of metformin. Results37 out of 82 eligible patients were enrolled in the final analysis of whom 35 completed the 32 weeks study period and 2 patients resigned at visit 5. Regardless of the treatment arm allocation, while on probiotic supplementation, there was a significant reduction of incidence (for the probiotic period in PRO-PLA/PLA-PRO: P = 0.017/P = 0.054), quantity and severity of nausea (P = 0.016/P = 0.024), frequency (P = 0.009/P = 0.015) and severity (P = 0.019/P = 0.005) of abdominal bloating/pain as well as significant improvement in self-assessed tolerability of metformin (P < 0.01/P = 0.005). Moreover, there was significant reduction of incidence of diarrhea while on probiotic supplementation in PRO-PLA treatment arm (P = 0.036). ConclusionA multi-strain probiotic diminishes the incidence of gastrointestinal adverse effects in patients with type 2 diabetes and metformin intolerance.

Probiotics, Prebiotics, Lactoferrin, and Combination Products for Prevention of Mortality and Morbidity in Preterm Infants

Modulation of intestinal microbiome by administering probiotics, prebiotics, or both may prevent morbidity and mortality in premature infants. To assess the comparative effectiveness of alternative prophylactic strategies through a network meta-analysis (NMA) of randomized clinical trials. MEDLINE, EMBASE, Science Citation Index Expanded, CINAHL, Scopus, Cochrane CENTRAL, and Google Scholar from inception until May 10, 2023. Eligible trials tested probiotics, prebiotics, lactoferrin, and combination products for prevention of morbidity or mortality in preterm infants. A frequentist random-effects model was used for the NMA, and the certainty of evidence and inferences regarding relative effectiveness were assessed using the GRADE approach. All-cause mortality, severe necrotizing enterocolitis, culture-proven sepsis, feeding intolerance, time to reach full enteral feeding, and duration of hospitalization. A total of 106 trials involving 25 840 preterm infants were included. Only multiple-strain probiotics were associated with reduced all-cause mortality compared with placebo (risk ratio [RR], 0.69; 95% CI, 0.56 to 0.86; risk difference [RD], -1.7%; 95% CI, -2.4% to -0.8%). Multiple-strain probiotics alone (vs placebo: RR, 0.38; 95% CI, 0.30 to 0.50; RD, -3.7%; 95% CI, -4.1% to -2.9%) or in combination with oligosaccharides (vs placebo: RR, 0.13; 95% CI, 0.05 to 0.37; RD, -5.1%; 95% CI, -5.6% to -3.7%) were among the most effective interventions reducing severe necrotizing enterocolitis. Single-strain probiotics in combination with lactoferrin (vs placebo RR, 0.33; 95% CI, 0.14 to 0.78; RD, -10.7%; 95% CI, -13.7% to -3.5%) were the most effective intervention for reducing sepsis. Multiple-strain probiotics alone (RR, 0.61; 95% CI, 0.46 to 0.80; RD, -10.0%; 95% CI, -13.9% to -5.1%) or in combination with oligosaccharides (RR, 0.45; 95% CI, 0.29 to 0.67; RD, -14.1%; 95% CI, -18.3% to -8.5%) and single-strain probiotics (RR, 0.61; 95% CI, 0.51 to 0.72; RD, -10.0%; 95% CI, -12.6% to -7.2%) proved of best effectiveness in reduction of feeding intolerance vs placebo. Single-strain probiotics (MD, -1.94 days; 95% CI, -2.96 to -0.92) and multistrain probiotics (MD, -2.03 days; 95% CI, -3.04 to -1.02) proved the most effective in reducing the time to reach full enteral feeding compared with placebo. Only single-strain and multistrain probiotics were associated with greater effectiveness compared with placebo in reducing duration of hospitalization (MD, -3.31 days; 95% CI, -5.05 to -1.58; and MD, -2.20 days; 95% CI, -4.08 to -0.31, respectively). In this systematic review and NMA, moderate- to high-certainty evidence demonstrated an association between multistrain probiotics and reduction in all-cause mortality; these interventions were also associated with the best effectiveness for other key outcomes. Combination products, including single- and multiple-strain probiotics combined with prebiotics or lactoferrin, were associated with the largest reduction in morbidity and mortality.

The Different Ways Multi-Strain Probiotics with Different Ratios of Bifidobacterium and Lactobacillus Relieve Constipation Induced by Loperamide in Mice.

Constipation is currently one of the most common gastrointestinal disorders, and its causes are diverse. Multi-strain probiotics are often considered a more effective treatment than single-strain probiotics. In this study, a constipation model was constructed using loperamide hydrochloride to evaluate the ability of a multi-strain probiotic combination of four different ratios of Bifidobacterium and Lactobacillus to regulate intestinal flora, relieve constipation, and explore the initial mechanism in mice. After four weeks of probiotic intervention, BM1, BM2, and PB2 effectively relieved constipation; however, the pathways involved were different. The Bifidobacteria-dominated formulations BM1 and BM2 mainly changed the composition and structure of the intestinal flora and significantly decreased the relative abundance of Tyzzerella, Enterorhabdus, Faecalibaculum, Gordonibacter, and Mucispirillum in stool; increased the relative abundance of Parabacteroides and the content of short-chain fatty acids (SCFAs) in stool; restored motilin (MTL) and vasoactive intestinal peptide (VIP) levels; and downregulated interleukin 6 (IL-6) and IL-8 levels in serum. This repaired the inflammatory response caused by constipation. Finally, it promoted peristalsis of the gastrointestinal tract, increasing stool water content, and relieving constipation. While Lactobacillus-dominated formula PB2 mainly restored the levels of serum neurotransmitters (MTL, SP (substance P), VIP and PYY (Peptide YY)) and inflammatory factors (IL-1, IL-6 and IL-8), it significantly decreased the relative abundance of Tyzzerella, Enterorhabdus, Faecalibaculum, Gordonibacter and Mucispirillum in stool; it then increased acetic acid content, thereby reducing the level of inflammation and changing stool properties and gastrointestinal motility.

Probiotic for Pancreatic β-Cell Function in Type2 Diabetes: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trial.

Many clinical studies have proved the effectiveness of probiotics in metabolic disorders associated with insulin resistance. However, the impact of probiotic therapy on pancreatic β-cell function is ambiguous. The influence of probiotic supplementation vs. placebo on β-cell function in people with type2 diabetes (T2D) was assessed in a double-blind, single-center, randomized, placebo-controlled trial (RCT). Sixty-eight patients with T2D were selected for participation in the RCT. Patients were randomly allocated to consumption of live multistrain probiotics or a placebo for 8weeks, administered as a sachet formulation in double-blind treatment. The primary main outcome was the assessment of β-cell function as change in C-peptide and HOMA-β (homeostasis model assessment-estimated β-cell function), which was calculated using the HOMA2 calculator (Diabetes Trials Unit, University of Oxford). Secondary outcomes were the changes in glycemic control-related parameters, anthropomorphic variables, and cytokines levels. Analysis of covariance was used to assess the difference between groups. Supplementation with live multiprobiotic was associated with slight significant improvement of β-cell function (HOMA-β increased from 32.48 ± 13.12 to 45.71 ± 25.18; p = 0.003) and reduction of fasting glucose level (13.03 ± 3.46 vs 10.66 ± 2.63mmol/L and 234.63 ± 62.36 vs 192.07 ± 47.46mg/dL; p < 0.001) and HbA1c (8.86 ± 1.28 vs 8.48 ± 1.22; p = 0.043) as compared to placebo. Probiotic therapy significantly affects chronic systemic inflammation in people with T2D by reducing pro-inflammatory cytokine levels. Probiotic therapies modestly improved β-cell function in patients with T2D. Modulating the gut microbiota represents a new diabetes treatment and should be tested in more extensive studies. NCT05765292.

Efficacy of Probiotics in Improving Motor Function and Alleviating Constipation in Parkinson's Disease: A Randomized Controlled Trial.

Parkinson's disease (PD) is one of the common neurodegenerative diseases, and there has been an increasing interest in the potential role of intestinal dysbiosis in its pathogenesis and related gastrointestinal complications such as constipation. This study aims to evaluate the effects of multi-strain probiotics on constipation and motor function in PD patients. This study was a blinded, randomized controlled trial (RCT) that involved 27 PD patients who were diagnosed with constipation according to the ROME IV criteria for functional constipation. The primary outcome measured before and after the intervention in both the placebo and probiotic groups was the frequency of defecation. Secondary outcomes evaluated were laxative use, sense of complete evacuation, Bristol Stool Scale for consistency, and Unified Parkinson's Disease Rating Scale (UPDRS) scale. The study lasted for eight weeks. Both groups also were educated about lifestyle modification. Of 30 included patients (15 in each group), 13 were women, and 17 were men. Three patients dropped out of the study. Between-group analysis showed that the frequency of bowel movements significantly increased in the probiotic group 4 [3 - 5] in comparison with 2 [2 - 3] in placebo (P = 0.02). Stool consistency also improved in the probiotic group (P = 0.04). However, there were no significant differences in other outcomes. The within-group analysis showed improvement in stool consistency in both probiotics and placebo groups (P = 0.01 and P = 0.007, respectively), while stool frequency and sense of complete evacuation significantly improved only in the probiotic group (P < 0.05). This study demonstrated that multi-strain probiotics could improve frequency, consistency, and sense of complete evacuation in PD patients, while there was no significant effect on motor functions in 8 weeks. It is suggested that additional studies be conducted on longer-term effects.

A randomized controlled trial to examine the impact of a multi-strain probiotic on self-reported indicators of depression, anxiety, mood, and associated biomarkers.

To examine the efficacy of supplementing with a multi-strain probiotic (MSP) on changes associated with mood, anxiety, and neurotransmitter levels. In a randomized, double-blind, placebo-controlled fashion, 70 healthy men and women (31.0 ± 9.5 years, 173.0 ± 10.4 cm, 73.9 ± 13.8 kg, 24.6 ± 3.5 kg/m2) supplemented with a single capsule of MSP (a total daily dose of 4 × 109 colony forming units [CFU] comprised of a 1 × 109 CFU dose from each of the following strains: Limosilactobacillus fermentum LF16, Lacticaseibacillus rhamnosus LR06, Lactiplantibacillus plantarum LP01, and Bifidobacterium longum 04, Probiotical S.p.A., Novara, Italy) or a maltodextrin placebo (PLA). After 0, 2, 4, and 6 weeks of supplementation and 3 weeks after ceasing supplementation, study participants completed the Beck Depression Inventory (BDI-II), State-Trait Anxiety Inventory (STAI), and Leiden Index of Depression Sensitivity (LEIDS-R) questionnaires and had plasma concentrations of cortisol, dopamine, serotonin, and C-reactive protein determined. BDI, STAI, and total LEIDS-R scores were reduced from baseline (p < 0.05) with MSP supplementation after 4 and 6 weeks of supplementation and 3 weeks after supplementation while no changes (p > 0.05) were reported in PLA. When compared to PLA, MSP scores for state anxiety, trait anxiety, and LEIDS-R (hopeless, aggression, rumination, and total score) were significantly lower (p < 0.05) after supplementation. Plasma serotonin concentrations in MSP were increased from baseline after 6 weeks of supplementation and 3 weeks after ceasing supplementation. No changes (p > 0.05) in plasma dopamine, C-reactive protein, or cortisol concentrations were observed between groups. MSP supplementation resulted in widespread improvements in several questionnaires evaluating mood, anxiety, and depression in young, healthy men and women. MSP supplementation increased serotonin increased after 6 weeks of MSP supplementation with no change in dopamine, C-reactive protein, or cortisol. https://classic.clinicaltrials.gov/ct2/show/NCT05343533, NCT05343533.

Effect of multi-strain probiotics on the growth, hematological profile, blood biochemistry, antioxidant capacity, and physiological responses of Clarias batrachus fingerlings

Effect of multi-strain probiotics on the growth, hematological profile, blood biochemistry, antioxidant capacity, and physiological responses of Clarias batrachus fingerlings