Probiotics′ Effects on Depression, High-Sensitivity C-Reactive Protein (hs-CRP), and Oxidative Stress in Patients With Multiple Sclerosis: A Meta-Analysis

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL International Journal of Clinical Practice Pub Date : 2025-03-30 DOI:10.1155/ijcp/3754973

Seyed-Amir Tabatabaeizadeh, Niayesh Tafazoli

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Abstract

Objectives: Major depressive disorder (MDD) is highly prevalent in patients with multiple sclerosis (MS). There is evidence that the gut microbiota affect the inflammatory responses and oxidative status in MS and may affect depression signs and symptoms in these patients. Based on this fact, this updated meta-analysis assessed the effect of probiotic supplementation on the Beck Depression Inventory (BDI), high-sensitivity C-reactive protein (hs-CRP), total antioxidant capacity (TAC), and malondialdehyde (MDA) in patients with MS.

Methods: A systematic literature search was done for English literature through PubMed/Medline, Cochrane Library, Google Scholar, and ScienceDirect from 1 January 2011 to 1 June 2024. This study followed the PRISMA guidelines. Based on the heterogeneity, the random-effects or fixed-effects models were used in the present meta-analysis.

Results: After checking for eligibility, four RCTs were included in the final analysis. There was an improvement in BDI-II score, hs-CRP level, MDA, and TAC in patients with MS (BDI-II score: MD = −2.78; 95% CI, −3.32 to −2.24; Z = 10.09; p < 0.00001; I² = 57%; p = 0.1; hs-CRP level: MD = −1.69; 95% CI, −1.98 to −1.40; Z = 11.38; p < 0.00001; I² = 0%; p = 0.96; MDA: MD = −0.37; 95% CI, −0.52 to −0.23; Z = 5.00; p < 0.00001; I² = 90%; p < 0.0001; and TAC: MD = 5.48; 95% CI, −6.71 to 17.66; Z = 0.88; p = 0.38; I² = 93%; p < 0.00001).

Conclusion: This meta-analysis suggests that probiotic supplementation has improved BDI scores and inflammatory and oxidative status. This finding promises that probiotic supplementation can be considered as a therapeutic option for depression symptoms and inflammatory status in patients with MS. However, more interventional studies are required to assess the complex relationship between MS, depression, and the gut microbiome. PROSPERO Registration ID: CRD42024552648.

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益生菌对多发性硬化症患者抑郁、高敏c反应蛋白（hs-CRP）和氧化应激的影响：一项荟萃分析

目的：重度抑郁障碍（MDD）在多发性硬化症（MS）患者中非常普遍。有证据表明，肠道微生物群影响MS的炎症反应和氧化状态，并可能影响这些患者的抑郁体征和症状。基于这一事实，本更新的荟萃分析评估了益生菌补充对ms患者贝克抑郁量表（BDI）、高敏c反应蛋白（hs-CRP）、总抗氧化能力（TAC）和丙二醛（MDA）的影响。方法：从2011年1月1日至2024年6月1日，通过PubMed/Medline、Cochrane图书馆、谷歌Scholar和ScienceDirect进行系统文献检索。本研究遵循PRISMA指南。基于异质性，本meta分析采用随机效应或固定效应模型。结果：经合格性检查，4项rct纳入最终分析。MS患者BDI-II评分、hs-CRP水平、MDA和TAC均有改善(BDI-II评分：MD = - 2.78；95% CI,−3.32 ~−2.24；z = 10.09；p & lt;0.00001;i2 = 57%；P = 0.1；hs-CRP水平：MD =−1.69；95% CI,−1.98 ~−1.40；z = 11.38；p & lt;0.00001;i2 = 0%；P = 0.96；Mda: md =−0.37；95% CI,−0.52 ~−0.23；z = 5.00；p & lt;0.00001;i2 = 90%；p & lt;0.0001;和TAC: MD = 5.48；95% CI,−6.71 ~ 17.66；z = 0.88；P = 0.38；i2 = 93%；p & lt;0.00001)。结论：这项荟萃分析表明，补充益生菌可以改善BDI评分和炎症和氧化状态。这一发现表明，补充益生菌可以作为多发性硬化症患者抑郁症状和炎症状态的治疗选择。然而，需要更多的介入性研究来评估多发性硬化症、抑郁症和肠道微生物组之间的复杂关系。普洛斯彼罗注册ID: CRD42024552648。

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来源期刊

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.