Probiotic Supplementation: A complete boon for inflammatory arthritis

CHINA: A recent study has proven the beneficial effect of probiotics in improvising eight forms of inflammatory arthritis, namely Hyperuricemia and gout, Inflammatory bowel disease arthritis, juvenile idiopathic arthritis [JIA], Osteoarthritis [OA], Osteoporosis and Osteopenia, Psoriasis, rheumatoid arthritis (RA), Spondyloarthritis.

The research was published in the Frontiers in Immunology.

Probiotics are live microorganisms that provide health benefits when used in adequate amounts. There is well-structured evidence of probiotic usage for immunomodulation.

Probiotics regulate intestinal inflammation and immune function, prevent increased intestinal permeability, reduce autoantibodies production and minimize the entry of pro-inflammatory immune cells. Probiotics can be used in arthritis intervention by inhibiting inflammatory factors and immunity regulation and may offer benefits in improving pain scores. There is a lack of summarised information on the effect of different probiotics on different types of arthritis. More concisely, there is a lack of summary clarifying the efficacy and Safety of probiotics in arthritis.

To summarise the scope of probiotics and add reference information to this clinical application, a study was conducted to evaluate the Safety and efficacy of probiotic supplementation in inflammatory arthritis.

The critical points of the study are:

• The study information on RCT of probiotic application in Hyperuricemia and gout was collected from databases like CNKI, Pubmed, Cochrane library, Embase, etc. (until May 2022).

• The quality evaluation was done using the Cochrane risk assessment tool, and the Rev Man5.3 software was used for meta-analysis.

• The final evaluation included eight types of autoimmune disease (Hyperuricemia and gout, Inflammatory bowel disease arthritis, juvenile idiopathic arthritis [JIA], Osteoarthritis [OA], Osteoporosis and Osteopenia, Psoriasis, rheumatoid arthritis (RA), Spondyloarthritis).

•  In 10 RCTs of 632 participants, the probiotic intervention reduced C-Reactive Protein in RA.

•  4 RCTs of 214 participants revealed that the probiotic intervention reduced Psoriasis Area and Severity Index (PASI) scores in Psoriasis.

• The probiotic intervention improved symptoms of Spondyloarthritis in 2 RCTs of 197 participants.

• The probiotic intervention improved bone mineral density in 10 RCTs of 1156 participants for Osteoporosis and Osteopenia.

• The probiotic intervention improved serum uric acid levels in 4 RCTs of 294 participants with Hyperuricemia and gout.

• In 1 RCT of 433 participants of OA, the intervention improved symptoms.

• JIA involving 2 RCTs of 72 participants showed that probiotic intervention improved symptoms in patients.

• In 1 RCT of 120 participants of Inflammatory bowel disease arthritis, the probiotic intervention improved symptoms.

• The incidence of adverse events does not increase with probiotics in all the RCTs.

Dr. Ying Dang, from the People's Hospital of Ningxiang City, added, " The strength of our study included the efficacy and Safety of probiotics on eight types of inflammatory arthritis for the first time. The results of our study help provide a clinical reference."

The researchers added, "More randomized controlled trials in the future are needed to determine the efficacy and optimal dosing design of probiotics."

Reference:

Zeng L, Deng Y, He Q, et al. Safety and efficacy of probiotic supplementation in 8 types of inflammatory arthritis: A systematic review and meta-analysis of 34 randomized controlled trials. Front Immunol. 2022;13:961325. Published 2022 Sep 23. doi:10.3389/fimmu.2022.961325