Effect of probiotics on the maintenance of intestinal homeostasis after chemotherapy: systematic review and meta-analysis of pre-clinical studies

Abstract

Gastrointestinal mucositis (GIM) is an inflammation caused by antitumor therapy, especially after chemotherapy and radiotherapy. Currently in the clinical practice, only palliative measures are taken to treat GIM, representing the main clinical limitation in the management of this condition. Several studies have highlighted the potential benefits of probiotics for the management of GIM, but the actual role of these microorganisms in the maintenance of intestinal homeostasis remains elusive. In this context, here we aimed to realise a systematic review with meta-analysis to evaluate the effect of probiotics on experimental GIM. The meta-analysis showed that probiotics significantly suppressed the body weight loss related to GIM in rodents (95% confidence interval (CI): -2.67 to -0.70; I2=98%, P<0.00). Subgroup analysis showed that pre-treatment (≥7 days before chemotherapy) (95% CI: -8.84 to -0.17; I2=98%, P<0.04) with a high dose of probiotics (≥ 109 cfu/day) (95% CI: -2.58 to -0.28; I2=98%, P<0.00) comprising two or more microorganism species (95% CI: -6.49 to -0.28; I2=96%, P=0.03) remedied GIM more effectively. It was also revealed that fungi (specifically Saccharomyces boullardii) are more effective in remedying GIM than bacteria (P=0.03 vs P<0.00), and the mouse models are more receptive than rats to the enteroprotective effects of probiotics (95% CI: -4.76, -0.69; I2=97%, P=0.01). Qualitative analyses highlighted that probiotics suppress GIM through several mechanisms; they reduce the intestinal permeability, suppress the pro-inflammatory cytokine production while stimulating production and secretion of anti-inflammatory cytokines, inhibit the signalling pathways coupled to inflammation and apoptosis, accelerate the proliferation of enterocytes, reduce the levels of reactive oxygen species, and help maintain the protective mucus layer. In conclusion, this review highlights the therapeutic benefits of probiotics in experimental GIM.

Moxibustion treatment increases the survival rate of lung infection of patients bed-ridden due to osteoporotic fracture of the spine via regulation of the inflammatory responses

“…According to Tourkochristou et al, upon the activation of P r e p r i n t NLRP3, apoptosis-associated speck-like protein (ASC) could trigger the activation of caspase-1, which helps to produce mature IL-1β and IL-18 and induce chronic intestinal inflammation (21)(22)(23). Also, it was found that the continuous between the harmful gut bacteria and the pathogenassociated molecular patterns will accelerate the activation of NLRP3 inflammasome, which results in severer inflammatory reactions by the subsequent upregulation of the downstream pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β) and interleukin-18 (IL-18), thereby further aggravating the inflammatory reaction (24,25). Accordingly, compared with the MOX (-) patient group, we found that moxibustion in the MOX (+) patient group not only suppressed the expression of NLRP3, but also inhibited expression of pro-inflammatory factors such as TNF-α, IL-1β, IL-6 and IL-18 while promoting the level of IL-10.…”

Effectiveness of supplementation with quercetin‐type flavonols for treatment of viral lower respiratory tract infections: Systematic review and meta‐analysis of preclinical studies

“…After a full analytical reading, all data of interest were summarized in Table 1 for further analysis and interpretation. Furthermore, the data regarding mortality rate and viral load in the lung of mice with virus‐induced lower respiratory tract infection treated or not with quercetin and its derivatives were pooled to estimate the mean difference and the confidence intervals by meta‐analysis using Review Manager (RevMan)® 5.3 software (Lima et al, 2020b). All pooled data were estimated using a random effect model (Lima, Silva Alves, Sanches, Antunes Fernandes, & de Paiva, 2019; Lima, Souza, Fernandes, Cardoso, & Godói, 2019).…”

Jelleine, a Family of Peptides Isolated from the Royal Jelly of the Honey Bees (Apis mellifera), as a Promising Prototype for New Medicines: A Narrative Review

“…Furthermore, the combination has little effect on probiotic bacteria ( Lactobacillus plantarum , Lactobacillus Paracasei , Bifidus animalis ), whereas gentamycin kills all of them [ 29 ]. This effect is relevant because many of the adverse drug reactions are related to their activity on the gut microbiota, which can lead to diarrhea, nausea, vomiting and even chronic changes in the gut mucosa [ 103 ].…”