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Studies investigating the effects of spirulina on inflammation and oxidative stress status are controversial. Therefore, the current systematic review and meta‐analysis aimed to evaluate the impacts of spirulina supplementation on oxidative stress indicators and inflammatory markers. PubMed‐Medline, SCOPUS, Web of Science, Embase databases and Google Scholar were searched up to 1 October 2020. Random‐effect analysis was applied to perform meta‐analysis. Subgroup analyses and multivariate meta‐regression were performed to find heterogeneity sources. Quality assessment was conducted using Cochrane Collaboration’s tool. A total of 11 studies that enrolled 465 subjects were included in our meta‐analysis. Pooled results demonstrated a significant increase in interleukin‐2 (IL‐2) concentrations [Standardized mean difference (SMD = 2.69 pg/mL; 95% CI: 0.26, 5.11; P = .03)]; however this result changed to insignificant (SMD = 0.54 pg/mL; 95% CI: −1.29, 2.27; P > .05) when sensitivity analysis performed. A marginal decreasing effect were also found on interleukin‐6 (IL‐6) (SMD = −0.72 mg/dL; 95% CI: −1.50, 0.07; P = .073) and thiobarbituric acid reactive substances (TBARS) levels (SMD = −0.65; 95% CI: −1.37, 0.08; P = .08). In addition, results of subgroup analysis revealed a significant reduction in IL‐6 and TBARS concentrations when the baseline body mass index (BMI) of participants was lower than 25 kg/m2. Moreover, spirulina had no significant effect on tumour necrosis factor‐α (TNF‐α) (SMD = −0.07 mg/dL; 95% CI: −0.33, 0.18; P = .56) and malondialdehyde (MDA) concentrations (SMD = −0.42; 95% CI: −0.98, 0.14; P = .14). Spirulina consumption contributed to a significant increase in IL‐2 concentrations changing to insignificant after sensitivity analysis and marginal decreasing effects on IL‐6 and TBARS levels. No considerable impacts were observed on TNF‐α and MDA concentrations.

Background. T2DM may cause increased levels of oxidative stress and cardiac apoptosis through elevated blood glucose. The present study investigated the effects of Lactobacillus plantarum (L. plantarum) as a probiotic strain and inulin as a prebiotic supplement on cardiac oxidative stress and apoptotic markers in type 2 diabetes mellitus (T2DM) rats. Methods. A high-fat diet and a low dose of streptozotocin were used to induce type 2 diabetes. The rats were divided into six groups which were supplemented with L. plantarum, inulin, or their combination for 8 weeks. Results. The results showed improved activity of cardiac antioxidant parameters including total antioxidant capacity (TAC), superoxide dismutase (SOD), and glutathione peroxidase (GPx) (P<0.001, P<0.01, and P<0.01, respectively) and decreased level of cardiac malondialdehyde (MDA) concentration (P<0.05). These changes were accompanied with increased protein expression of cardiac obesity receptor (Ob-R) (P=0.05) and reduced apoptotic markers such as tumor necrosis factor-alpha (TNF-α), Fas ligand (FasL), and caspase proteins (P<0.001, P=0.003, and P<0.01, respectively) in T2DM rats after concurrent L. plantarum and inulin supplementation. Moreover, a remarkable correlation of cardiac Ob-R and oxidative stress parameters with cardiac apoptotic markers was observed (P<0.01). Conclusion. The concurrent use of L. plantarum and inulin seems to be beneficial, as they can lead to decreased heart complications of T2DM via reducing cardiac apoptotic markers.

Background: Spirulina, a type of blue-green algae, is used as an adjuvant treatment of metabolic and inflammatory diseases. Evidence about the effects of spirulina on antioxidant system are conflicting. Thus, this quantitative review aimed to summarise the effects of spirulina administration on antioxidant status biomarkers.Methods: Systematic searches were conducted using the PubMed/Medline, Scopus, Web of Science and EMBASE, up to May 2021. Random effect analysis was applied to perform meta-analysis. Subgroup analyses and multivariate meta-regression were performed to find heterogeneity sources. Quality assessment was conducted using Cochrane Collaboration's tool. Trim and fill analysis were also carried out in case of the presence of publication bias.Results: A total of nine articles that enrolled 415 subjects were included in the present meta-analysis. Obtained findings exhibited that spirulina supplementation had marginal significant effect on total antioxidant capacity (TAC)