The therapeutic effect of probiotics on rheumatoid arthritis: a systematic review and meta-analysis of randomized control trials

Abstract

Rheumatoid arthritis is an autoimmune disease in which probiotics appears to have an immune modulating action along with decreased inflammatory process. Therefore, we aim to investigate the efficacy of probiotics as an adjuvant therapy for rheumatoid arthritis. A comprehensive literature search was performed using nine databases including PubMed and Web of Science. Interesting data was extracted and meta-analyzed. We assessed the risk of bias using Cochrane Collaboration's tool. The protocol was registered in PROSPERO (CRD 42016036769). We found nine studies involving 361 patients who met our eligibility criteria. Our meta-analysis indicated that pro-inflammatory cytokine IL-6 was significantly lower in the probiotics compared with the placebo group (standardized mean difference = - 0.708; 95% confidence interval (CI) - 1.370 to 0.047, P = 0.036). However, there was no difference between probiotics and placebo in disease activity score (mean difference 0.023; 95% CI - 0.584 to 0.631, P = 0.940). Probiotics lowered pro-inflammatory cytokines IL-6 in RA; however, its clinical effect is still unclear. Hence, many high-quality randomized controlled trials (RCTs) are still needed to prove this effect.

Can dietary intervention be an auxiliary therapy for Rheumatoid Arthritis?

“…Compared with placebo, taking LGG capsules twice a day could remarkably reduce the number of tenderness and swollen joints in RA patients, but there was no significant difference in the levels of serum IL-6, TNF, IL-10 and IL-12 between the two groups [46]. A recent meta-analysis showed that probiotics supplementation reduced the expression of IL-6 in RA patients versus the placebo group, but there was no significant difference in disease activity between the two groups [47].…”

Probiotics for the Management of Rheumatoid Arthritis

“…RA is a specific type of arthritis which has a prevalence between 0.5 and 1% among adults worldwide, with greater prevalence among women. 8 It is an inflammatory autoimmune disease in which the immune system attacks healthy cells of the body to cause inflammation, pain, and eventually joint deformities. RA generally inflicts joints of the hands, wrists, and knees.…”

“…The experiments described in this paper have individually demonstrated a beneficial link between probiotic supplementation and RA. Mohammed et al 8 It was determined that probiotics significantly lowered pro-inflammatory cytokine IL-6. 8 There was no difference of DAS 28 between the probiotic and placebo groups.…”

“…Mohammed et al 8 It was determined that probiotics significantly lowered pro-inflammatory cytokine IL-6. 8 There was no difference of DAS 28 between the probiotic and placebo groups. The remaining outcome variables did not show a statistically significant difference.…”

Lactobacillus sakei suppresses collagen-induced arthritis and modulates the differentiation of T helper 17 cells and regulatory B cells

“…Therefore, controlling the gastrointestinal tract microbiome via oral administration of probiotics has therapeutic potential for RA. However, oral probiotics reportedly have minimal clinical e cacy in patients with RA [8]; notably, the prior study was limited by its small sample size and the use of various strains and quantities of probiotics. Few studies have demonstrated the therapeutic potential of probiotics in animal models of RA [9][10][11].…”