Is Probiotics Supplementation an Appropriate Strategy to Modulate Inflammation in Physically Active Healthy Adults or Athletes? A Systematic Review

Abstract

Supplementation with probiotics in sports is on the rise with the aim of improving health and athletic performance. Since intense exercise-induced muscle damage leads to an inflammatory process by increasing circulating inflammatory cytokines, probiotic supplementation may modulate and correct the inflammation. We systematically reviewed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the Scopus, Web of Science, and Medline databases for the 10 years until January 2023. This review aimed to evaluate probiotic supplementation as a strategy for modulating inflammation in healthy physically active adults or athletes. Studies were indexed to assess the effect of probiotic supplementation on cytokine behavior in the inflammatory response in physically active individuals. Of the 136 studies identified in the search, 13 met the inclusion criteria, and their quality was assessed using the McMaster Critical Review Form. The results of these trials indicated a significant improvement in inflammatory cytokines in probiotic-supplemented participants, with a significant increase in anti-inflammatory cytokines (IL-10) and a significant decrease in proinflammatory cytokines (IL-6, TNF-α, and IL-8). This would create uncertainty about probiotics’ effect on interleukins’ behavior after exercise, and further clinical trials are needed to establish a solid basis.

Influence of N-Acetylcysteine Supplementation on Physical Performance and Laboratory Biomarkers in Adult Males: A Systematic Review of Controlled Trials

“…However, TNF-α was significantly (p < 0.05) increased when comparing both groups (CG and IG) [23]. TNF-α is the early-response, pro-inflammatory after strenuous exercise [54]. The increase in the TNF-α-supplemented group could be related to muscle damage altering a transition phase between intracellular TNF-α production and release [23].…”

Impact of Melatonin Supplementation on Sports Performance and Circulating Biomarkers in Highly Trained Athletes: A Systematic Review of Randomized Controlled Trials

“…Melatonin modulates inflammation by inhibiting the activation of the NF-κB, JAK/STAT, and MAPK signaling pathways [85,86]. Interestingly, inhibition of the NF-κB pathway is the target of other sports supplements such as N-acetylcysteine [21], curcumin [20], probiotics [13], the antioxidants ascorbate (vitamin C), and α-tocopherol (vitamin E) [87], and Tribulus terrestris [88]. Thus, according to the results described in this systematic review, melatonin supplementation would modulate the inflammatory response in athletes through different protocols [41,42,55].…”

“…It has to be emphasized that the stress caused by intense training could progress to chronic and/or systemic inflammation if poor rest and inadequate recovery are wrongly scheduled post-exercise [12]. Additionally, the athlete's immune system can become functionally depressed as a result of extreme physical stress, as described in elite/professional sports [13,14]. In this context, sleep is a restorative element that improves performance as a result of optimal recovery of athletes [15].…”

Efficacy of Lactococcus lactis subsp. lactis LY-66 and Lactobacillus plantarum PL-02 in Enhancing Explosive Strength and Endurance: A Randomized, Double-Blinded Clinical Trial

“…During the initial phases of muscle damage, mechanical trauma triggers an acute inflammatory cascade, resulting in the release of pro-inflammatory cytokines such as interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-α), and IL-1β, alongside heightened levels of creatine kinase (CK) and myoglobin [ 10 , 11 ]. Beyond the acute inflammatory response, prolonged endurance exercise precipitates oxidative and metabolic stress, further exacerbating inflammation [ 12 , 13 ]. These physiological alterations result in a temporary decrease in muscle strength and performance.…”