The Effect of Probiotic Supplementation on Inflammatory and Metabolic Response and Disease Activity in Patients with Systemic Lupus Erythematosus: A Randomized Placebo-controlled Trial

Summary Introduction Systemic lupus erythematosus (SLE) is a chronic multisystem inflammator autoimmune disease. Probiotic has potent immunomodulatory properties that support its use in the treatment of autoimmune conditions, including SLE. .This trial was performed to evaluate the effects of probiotic intake on inflammatory and metabolic condition and disease activity before and after Probiotic supplementation. Methods This randomized double-blind placebo-controlled clinical trial was conducted among 60 SLE patients. Participants were randomly allocated into two groups to receive either a probiotic capsule (n = 30) or placebo containing starch (n = 30) for 12 weeks. Outcome measures included assessment of alterations in levels of proinflammatory cytokines and metabolic condition, and improvement in disease activity before and after 12 months of supplementation. Disease activity was measured by the SLE Disease Activity Index. Results Compared with the placebo, probiotic intake improved the SLE Disease Activity Index (−0.3 ± 0.6 vs. +0.1 ± 0.3, P = 0.001and depression anxiety and stress scale (−16.5 ± 12.9 vs. −6.2 ± 11.0, P = 0.001). In addition, changes in high-sensitivity C-reactive protein (−1.3 ± 3.5 vs. +0.4 ± 1.4 μg/mL, P = 0.01), plasma nitric oxide metabolites (+1.0 ± 7.9 vs. −6.0 ± 8.3 μmol/L, P = 0.002) and malondialdehyde (MDA) (+0.009 ± 0.4 vs. +0.3 ± 0.5 μmol/L, P = 0.04) in the probiotic group were significantly different from the changes in these parameters in the placebo group. Additionally, the consumption of probiotic capsule significantly decreased serum insulin (−2.9 ± 3.7 vs. +1.1 ± 4.8 μIU/mL, P < 0.001), homeostasis model of assessment-estimated insulin resistance (−0.6 ± 0.8 vs.+0.2 ± 1.0, P = 0.001), Beta cell function (−12.1 ± 15.5 vs. +4.4 ± 17.5, P < 0.001) and total-/HDL-cholesterol (−0.1 ± 0.3 vs.0.1 ± 0.3, P = 0.02), and significantly increased quantitative insulin sensitivity check index (+0.01 ± 0.02 vs. −0.005 ± 0.01, P < 0.001) and HDL-cholesterol levels (2.7 ± 3.4 vs. 0.9 ± 2.9 mg/dL, P = 0.02) compared with the placebo. Conclusions Our study demonstrated that the use of probiotic capsule for 12 weeks among subjects with SLE had favorable effects on SLE Disease Activity Index, inflammatory and metabolic condition and show a tendency toward subsequent clinical improvement

کلیدواژه ها:

ystemic Lupus Erythematosus ، Probiotic ، Inflammatory and Metabolic Response ، Disease Activity ،