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Published in: Journal of Translational Medicine 1/2017

Open Access 01-12-2017 | Research

Effects of a multi-strain probiotic supplement for 12 weeks in circulating endotoxin levels and cardiometabolic profiles of medication naïve T2DM patients: a randomized clinical trial

Authors: Shaun Sabico, Ayah Al-Mashharawi, Nasser M. Al-Daghri, Sobhy Yakout, Abdullah M. Alnaami, Majed S. Alokail, Philip G. McTernan

Published in: Journal of Translational Medicine | Issue 1/2017

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Abstract

Background

The present randomized clinical trial characterized the beneficial effects of a multi-strain probiotics supplementation on improving circulating endotoxin levels (primary endpoint) and other cardiometabolic biomarkers (secondary endpoint) in patients with T2DM.

Methods

A total of 78 adult Saudi T2DM patients (naïve and without co-morbidities) participated in this clinical trial and were randomized to receive twice daily placebo or probiotics [(2.5 × 109 cfu/g) containing the following bacterial strains: Bifidobacterium bifidum W23, Bifidobacterium lactis W52, Lactobacillus acidophilus W37, Lactobacillus brevis W63, Lactobacillus casei W56, Lactobacillus salivarius W24, Lactococcus lactis W19 and Lactococcus lactis W58 (Ecologic®Barrier)] in a double-blind manner for 12 weeks. Anthropometrics and cardiometabolic profiles were obtained at baseline and after 12/13 weeks of treatment.

Results

After 12/13 weeks of intervention and using intention-to-treat analysis, no difference was noted in endotoxin levels between groups [Placebo − 9.5% vs. Probiotics − 52.2%; (CI − 0.05 to 0.36; p = 0.15)]. Compared with the placebo group however, participants in the probiotics groups had a significant but modest improvement in WHR [Placebo 0.0% vs. Probiotics 1.11%; (CI − 0.12 to − 0.01; p = 0.02)] as well as a clinically significant improvement in HOMA-IR [Placebo − 12.2% vs. Probiotics − 60.4%; (CI − 0.34 to − 0.01; p = 0.04)].

Conclusion

Using a multi-strain probiotic supplement daily for 12/13 weeks significantly improved HOMA-IR and modestly reduced abdominal adiposity among medication naïve T2DM patients.
Trial Registration: ClinicalTrials.gov Identifier: NCT01765517, Registered January 10, 2013
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Literature
1.
go back to reference Backhed F, Ley RE, Sonnenburg JL, Peterson DA, Gordon JI. Host-bacterial mutualism in the human intestine. Science. 2005;307:1915–20.CrossRefPubMed Backhed F, Ley RE, Sonnenburg JL, Peterson DA, Gordon JI. Host-bacterial mutualism in the human intestine. Science. 2005;307:1915–20.CrossRefPubMed
2.
go back to reference Harte AL, da Silva NF, Creely SJ, McGee KC, Billyard T, Youssef-Elabd EM, Tripathi G, Ashour E, Abdalla MS, Sharada HM, Amin AI, Burt AD, Kumar S, Day CP, McTernan PG. Elevated endotoxin levels in non-alcoholic fatty liver disease. J Inflamm (Lond). 2010;30:7–15. Harte AL, da Silva NF, Creely SJ, McGee KC, Billyard T, Youssef-Elabd EM, Tripathi G, Ashour E, Abdalla MS, Sharada HM, Amin AI, Burt AD, Kumar S, Day CP, McTernan PG. Elevated endotoxin levels in non-alcoholic fatty liver disease. J Inflamm (Lond). 2010;30:7–15.
3.
go back to reference Creely SJ, McTernan PG, Kusminski CM, Fisher M, Da Silva NF, Khanolkar M, Evans M, Harte AL, Kumar S. Lipopolysaccharide activates an innate immune system response in human adipose tissue in obesity and type 2 diabetes. Am J Physiol Endocrinol Metab. 2007;292:E740–7.CrossRefPubMed Creely SJ, McTernan PG, Kusminski CM, Fisher M, Da Silva NF, Khanolkar M, Evans M, Harte AL, Kumar S. Lipopolysaccharide activates an innate immune system response in human adipose tissue in obesity and type 2 diabetes. Am J Physiol Endocrinol Metab. 2007;292:E740–7.CrossRefPubMed
4.
go back to reference Brunkwall L, Orho-Melander M. The gut microbiome as a target for prevention and treatment of hyperglycaemia in type 2 diabetes: from current human evidence to future possibilities. Diabetologia. 2017;60:943–51.CrossRefPubMedPubMedCentral Brunkwall L, Orho-Melander M. The gut microbiome as a target for prevention and treatment of hyperglycaemia in type 2 diabetes: from current human evidence to future possibilities. Diabetologia. 2017;60:943–51.CrossRefPubMedPubMedCentral
5.
go back to reference Singh RK, Chang HW, Yan D, Lee KM, Ucmak D, Wong K, Abrouk M, Farahnik B, Nakamura M, Zhu TH, Bhutani T, Liao W. Influence of diet on the gut microbiome and implications for human health. J Transl Med. 2017;15:73.CrossRefPubMedPubMedCentral Singh RK, Chang HW, Yan D, Lee KM, Ucmak D, Wong K, Abrouk M, Farahnik B, Nakamura M, Zhu TH, Bhutani T, Liao W. Influence of diet on the gut microbiome and implications for human health. J Transl Med. 2017;15:73.CrossRefPubMedPubMedCentral
6.
go back to reference Alokail MS, Sabico S, Al-Saleh Y, Al-Daghri NM, Alkharfy KM, Vanhoutte PM, McTernan PG. Effects of probiotics in patients with diabetes mellitus type 2: study protocol for a randomized, double-blind, placebo-controlled trial. Trials. 2013;14:95.CrossRef Alokail MS, Sabico S, Al-Saleh Y, Al-Daghri NM, Alkharfy KM, Vanhoutte PM, McTernan PG. Effects of probiotics in patients with diabetes mellitus type 2: study protocol for a randomized, double-blind, placebo-controlled trial. Trials. 2013;14:95.CrossRef
7.
go back to reference Gomes JM, Costa JA, Alfenas RC. Metabolic endotoxemia and diabetes mellitus: a systemic review. Metabolism. 2017;68:133–44.CrossRefPubMed Gomes JM, Costa JA, Alfenas RC. Metabolic endotoxemia and diabetes mellitus: a systemic review. Metabolism. 2017;68:133–44.CrossRefPubMed
8.
go back to reference Brun P, Castigaliuolo I, Leo VD, Buda A, Pinzani M, Palu G, Martines D. Increased intestinal permeability in obese mice: new evidence in the pathogenesis of nonalcoholic steatohepatitis. Am J Physiol Gastrointest Liver Physiol. 2007;292:G518–25.CrossRefPubMed Brun P, Castigaliuolo I, Leo VD, Buda A, Pinzani M, Palu G, Martines D. Increased intestinal permeability in obese mice: new evidence in the pathogenesis of nonalcoholic steatohepatitis. Am J Physiol Gastrointest Liver Physiol. 2007;292:G518–25.CrossRefPubMed
9.
go back to reference Le Barz M, Anhe FF, Varin TC, Desjardins Y, Levy E, Roy D, Urdaci MC, Marette A. Probiotics as complementary treatment for metabolic disorders. Diabetes Metab J. 2015;39:291–303.CrossRefPubMedPubMedCentral Le Barz M, Anhe FF, Varin TC, Desjardins Y, Levy E, Roy D, Urdaci MC, Marette A. Probiotics as complementary treatment for metabolic disorders. Diabetes Metab J. 2015;39:291–303.CrossRefPubMedPubMedCentral
10.
go back to reference Hu YM, Zhou F, Yuan Y, Xu YC. Effects of probiotics supplement in patients with type 2 diabetes mellitus: a meta-analysis of randomized trials. Med Clin (Barc). 2017;148:362–70.CrossRefPubMed Hu YM, Zhou F, Yuan Y, Xu YC. Effects of probiotics supplement in patients with type 2 diabetes mellitus: a meta-analysis of randomized trials. Med Clin (Barc). 2017;148:362–70.CrossRefPubMed
11.
go back to reference Gomes AC, de Sousa RG, Botelho PB, Gomes TL, Prada PO, Mota JF. The additional effects of a probiotic mix on abdominal adiposity and antioxidant status. A double-blind, randomized trial. Obesity (Silver Spring). 2017;25:30–8.CrossRef Gomes AC, de Sousa RG, Botelho PB, Gomes TL, Prada PO, Mota JF. The additional effects of a probiotic mix on abdominal adiposity and antioxidant status. A double-blind, randomized trial. Obesity (Silver Spring). 2017;25:30–8.CrossRef
12.
go back to reference Karamali M, Dadkhah F, Sadrkhanlou M, Jamilian M, Ahmadi S, Tajabadi-Ebrahimi M, Jafari P, Asemi Z. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab. 2016;42:234–41.CrossRefPubMed Karamali M, Dadkhah F, Sadrkhanlou M, Jamilian M, Ahmadi S, Tajabadi-Ebrahimi M, Jafari P, Asemi Z. Effects of probiotic supplementation on glycaemic control and lipid profiles in gestational diabetes: a randomized, double-blind, placebo-controlled trial. Diabetes Metab. 2016;42:234–41.CrossRefPubMed
13.
14.
go back to reference Takiishi T, Cook DP, Korf H, Sebastiani G, Mancarella F, Cunha JP, Wasserfall C, Casares N, Lasarte JJ, Steidler L, Rottiers P, Dotta F, Gysemans C, Mathieu C. Reversal of diabetes in NOD mice bu clinical-grade pro-insulin and IL-10 secreting Lactococcus lactis in combination with low-dose anti-CD3 depends on the induction of Foxp3-positive T cells. Diabetes. 2017;66:448–59.CrossRefPubMed Takiishi T, Cook DP, Korf H, Sebastiani G, Mancarella F, Cunha JP, Wasserfall C, Casares N, Lasarte JJ, Steidler L, Rottiers P, Dotta F, Gysemans C, Mathieu C. Reversal of diabetes in NOD mice bu clinical-grade pro-insulin and IL-10 secreting Lactococcus lactis in combination with low-dose anti-CD3 depends on the induction of Foxp3-positive T cells. Diabetes. 2017;66:448–59.CrossRefPubMed
15.
go back to reference Chung PH, Wu YY, Chen PH, Fung CP, Hsu CM, Chen LW. Lactobacillus salivarius reverse diabetes-induced intestinal defense impairment in mice through non-defensin protein. J Nutr Biochem. 2016;35:48–57.CrossRefPubMed Chung PH, Wu YY, Chen PH, Fung CP, Hsu CM, Chen LW. Lactobacillus salivarius reverse diabetes-induced intestinal defense impairment in mice through non-defensin protein. J Nutr Biochem. 2016;35:48–57.CrossRefPubMed
16.
go back to reference Lindsay KL, Brennan L, Kennelly MA, Maguire OC, Smith T, Curran S, Coffey M, Foley ME, Hatunic M, Shanahan F, McAuliffe FM. Impact of probiotics in women with gestational diabetes mellitus on metabolic health: a randomized controlled trial. Am J Obstet Gynecol. 2015;212:496.e1–11.CrossRef Lindsay KL, Brennan L, Kennelly MA, Maguire OC, Smith T, Curran S, Coffey M, Foley ME, Hatunic M, Shanahan F, McAuliffe FM. Impact of probiotics in women with gestational diabetes mellitus on metabolic health: a randomized controlled trial. Am J Obstet Gynecol. 2015;212:496.e1–11.CrossRef
17.
go back to reference Firouzi S, Majid HA, Ismail A, Kamaruddin NA, Barakatun-Nisak MY. Effect of multi-strain probiotics (multi-strain microbial cell preparation) on glycemic control and other diabetes-related outcomes in people with type 2 diabetes: a randomized controlled trial. Eur J Nutr. 2017;56:1535–50.CrossRefPubMed Firouzi S, Majid HA, Ismail A, Kamaruddin NA, Barakatun-Nisak MY. Effect of multi-strain probiotics (multi-strain microbial cell preparation) on glycemic control and other diabetes-related outcomes in people with type 2 diabetes: a randomized controlled trial. Eur J Nutr. 2017;56:1535–50.CrossRefPubMed
18.
go back to reference Park S, Bae JH. Probiotics for weight loss: a systematic review and meta-analysis. Nutr Res. 2015;35:566–75.CrossRefPubMed Park S, Bae JH. Probiotics for weight loss: a systematic review and meta-analysis. Nutr Res. 2015;35:566–75.CrossRefPubMed
19.
go back to reference Yap WB, Ahmad FM, Lim YC, Zainalabidin S. Lactobacillus casei strain C1 attenuates vascular changes in spontaneously hypertensive rats. Korean J Physiol Pharmacol. 2016;20:621–8.CrossRefPubMedPubMedCentral Yap WB, Ahmad FM, Lim YC, Zainalabidin S. Lactobacillus casei strain C1 attenuates vascular changes in spontaneously hypertensive rats. Korean J Physiol Pharmacol. 2016;20:621–8.CrossRefPubMedPubMedCentral
20.
go back to reference Khalesi S, Sun J, Buys N, Jayasinghe R. Effects of probiotics on blood pressure: a systematic review and meta-analysis of randomized controlled trials. Hypertension. 2014;64:897–903.CrossRefPubMed Khalesi S, Sun J, Buys N, Jayasinghe R. Effects of probiotics on blood pressure: a systematic review and meta-analysis of randomized controlled trials. Hypertension. 2014;64:897–903.CrossRefPubMed
21.
go back to reference Luyer MD, Buurman WA, Hadfoune M, Speelmans G, Knowl J, Jacobs JA, Dejong CH, Vriesema AJ, Greve JW. Strain-specific effects of probiotics on gut barrier intergrity following hemorrhagic shock. Infect Immun. 2005;73(6):3686–92.CrossRefPubMedPubMedCentral Luyer MD, Buurman WA, Hadfoune M, Speelmans G, Knowl J, Jacobs JA, Dejong CH, Vriesema AJ, Greve JW. Strain-specific effects of probiotics on gut barrier intergrity following hemorrhagic shock. Infect Immun. 2005;73(6):3686–92.CrossRefPubMedPubMedCentral
22.
go back to reference Campana R, van Hemert S, Baffone W. Strain-specific probiotic properties of lactic acid bacteria and their interference with human intestinal pathogens invasion. Gut Pathog. 2017;9:12.CrossRefPubMedPubMedCentral Campana R, van Hemert S, Baffone W. Strain-specific probiotic properties of lactic acid bacteria and their interference with human intestinal pathogens invasion. Gut Pathog. 2017;9:12.CrossRefPubMedPubMedCentral
23.
go back to reference Van Hemert S, Ormel G. Influence of the multispecies probiotic Ecologic®Barrier on parameters of intestinal barrier function. Food Nutr Sci. 2014;5:1739–45.CrossRef Van Hemert S, Ormel G. Influence of the multispecies probiotic Ecologic®Barrier on parameters of intestinal barrier function. Food Nutr Sci. 2014;5:1739–45.CrossRef
24.
go back to reference Gupta VK, Paul S, Dutta C. Geography, ethnicity or subsistence-specific variations in human microbiome composition and diversity. Front Microbiol. 2017;8:1162.CrossRefPubMedPubMedCentral Gupta VK, Paul S, Dutta C. Geography, ethnicity or subsistence-specific variations in human microbiome composition and diversity. Front Microbiol. 2017;8:1162.CrossRefPubMedPubMedCentral
Metadata
Title
Effects of a multi-strain probiotic supplement for 12 weeks in circulating endotoxin levels and cardiometabolic profiles of medication naïve T2DM patients: a randomized clinical trial
Authors
Shaun Sabico
Ayah Al-Mashharawi
Nasser M. Al-Daghri
Sobhy Yakout
Abdullah M. Alnaami
Majed S. Alokail
Philip G. McTernan
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Translational Medicine / Issue 1/2017
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/s12967-017-1354-x

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