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Use of probiotics to correct dysbiosis of normal microbiota following disease or disruptive events : a systematic review
Open accessAbstract
OBJECTIVE: To assess the evidence for the claim probiotics can correct dysbiosis of the normal microbiota resulting from disease or disruptive events. SETTING: Systematic review of published clinical trials of patients receiving a probiotic intervention for the prevention or treatment of various diseases. DATA SOURCES: Sources searched (1985-2013): PubMed, EMBASE, Cochrane Database of Systematic Reviews, CINAHL, AMED and ISI Web of Science. Three on-line clinical trial registries were searched: Cochrane Central Register of Controlled trials, MetaRegister of Controlled Trials and National Institutes of Health. REVIEW METHODS: Included studies were randomised clinical trials of probiotic interventions having microbiological assays. Studies were evaluated following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for specific probiotic strains. A standard data extraction form was used to collect the raw data. OUTCOME MEASURES: The primary outcome is the degree of microbiota correction by specific probiotic strains. Secondary outcome was the association between the degree of dysbiosis correction and clinical efficacy. RESULTS: The review of the literature found three distinct study designs: model A (restoration) assayed patients enrolled with a healthy, undisturbed microbiota and then assayed postdisruptive event and probiotic therapy; model B (alteration) assayed patients with pre-existing disrupted microbiota and then postprobiotic therapy; model C (no dysbiosis) assayed volunteers with no disruptive event prebiotic and postprobiotic. From a total of 63 trials, 83% of the probiotic products using model A restored the microbiota, 56% using model B improved the microbiota and only 21% using model C had any effect on microbiota. Clinical efficacy was more commonly associated with strains capable of restoration of the normal microbiota. CONCLUSIONS: The ability to assess the degree of dysbiosis improvement is dependent on the enrolled population and the timing of microbiological assays. The functional claim for correcting dysbiosis is poorly supported for most probiotic strains and requires further research. TRIAL REGISTRATION NUMBER: PROSPERO (CRD42014007224).
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“and probiotics seem to offer some promising potential for re-establishing the microbiome following antimicrobial insult (Mcfarland, 2014).”
From Viral Infections, the Microbiome, and Probiotics (2021) · cites this paper as Mcfarland, 2014
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Metadata
- Authors
- McFarland, L. V.
- Affiliations
- University of Washington (US)
- Corresponding author
- McFarland, Lynne V
- ORCID
- McFarland, Lynne V
- Venue
- BMJ Open
- Publisher
- BMJ
- Published
- 2014-08
- Volume
- 4
- Issue
- 8
- Pages
- e005047
- ISSN
- 2044-6055 (ISSN-L)
- PMC
- PMC4156804
- OpenAlex
- W1987378090
- Cited by
- 235
- References
- 118
- Citations by year
- 2026: 8 · 2025: 23 · 2024: 23 · 2023: 28 · 2022: 22 · 2021: 33 · 2020: 19 · 2019: 15 · 2018: 19 · 2017: 15 · 2016: 14 · 2015: 16
- FWCI
- 1.87
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc
- Locations
- BMJ Open (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- probiotics, dysbiosis, gut microbiota, microbiota restoration, probiotic strains, microbiological assay, disruptive events, clinical efficacy, prebiotics
- MeSH terms
- Disease, Humans, Severity of Illness Index, Treatment Outcome, Probiotics, Microbiota, Dysbiosis
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