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Randomized Controlled Trial
. 2021 Jan-Dec;13(1):1-9.
doi: 10.1080/19490976.2021.1900997.

Probiotics reduce self-reported symptoms of upper respiratory tract infection in overweight and obese adults: should we be considering probiotics during viral pandemics?

Benjamin H Mullish  1 , Julian R Marchesi  1 , Julie A K McDonald  2 , Daniel A Pass  3 , Giulia Masetti  4   5 , Daryn R Michael  4 , Sue Plummer  4 , Alison A Jack  4 , Thomas S Davies  4 , Timothy R Hughes  6 , Duolao Wang  7
Affiliations
Randomized Controlled Trial

Probiotics reduce self-reported symptoms of upper respiratory tract infection in overweight and obese adults: should we be considering probiotics during viral pandemics?

Benjamin H Mullish et al. Gut Microbes. 2021 Jan-Dec.

Abstract

Gut microbiome manipulation to alter the gut-lung axis may potentially protect humans against respiratory infections, and clinical trials of probiotics show promise in this regard in healthy adults and children. However, comparable studies are lacking in overweight/obese people, who have increased risks in particular of viral upper respiratory tract infections (URTI). This Addendum further analyses our recent placebo-controlled trial of probiotics in overweight/obese people (focused initially on weight loss) to investigate the impact of probiotics upon the occurrence of URTI symptoms. As well as undergoing loss of weight and improvement in certain metabolic parameters, study participants taking probiotics experienced a 27% reduction in URTI symptoms versus control, with those ≥45 years or BMI ≥30 kg/m2 experiencing greater reductions. This symptom reduction is apparent within 2 weeks of probiotic use. Gut microbiome diversity remained stable throughout the study in probiotic-treated participants. Our data provide support for further trials to assess the potential role of probiotics in preventing viral URTI (and possibly also COVID-19), particularly in overweight/obese people.

Keywords: Probiotics; gut microbiome; gut-lung axis; obesity; upper respiratory tract infection.

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Figures

Figure 1.
Figure 1.
Overall and subgroup analysis of the impact of probiotic supplementation on the incidence of URTI symptoms. Statistical analysis was performed using a generalized linear model with Poisson distribution and log link function, data is presented as IRR ± 95% CI (n, number of participants (placebo group/probotic group); IRR, incidence rate ratio; CI, confidence interval)
Figure 2.
Figure 2.
Impact of probiotic supplementation on time to onset of URTI symptoms during the PROMAGEN study. Kaplan-meier plots of time to first URTI symptoms in subgroups of participants who were: A) <45 year olds; B) ≥45 year olds; C) overweight (BMI <30 kg/m2) and; D) obese (BMI ≥30 kg/m2). Statistical analysis was performed using the log-rank Mantel-Cox test
Figure 3.
Figure 3.
Scatterplot of relationship between change in Shannon diversity index of the stool microbiota versus the number of days with URTI symptoms in participants ≥45 years old given probiotics or placebo. Shannon diversity was measured in stool samples from study participants ≥45 years old at baseline and at end of the study (six months) using 16S rRNA gene profiling. Statistical analysis was performed using Pearson’s correlation analysis. Probiotic arm: n = 18; placebo arm: n= 13
See this image and copyright information in PMC

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