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Meta-Analysis
. 2024 Sep 11:14:1411222.
doi: 10.3389/fcimb.2024.1411222. eCollection 2024.

Effects of probiotic treatment on patients and animals with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized control trials

Ziying Su  1 , Chenxi Ma  1 , Xiaosong Ru  1 , Sijia Zhang  2 , Chuyi Wu  2 , Yue Huang  1 , Huijie Cen  3 , Zihui Yin  3 , Jianping Zhang  4
Affiliations
Meta-Analysis

Effects of probiotic treatment on patients and animals with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized control trials

Ziying Su et al. Front Cell Infect Microbiol. .

Abstract

Objective: In recent years, the lung-gut axis has received increasing attention. The oxidative stress and systemic hypoxia occurring in chronic obstructive pulmonary disease (COPD) are related to gut dysfunction. That suggests probiotics have a potential therapeutic role in COPD. In this study, we therefore evaluated the ameliorative effects of probiotics on COPD.

Methods: Searches were conducted in four electronic databases, including PubMed, Cochrane Library, the NIH clinical registry Clinical Trials. Gov and EMBASE. The data extracted was analyzed statistically in this study using StataMP17 software, with mean difference (MD) chosen as the effect size for continuous variables, and the results expressed as effect sizes and their 95% confidence intervals (CIs). Standardized Mean Difference (SMD) was used if the data units were different.

Results: We included three randomized, controlled, double-blind clinical trials and five randomized controlled animal studies. The results show that for lung function, probiotics improved %FEV1 in COPD patients (MD = 3.02, 95%CI: 1.10, 4.93). Additionally, in inflammation, probiotics increased IL-10 (SMD = 1.99, 95%CI: 1.02, 2.96) and decreased inflammatory markers such as TNF-α (SMD= -2.64, 95%Cl: -3.38, -1.90), IL-1β (SMD= -3.49, 95%Cl: -4.58, -2.40), and IL-6 (SMD= -6.54, 95%Cl: -8.36, -4.73) in COPD animals, while having no significant effect on C-reactive protein (MD = 0.30, 95%CI: -0.71, 1.32) in COPD patients. For lung structure, probiotics significantly reduced the degree of pulmonary collagen fibers deposition in COPD animals (SMD = -2.25, 95%CI: -3.08, -1.41).

Conclusion: Overall, probiotics may be an additional approach that can improve COPD. Further clinical trials are needed to evaluate the efficacy, safety, and impact factors of probiotics for COPD.

Systematic review registration: https://inplasy.com/inplasy-2023-4-0023/, identifier INPLASY202340023.

Keywords: chronic obstructive pulmonary disease; deposition of pulmonary collagen fibers; forced expiratory volume in one second; inflammatory changes; meta-analysis; probiotics.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Risk of bias assessment for human and animal studies.
Figure 3
Figure 3
Effect of probiotics on %FEV1 in COPD patients.
Figure 4
Figure 4
Effect of probiotics on CRP in COPD patients.
Figure 5
Figure 5
Effect of probiotics on TNF-α in COPD animals.
Figure 6
Figure 6
Effect of probiotics on IL-1β in COPD animals.
Figure 7
Figure 7
Effect of probiotics on IL-6 in COPD animals.
Figure 8
Figure 8
Effect of probiotics on IL-10 in COPD animals.
Figure 9
Figure 9
Effect of probiotics on collagen fiber deposition in the lungs of COPD animals.
See this image and copyright information in PMC

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