HealthDay News – Decreased levels of serum insulin, C-reactive protein (CRP), and lower disease activity score of 28 joints (DAS28) were found in patients with rheumatoid arthritis (RA) treated with 3 strains of probiotic, according to a study published in the International Journal of Rheumatic Diseases.  No detectable changes were found in fasting plasma glucose, quantitative insulin sensitivity check indices, homeostatic model assessments of B cell function, or plasma nitric oxide.

“This study is the first that simultaneously has examined the effects of multispecies probiotic (6 × 109 CFU/g) on DAS-28 and biomarkers,” study authors indicated.

Batol Zamani, from Kashan University of Medical Sciences in Iran, and colleagues randomized 60 patients (aged 25 to 70 years) with RA in a 1:1 ratio to receive probiotic capsules or placebo for eight weeks. The probiotic capsule contained three viable, freeze-dried strains: Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum. Related markers were quantified in fasting blood samples taken at the beginning and end of the study.

The researchers found that probiotic supplementation correlated with improved DAS-28 compared with placebo (P = .01) after eight weeks of intervention. Compared with placebo, probiotic supplementation was also associated with a significant decrease in serum insulin levels (P = .03), homeostatic model assessment-B cell function (HOMA-B; P = .03), and serum high-sensitivity C-reactive protein (hs-CRP) concentrations (P < .001). 

Borderline statistically significant improvements were seen in total and low-density lipoprotein cholesterol levels with probiotics versus placebo (P = .09 and .07, respectively).

Summary and Clinical Applicability

Study participants with RA who took probiotic supplements for 8 weeks had improvements in DAS-28 scores, decreased levels of serum insulin, HOMA-B, and hs-CRP levels relative to treatment with placebo. No detectable changes were found in fasting plasma glucose, quantitative insulin sensitivity check indices, homeostatic model assessments of B cell function, or plasma nitric oxide.

“Probiotic intake may improve clinical and metabolic status in RA patients through its anti-inflammatory effects both locally in the gut and systemically,” the authors concluded.

Limitations and Disclosures

Analysis of fecal short chain fatty acids to assess medication compliance was not done, and the 8-week intervention was relatively short.  The effects of probiotic supplementation on inflammatory mediators such as tumor necrosis factor-α, interleukin (IL)-6 or IL-1-beta were not assessed. 

Reference

Zamani B, Golkar HR, Farshbaf S, et al. Clinical and metabolic response to probiotic supplementation in patients with rheumatoid arthritis: a randomized, double-blind, placebo-controlled trial. Int J Rheum Dis. 2016; doi: 10.1111/1756-185X.12888