journal article·2023-03-08Open access

Is Probiotics Supplementation an Appropriate Strategy to Modulate Inflammation in Physically Active Healthy Adults or Athletes? A Systematic Review

Diego Fernández-Lázaro, Nerea Sánchez-Serrano, Roshina Rabail, Rana Muhammad Aadil, Juan Mielgo-Ayuso, Krizia Radesca Fabiano, Evelina Garrosa

Applied Sciences· Volume 13· Issue 6

Abstract

Supplementation with probiotics in sports is on the rise with the aim of improving health and athletic performance. Since intense exercise-induced muscle damage leads to an inflammatory process by increasing circulating inflammatory cytokines, probiotic supplementation may modulate and correct the inflammation. We systematically reviewed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in the Scopus, Web of Science, and Medline databases for the 10 years until January 2023. This review aimed to evaluate probiotic supplementation as a strategy for modulating inflammation in healthy physically active adults or athletes. Studies were indexed to assess the effect of probiotic supplementation on cytokine behavior in the inflammatory response in physically active individuals. Of the 136 studies identified in the search, 13 met the inclusion criteria, and their quality was assessed using the McMaster Critical Review Form. The results of these trials indicated a significant improvement in inflammatory cytokines in probiotic-supplemented participants, with a significant increase in anti-inflammatory cytokines (IL-10) and a significant decrease in proinflammatory cytokines (IL-6, TNF-α, and IL-8). This would create uncertainty about probiotics’ effect on interleukins’ behavior after exercise, and further clinical trials are needed to establish a solid basis.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Exercise and Physiological Responses · Herbal Medicine Research Studies · Muscle metabolism and nutrition

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Cellular Biology, Genetics, Histology and Pharmacology, Faculty of Health Sciences, University of Valladolid, Campus of Soria, 42003 Soria, Spain

Neurobiology Research Group, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain

Microbiology Unit of Soria University Assistance Complex (CAUSO), Santa Bárbara Hospital, Castille and Leon Health (SACyL), 42003 Soria, Spain

National Institute of Food Science and Technology, University of Agriculture, Faisalabad 38000, Pakistan

Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain

Department of Sports Sciences, Faculty of Physical Activity and Sports Sciences, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain

References (49)

Show source-provided references
1. The Human Microbiome: From Symbiosis to Pathogenesis10.1146/annurev-med-010312-133513 ↗
2. Moles, L., and Otaegui, D. (2020). The Impact of Diet on Microbiota Evolution and Human Health. Is Diet an Adequate Tool for Microbiota Modulation?. Nutrients, 12.10.3390/nu12061654 ↗
3. Exercise Modifies the Gut Microbiota with Positive Health Effects10.1155/2017/3831972 ↗
4. Microbiota in human health: Characterization and transfer techniques
5. Stojanov, S., Berlec, A., and Štrukelj, B. (2020). The Influence of Probiotics on the Firmicutes/Bacteroidetes Ratio in the Treatment of Obesity and Inflammatory Bowel disease. Microorganisms, 8.10.3390/microorganisms8111715 ↗
6. Fernández-Lázaro, D., González-Bernal, J.J., Sánchez-Serrano, N., Navascués, L.J., Del Río, A.A., and Mielgo-Ayuso, J. (2020). Physical Exercise as a Multimodal Tool for COVID-19: Could It Be Used as a Preventive Strategy?. Int. J. Environ. Res. Public Health, 17.10.3390/ijerph17228496 ↗
7. Overtraining Syndrome: A Practical Guide10.1177/1941738111434406 ↗
8. Cytokine hypothesis of overtraining: A physiological adaptation to excessive stress?10.1097/00005768-200002000-00011 ↗
9. Fernández-Lázaro, D., Fernandez-Lazaro, C.I., Mielgo-Ayuso, J., Navascués, L.J., Martínez, A.C., and Seco-Calvo, J. (2020). The Role of Selenium Mineral Trace Element in Exercise: Antioxidant Defense System, Muscle Performance, Hormone Response, and Athletic Performance. A Systematic Review. Nutrients, 12.10.3390/nu12061790 ↗
10. Pathophysiology of Exercise-Induced Muscle Damage and Its Structural, Functional, Metabolic, and Clinical Consequences
11. Exercise-induced muscle damage and inflammation: Fact or fiction?10.1046/j.1365-201x.2001.00825.x ↗
12. Exercise regulation of intestinal tight junction proteins10.1136/bjsports-2012-091585 ↗
13. Evaluation of physical activity as a therapeutic adjuvant for patients with inflammatory bowel disease: A review
14. The impact of exercise modality on exercise-induced gastrointestinal syndrome and associated gastrointestinal symptoms10.1016/j.jsams.2022.07.003 ↗
15. Interactions of Gut Microbiota, Endotoxemia, Immune Function, and Diet in Exertional Heatstroke10.1155/2018/5724575 ↗
16. Donati Zeppa, S., Agostini, D., Gervasi, M., Annibalini, G., Amatori, S., Ferrini, F., Sisti, D., Piccoli, G., Barbieri, E., and Sestili, P. (2019). Mutual Interactions among Exercise, Sport Supplements and Microbiota. Nutrients, 12.10.3390/nu12010017 ↗
17. Fernández-Lázaro, D., Mielgo-Ayuso, J., Calvo, J.S., Martínez, A.C., García, A.C., and Fernandez-Lazaro, C.I. (2020). Modulation of Exercise-Induced Muscle Damage, Inflammation, and Oxidative Markers by Curcumin Supplementation in a Physically Active Population: A Systematic Review. Nutrients, 12.10.3390/nu12020501 ↗
18. Probiotics in sports nutrition
19. International Society of Sports Nutrition Position Stand: Probiotics10.1186/s12970-019-0329-0 ↗
20. Controversies in the management of the critically ill: The role of probiotics10.1016/j.ijantimicag.2013.04.010 ↗
21. Adamdec1, Ednrb and Ptgs1/Cox1, inflammation genes upregulated in the intestinal mucosa of obese rats, are downregulated by three probiotic strains10.1038/s41598-017-02203-3 ↗
22. Probiotic Supplementation Has a Limited Effect on Circulating Immune and Inflammatory Markers in Healthy Adults: A Systematic Review of Randomized Controlled Trials10.1016/j.jand.2019.08.018 ↗
23. Probiotics, prebiotics and synbiotics: Useful for athletes and active individuals? A systematic review10.3920/BM2019.0076 ↗
24. Guo, Y.T., Peng, Y.C., Yen, H.Y., Wu, J.C., and Hou, W.H. (2022). Effects of Probiotic Supplementation on Immune and Inflammatory Markers in Athletes: A Meta-Analysis of Randomized Clinical Trials. Medicina, 58.10.3390/medicina58091188 ↗
25. PRISMA 2020 explanation and elaboration: Updated guidance and exemplars for reporting systematic reviews10.1136/bmj.n160 ↗
26. Law, M., Stewart, C., Pollock, N., Letts, L., Bosch, J., and Westmorland, M. (1998). Guidelines for Critical Review of Qualitative Studies, McMaster University Occupational Therapy Evidence-Based Practice Research Group.
27. UCC118 supplementation reduces exercise-induced gastrointestinal permeability and remodels the gut microbiome in healthy humans10.14814/phy2.14276 ↗
28. Probiotic supplementation in marathonists and its impact on lymphocyte population and function after a marathon: A randomized placebo-controlled double-blind study10.1038/s41598-020-75464-0 ↗
29. Effects of probiotics supplementation on gastrointestinal permeability, inflammation and exercise performance in the heat10.1007/s00421-013-2748-y ↗
30. Tavares-Silva, E., Caris, A.V., Santos, S.A., Ravacci, G.R., and Thomatieli-Santos, R.V. (2021). Effect of Multi-Strain Probiotic Supplementation on URTI Symptoms and Cytokine Production by Monocytes after a Marathon Race: A Randomized, Double-Blind, Placebo Study. Nutrients, 13.10.3390/nu13051478 ↗
31. Aisberg, M., Paixão, V., Almeida, E.B., Santos, J.M.B., Foster, R., Rossi, M., Pithon-Curi, T.C., Gorjão, R., Momesso, C.M., and Andrade, M.S. (2019). Daily Intake of Fermented Milk Containing Lactobacillus casei Shirota (Lcs) Modulates Systemic and Upper Airways Immune/Inflammatory Responses in Marathon Runners. Nutrients, 11.10.3390/nu11071678 ↗
32. Does Short-Term High Dose Probiotic Supplementation Containing Lactobacillus casei Attenuate Exertional-Heat Stress Induced Endotoxaemia and Cytokinaemia?10.1123/ijsnem.2015-0186 ↗
33. The Effect of 2 Weeks of Inactivated Probiotic Bacillus coagulans on Endocrine, Inflammatory, and Performance Responses during Self-Defense Training in Soldiers10.1519/JSC.0000000000003265 ↗
34. Huang, W.C., Wei, C.C., Huang, C.C., Chen, W.L., and Huang, H.Y. (2019). The Beneficial Effects of Lactobacillus plantarum PS128 on High-Intensity, Exercise-Induced Oxidative Stress, Inflammation, and Performance in Triathletes. Nutrients, 11.10.3390/nu11020353 ↗
35. Jäger, R., Purpura, M., Stone, J.D., Turner, S.M., Anzalone, A.J., Eimerbrink, M.J., Pane, M., Amoruso, A., Rowlands, D.S., and Oliver, J.M. (2016). Probiotic Streptococcus thermophilus FP4 and Bifidobacterium breve BR03 Supplementation Attenuates Performance and Range-of-Motion Decrements Following Muscle Damaging Exercise. Nutrients, 8.10.3390/nu8100642 ↗
36. Probiotic supplementation affects markers of intestinal barrier, oxidation, and inflammation in trained men; a randomized, double-blinded, placebo-controlled trial10.1186/1550-2783-9-45 ↗
37. Four weeks of probiotic supplementation reduces GI symptoms during a marathon race10.1007/s00421-019-04136-3 ↗
38. Probiotic supplementation increases carbohydrate metabolism in trained male cyclists: A randomized, double-blind, placebo-controlled crossover trial10.1152/ajpendo.00452.2019 ↗
39. The effect of probiotic supplementation on performance, inflammatory markers and gastro-intestinal symptoms in elite road cyclists10.1186/s12970-021-00432-6 ↗
40. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic10.1038/nrgastro.2014.66 ↗
41. Probiotic supplements might not be universally-effective and safe: A review10.1016/j.biopha.2018.12.104 ↗
42. IOC consensus statement: Dietary supplements and the high-performance athlete10.1136/bjsports-2018-099027 ↗
43. Best Practices for Probiotic Research in Athletic and Physically Active Populations: Guidance for Future Randomized Controlled Trials10.3389/fnut.2022.809983 ↗
44. Risk and safety of probiotics10.1093/cid/civ085 ↗
45. The anti-inflammatory effect of exercise10.1152/japplphysiol.00164.2004 ↗
46. Pro- and anti-inflammatory cytokine balance in strenuous exercise in humans10.1111/j.1469-7793.1999.287ad.x ↗
47. Anti-Inflammatory and Immunomodulatory Effects of Probiotics in Gut Inflammation: A Door to the Body10.3389/fimmu.2021.578386 ↗
48. Modulatory Effects of Probiotics During Pathogenic Infections with Emphasis on Immune Regulation10.3389/fimmu.2021.616713 ↗
49. Shehzad, A., Rabail, R., Munir, S., Jan, H., Fernández-Lázaro, D., and Aadil, R.M. (2023). Impact of Oats on Appetite Hormones and Body Weight Management: A Review. Curr. Nutr. Rep., online ahead of print.10.1007/s13668-023-00454-3 ↗