Probiotic supplementation in Parkinson’s Disease

Probiotic supplementation in Parkinson’s diseases

Authors

DOI:

https://doi.org/10.59747/smjidisurabaya.v2i1.55

Keywords:

Probiotic, Parkinson's disease, gut-brain axis

Abstract

Background: Parkinson's disease (PD) is a prevalent neurodegenerative disease with both motor and non-motor symptoms. It has been postulated that dysbiosis and gut infections may have metabolic consequences that go unchecked and exacerbate the neurodegenerative process or peripheral inflammation in PD. Objective: This meta-analysis aims to elucidate the potential benefits of of probiotics as supplemental therapy for PD. Materials and Method: PRISMA 2020 was used for literature search. Multiple databases, such as PubMed, Science Direct, and CINAHL Plus, as well as Full Text, Sage Journals, and Web of Science, and clinical registries were investigated. The quality assessment and statistical analysis were conducted using the Jadad scale and the Review Manager software version 5.4.1. Results: Ten randomized controlled trials (RCTs) were included in this systematic review, six of which were quantitative studies. The results indicated that probiotic treatment significantly improved cognitive function based on the MMSE (mean difference [MD] = 0.4, 95% CI [-0.17, 0.97], I2 = 0%). Probiotic treatment also improved gastrointestinal symptoms as evidenced by the Bristol stool score (MD = 0.28, 95% CI [-0.40, 0.97], I2 = 93%) and the bowel movement score (MD = 1.25, 95% CI [0.74, 1.75], I2 = 0%). Significant effects were observed in the depression scale and quality of life, including the Patient Assessment of Constipation Quality of Life (PACQoL) and the Parkinson’s Disease Questionnaire (PDQ39). Conclusion:  Probiotic supplementation significantly improved disease progression, gastrointestinal effects, mental health, and quality of life in patients with PD. This improvement may be attributed to a reduction in the inflammatory response and an increase in the activity of gut-brain axis.

References

Aho, V.T.E., Houser, M.C., Pereira, P.A.B., Chang, J., Rudi, K., Paulin, L., Hertzberg, V., Auvinen, P., Tansey, M.G., Scheperjans, F., 2021. Relationships of gut microbiota, short-chain fatty acids, inflammation, and the gut barrier in Parkinson’s disease. Mol. Neurodegener. 16, 1–14.

Al-Khammash, N., Al-Jabri, N., Albishi, A., Al-Onazi, A., Aseeri, S., Alotaibi, F., Almazroua, Y., Albloushi, M., 2023. Quality of Life in Patients With Parkinson’s Disease: A Cross-Sectional Study. Cureus 15, 1–8.

Álvarez-Arraño, V., Martín-Peláez, S., 2021. Effects of probiotics and synbiotics on weight loss in subjects with overweight or obesity: A systematic review. Nutrients 13, 1–18.

Barichella, M., Pacchetti, C., Bolliri, C., Cassani, E., Iorio, L., Pusani, C., Pinelli, G., Privitera, G., Cesari, I., Faierman, S.A., Caccialanza, R., Pezzoli, G., Cereda, E., 2016. Probiotics and prebiotic fiber for constipation associated with Parkinson disease. Neurology 87, 1274–1280.

Barrenschee, M., Zorenkov, D., Böttner, M., Lange, C., Cossais, F., Scharf, A.B., Deuschl, G., Schneider, S.A., Ellrichmann, M., Fritscher-Ravens, A., Wedel, T., 2017. Distinct pattern of enteric phospho-alpha-synuclein aggregates and gene expression profiles in patients with Parkinson’s disease. Cerebellum and Ataxias 4, 1–14.

Chu, C., Yu, L., Li, Y., Guo, H., Zhai, Q., Chen, W., Tian, F., 2023. Meta-analysis of randomized controlled trials of the effects of probiotics in Parkinson’s disease. Food Funct. 14, 3406–3422.

Cox, L.M., Weiner, H.L., 2018. Microbiota Signaling Pathways that Influence Neurologic Disease. Neurotherapeutics 15, 135–145.

Dimidi, E., Christodoulides, S., Scott, S.M., Whelan, K., 2017. Mechanisms of action of probiotics and the gastrointestinal microbiota on gut motility and constipation. Adv. Nutr. 8, 484–494.

Fasano, A., Visanji, N.P., Liu, L.W.C., Lang, A.E., Pfeiffer, R.F., 2015. Gastrointestinal dysfunction in Parkinson’s disease. Lancet Neurol. 14, 625–639.

Fei, Y., Wang, R., Lu, J., Peng, S., Yang, S., Wang, Y., Zheng, K., Li, R., Lin, L., Li, M., 2023. Probiotic intervention benefits multiple neural behaviors in older adults with mild cognitive impairment. Geriatr. Nurs. (Minneap). 51, 167–175.

Georgescu, D., Ancusa, O.E., Georgescu, L.A., Ionita, I., Reisz, D., 2016. Nonmotor gastrointestinal disorders in older patients with Parkinson’s disease: Is there hope? Clin. Interv. Aging 11, 1601–1608.

Ghalandari, N., Assarzadegan, F., Habibi, S.A.H., Esmaily, H., Malekpour, H., 2023a. Efficacy of Probiotics in Improving Motor Function and Alleviating Constipation in Parkinson’s Disease: A Randomized Controlled Trial. Iran. J. Pharm. Res. 22, 1–9.

Ghalandari, N., Assarzadegan, F., Mahdavi, H., Jamshidi, E., Esmaily, H., 2023b. Evaluating the effectiveness of probiotics in relieving constipation in Parkinson’s disease: A systematic review and meta-analysis. Heliyon 9, e14312.

Gouda, N.A., Elkamhawy, A., Cho, J., 2022. Emerging Therapeutic Strategies for Parkinson’s Disease and Future Prospects: A 2021 Update. Biomedicines 10, 1–40.

Goya, M.E., Xue, F., Sampedro-Torres-Quevedo, C., Arnaouteli, S., Riquelme-Dominguez, L., Romanowski, A., Brydon, J., Ball, K.L., Stanley-Wall, N.R., Doitsidou, M., 2020. Probiotic Bacillus subtilis Protects against α-Synuclein Aggregation in C. elegans. Cell Rep. 30, 367-380.e7.

Gupta, S., Shukla, S., 2021. Non-motor symptoms in Parkinson’s disease: Opening new avenues in treatment. Curr. Res. Behav. Sci. 2, 100049.

Handajani, Y.S., Hengky, A., Schröder-Butterfill, E., Hogervorst, E., Turana, Y., 2023. Probiotic supplementation improved cognitive function in cognitively impaired and healthy older adults: a systematic review of recent trials. Neurol. Sci. 44, 1163–1169.

Hashish, S., Salama, M., 2023. The Role of an Altered Gut Microbiome in Parkinson’s Disease: A Narrative Review. Appl. Microbiol. 3, 429–447.

Helmy, A., Hamid, E., Salama, M., Gaber, A., El-Belkimy, M., Shalash, A., 2022. Baseline predictors of progression of Parkinson’s disease in a sample of Egyptian patients: clinical and biochemical. Egypt. J. Neurol. Psychiatry Neurosurg. 58, 1–10.

Hill, C., Guarner, F., Reid, G., Gibson, G.R., Merenstein, D.J., Pot, B., Morelli, L., Canani, R.B., Flint, H.J., Salminen, S., Calder, P.C., Sanders, M.E., 2014. Expert consensus document: The international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat. Rev. Gastroenterol. Hepatol. 11, 506–514.

Hirayama, M., Ohno, K., 2021. Parkinson’s Disease and Gut Microbiota. Ann. Nutr. Metab. 77, 28–35.

Hoffmann, A., Kleniewska, P., Pawliczak, R., 2019. Antioxidative activity of probiotics. Arch Med Sci 17, 792–804.

Hong, C., Chen, J., Huang, T., 2022. 7015 Aging 14, 7014–7025.

Hsieh, T.H., Kuo, C.W., Hsieh, K.H., Shieh, M.J., Peng, C.W., Chen, Y.C., Chang, Y.L., Huang, Y.Z., Chen, C.C., Chang, P.K., Chen, K.Y., Chen, H.Y., 2020. Probiotics alleviate the progressive deterioration of motor functions in a mouse model of Parkinson’s disease. Brain Sci. 10.

Htoo, Z.W., 2022. Randomized controlled trial of probiotics and vitamin B3 on gut microbiome and quality of life in people with Parkinson’s disease. Kansas State University.

Huang, R., Wang, K., Hu, J., 2016. Effect of probiotics on depression: A systematic review and meta-analysis of randomized controlled trials. Nutrients 8.

Ibrahim, A., Raja Ali, R.A., Abdul Manaf, M.R., Ahmad, N., Tajurruddin, F.W., Qin, W.Z., Md Desa, S.H., Ibrahim, N.M., 2020. Multi-strain probiotics (Hexbio) containing MCP BCMC strains improved constipation and gut motility in Parkinson’s disease: A randomised controlled trial. PLoS One 15, 1–17.

Ibrahim, S.A., Yeboah, P.J., Ayivi, R.D., Eddin, A.S., Wijemanna, N.D., Paidari, S., Bakhshayesh, R. V., 2023. A review and comparative perspective on health benefits of probiotic and fermented foods. Int. J. Food Sci. Technol. 58, 4948–4964.

Kali, A., 2016. Psychobiotics: An emerging probiotic in psychiatric practice. Biomed. J. 39, 223–224.

Khedr, E.M., Ali, A.M., Deaf, E., Hassan, H.M., Alaa, A., Gamea, A., 2021. Gut microbiota in Parkinson’s disease patients: hospital-based study. Egypt. J. Neurol. Psychiatry Neurosurg. 57.

Kim, C.S., Cha, L., Sim, M., Jung, S., Chun, W.Y., Baik, H.W., Shin, D.M., 2021. Probiotic supplementation improves cognitive function and mood with changes in gut microbiota in community- dwelling older adults: A randomized, double-blind, placebo-controlled, multicenter trial. Journals Gerontol. - Ser. A Biol. Sci. Med. Sci. 76, 32–40.

Liu, N., Yang, D., Sun, J., Li, Y., 2023. Probiotic supplements are effective in people with cognitive impairment: a meta-analysis of randomized controlled trials. Nutr. Rev. 81, 1091–1104.

Lu, C.S., Chang, H.C., Weng, Y.H., Chen, C.C., Kuo, Y.S., Tsai, Y.C., 2021. The Add-On Effect of Lactobacillus plantarum PS128 in Patients With Parkinson’s Disease: A Pilot Study. Front. Nutr. 8, 1–9.

Martin, W., 2010. Clinical features of parkinson disease. Park. Dis. A Heal. Policy Perspect. 9–20.

Mehrabani, S., Khorvash, F., Heidari, Z., Tajabadi-Ebrahimi, M., Amani, R., 2023. The effects of synbiotic supplementation on oxidative stress markers, mental status, and quality of life in patients with Parkinson’s disease: A double-blind, placebo-controlled, randomized controlled trial. J. Funct. Foods 100, 105397.

Milajerdi, A., Mousavi, S.M., Sadeghi, A., Salari-Moghaddam, A., Parohan, M., Larijani, B., Esmaillzadeh, A., 2020. The effect of probiotics on inflammatory biomarkers: a meta-analysis of randomized clinical trials. Eur. J. Nutr. 59, 633–649.

Mirzaei, H., Sedighi, S., Kouchaki, E., Barati, E., Dadgostar, E., Aschner, M., Tamtaji, O.R., 2022. Probiotics and the Treatment of Parkinson’s Disease: An Update. Cell. Mol. Neurobiol. 42, 2449–2457.

Montanari, M., Imbriani, P., Bonsi, P., Martella, G., Peppe, A., 2023. Beyond the Microbiota: Understanding the Role of the Enteric Nervous System in Parkinson’s Disease from Mice to Human. Biomedicines 11, 1–21.

Musazadeh, V., Faghfouri, A.H., Zarezadeh, M., Pakmehr, A., Moghaddam, P.T., Hamedi-Kalajahi, F., Jahandideh, A., Ghoreishi, Z., 2023. Remarkable impacts of probiotics supplementation in enhancing of the antioxidant status: results of an umbrella meta-analysis. Front. Nutr. 10.

Nowak, J.M., Kopczyński, M., Friedman, A., Koziorowski, D., Figura, M., 2022. Microbiota Dysbiosis in Parkinson Disease—In Search of a Biomarker. Biomedicines 10, 1–16.

Park, J.M., Lee, S.C., Ham, C., Kim, Y.W., 2023. Effect of probiotic supplementation on gastrointestinal motility, inflammation, motor, non-motor symptoms and mental health in Parkinson’s disease: a meta-analysis of randomized controlled trials. Gut Pathog. 15, 1–17.

Poewe, W., 2008. Non-motor symptoms in Parkinson’s disease. Eur. J. Neurol. 15, 14–20.

Ramesh, S., Arachchige, A.S.P.M., 2023. Depletion of dopamine in Parkinson’s disease and relevant therapeutic options: A review of the literature. AIMS Neurosci. 10, 200–231.

Ray Dorsey, E., Elbaz, A., Nichols, E., Abd-Allah, F., Abdelalim, A., Adsuar, J.C., Ansha, M.G., Brayne, C., Choi, J.Y.J., Collado-Mateo, D., Dahodwala, N., Do, H.P., Edessa, D., Endres, M., Fereshtehnejad, S.M., Foreman, K.J., Gankpe, F.G., Gupta, R., Hankey, G.J., Hay, S.I., Hegazy, M.I., Hibstu, D.T., Kasaeian, A., Khader, Y., Khalil, I., Khang, Y.H., Kim, Y.J., Kokubo, Y., Logroscino, G., Massano, J., Ibrahim, N.M., Mohammed, M.A., Mohammadi, A., Moradi-Lakeh, M., Naghavi, M., Nguyen, B.T., Nirayo, Y.L., Ogbo, F.A., Owolabi, M.O., Pereira, D.M., Postma, M.J., Qorbani, M., Rahman, M.A., Roba, K.T., Safari, H., Safiri, S., Satpathy, M., Sawhney, M., Shafieesabet, A., Shiferaw, M.S., Smith, M., Szoeke, C.E.I., Tabarés-Seisdedos, R., Truong, N.T., Ukwaja, K.N., Venketasubramanian, N., Villafaina, S., Weldegwergs, K.G., Westerman, R., Wijeratne, T., Winkler, A.S., Xuan, B.T., Yonemoto, N., Feigin, V.L., Vos, T., Murray, C.J.L., 2018. Global, regional, and national burden of Parkinson’s disease, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 17, 939–953.

Romano, S., Savva, G.M., Bedarf, J.R., Charles, I.G., Hildebrand, F., Narbad, A., 2021. Meta-analysis of the Parkinson’s disease gut microbiome suggests alterations linked to intestinal inflammation. npj Park. Dis. 7.

Sahay, S., Sutiono, D.R., 2018. Signi cance of Lewy Body Formation in Development of Parkinson ’ s Disease. CDK-267 45, 589–591.

Salim, S., Ahmad, F., Banu, A., Mohammad, F., 2023. Gut microbiome and Parkinson’s disease: Perspective on pathogenesis and treatment. J. Adv. Res. 50, 83–105.

Santos García, D., de Deus Fonticoba, T., Cores, C., Muñoz, G., Paz González, J.M., Martínez Miró, C., Suárez, E., Jesús, S., Aguilar, M., Pastor, P., Planellas, L., Cosgaya, M., García Caldentey, J., Caballol, N., Legarda, I., Hernández Vara, J., Cabo, I., López Manzanares, L., González Aramburu, I., Ávila Rivera, M.A., Catalán, M.J., Nogueira, V., Puente, V., Ruíz de Arcos, M., Borrué, C., Solano Vila, B., Álvarez Sauco, M., Vela, L., Escalante, S., Cubo, E., Carrillo Padilla, F., Martínez Castrillo, J.C., Sánchez Alonso, P., Alonso Losada, M.G., López Ariztegui, N., Gastón, I., Clavero, P., Kulisevsky, J., Blázquez Estrada, M., Seijo, M., Rúiz Martínez, J., Valero, C., Kurtis, M., de Fábregues, O., González Ardura, J., Ordás, C., López Díaz, L.M., McAfee, D., Martinez-Martin, P., Mir, P., Adarmes, D.A., Almeria, M., Alonso Cánovas, A., Alonso Frech, F., Alonso Redondo, R., Álvarez, I., Aneiros Díaz, Á., Arnáiz, S., Arribas, S., Ascunce Vidondo, A., Bernardo Lambrich, N., Bejr-Kasem, H., Botí, M.A., Buongiorno, M.T., Cabello González, C., Cámara Lorenzo, A., Canfield Medina, H., Carrillo, F., Casas, E., Cortina Fernández, A., Cots Foraster, A., Crespo Cuevas, A., Díez-Fairen, M., Dotor García-Soto, J., Erro, E., Estelrich Peyret, E., Fernández Guillán, N., Gámez, P., Gallego, M., García Campos, C., García Moreno, J.M., Gómez Garre, M.P., Gómez Mayordomo, V., González Aloy, J., González García, B., González Palmás, M.J., Toledo, G., Gabriel, R., Golpe Díaz, A., Grau Solá, M., Guardia, G., Horta-Barba, A., Idoate Calderón, D., Infante, J., Labandeira, C., Labrador, M.A., Lacruz, F., Lage Castro, M., Lastres Gómez, S., López Seoane, B., Lucas del Pozo, S., Macías, Y., Mata, M., Martí Andres, G., Martí, M.J., Meitín, M.T., Menéndez González, M., Méndez del Barrio, C., Miranda Santiago, J., Casado, M., María, I., Moreno Diéguez, A., Novo Amado, A., Novo Ponte, S., Pagonabarraga, J., Pareés, I., Pascual-Sedano, B., Pérez Fuertes, A., Pérez Noguera, R., Planas-Ballvé, A., Prats, M.A., Prieto Jurczynska, C., Pueyo Morlans, M., Puig Daví, A., Redondo Rafales, N., Rodríguez Méndez, L., Rodríguez Pérez, A.B., Roldán, F., Sánchez-Carpintero, M., Sánchez Díez, G., Sánchez Rodríguez, A., Santacruz, P., Segundo Rodríguez, J.C., Sierra Peña, M., Tartari, J.P., Vargas, L., Villanueva, C., Vives, B., Villar, M.D., 2021. Predictors of clinically significant quality of life impairment in Parkinson’s disease. NPJ Park. Dis. 16, 118.

Santos, S.F., De Oliveira, H.L., Yamada, E.S., Neves, B.C., Pereira, A., 2019. The gut and Parkinson’s disease - A bidirectional pathway. Front. Neurol. 10, 1–8.

Shen, T., Yue, Y., He, T., Huang, C., Qu, B., Lv, W., Lai, H.Y., 2021. The Association Between the Gut Microbiota and Parkinson’s Disease, a Meta-Analysis. Front. Aging Neurosci. 13, 1–12.

Stocchi, F., Torti, M., 2017. Constipation in Parkinson’s Disease, 1st ed, International Review of Neurobiology. Elsevier Inc.

Suez, J., Zmora, N., Segal, E., Elinav, E., 2019. The pros, cons, and many unknowns of probiotics. Nat. Med. 25, 716–729.

Sun, H., Zhao, F., Liu, Y., Ma, T., Jin, H., Quan, K., Leng, B., Zhao, J., Yuan, X., Li, Z., Li, F., Kwok, L.Y., Zhang, S., Sun, Z., Zhang, J., Zhang, H., 2022. Probiotics synergized with conventional regimen in managing Parkinson’s disease. npj Park. Dis. 8.

Tamtaji, O.R., Milajerdi, A., Reiner, Ž., Asemi, Z., Dadgostar, E., Heidari-Soureshjani, R., Mamsharifi, P., Amirani, E., Mirzaei, H., Hallajzadeh, J., Ghaderi, A., 2020. A systematic review and meta-analysis: The effects of probiotic supplementation on metabolic profile in patients with neurological disorders. Complement. Ther. Med. 53.

Tamtaji, O.R., Taghizadeh, M., Daneshvar Kakhaki, R., Kouchaki, E., Bahmani, F., Borzabadi, S., Oryan, S., Mafi, A., Asemi, Z., 2019. Clinical and metabolic response to probiotic administration in people with Parkinson’s disease: A randomized, double-blind, placebo-controlled trial. Clin. Nutr. 38, 1031–1035.

Tan, A.H., Hor, J.W., Chong, C.W., Lim, S.Y., 2021. Probiotics for Parkinson’s disease: Current evidence and future directions. JGH Open 5, 414–419.

Unger, M.M., Spiegel, J., Dillmann, K.U., Grundmann, D., Philippeit, H., Bürmann, J., Faßbender, K., Schwiertz, A., Schäfer, K.H., 2016. Short chain fatty acids and gut microbiota differ between patients with Parkinson’s disease and age-matched controls. Park. Relat. Disord. 32, 66–72.

Vera-Santander, V.E., Hernández-Figueroa, R.H., Jiménez-Munguía, M.T., Mani-López, E., López-Malo, A., 2023. Health Benefits of Consuming Foods with Bacterial Probiotics, Postbiotics, and Their Metabolites: A Review. Molecules 28.

Wang, Yang, Wu, Y., Wang, Yuanyuan, Xu, H., Mei, X., Yu, D., Wang, Yibing, Li, W., 2017. Antioxidant properties of probiotic bacteria. Nutrients 9.

Xie, C., Prasad, A.A., 2020. Probiotics treatment improves hippocampal dependent cognition in a rodent model of parkinson’s disease. Microorganisms 8, 1–13.

Xie, L., Chen, D., Zhu, X., Cheng, C., 2023. Efficacy and safety of probiotics in Parkinson’s constipation: A systematic review and meta-analysis. Front. Pharmacol. 13.

Yamamoto, T., Yamanaka, Y., Hirano, S., Higuchi, Y., Kuwabara, S., 2023. Utility of movement disorder society-unified Parkinson’s disease rating scale for evaluating effect of subthalamic nucleus deep brain stimulation. Front. Neurol. 13.

Yang, D., Zhao, D., Ali Shah, S.Z., Wu, W., Lai, M., Zhang, X., Li, J., Guan, Z., Zhao, H., Li, W., Gao, H., Zhou, X., Yang, L., 2019. The Role of the Gut Microbiota in the Pathogenesis of Parkinson’s Disease. Front. Neurol. 10, 1–13.

Yang, X., He, X., Xu, S., Zhang, Y., Mo, C., Lai, Y., Song, Y., Yan, Z., Ai, P., Qian, Y., Xiao, Q., 2023. Effect of Lacticaseibacillus paracasei strain Shirota supplementation on clinical responses and gut microbiome in Parkinson’s disease. Food Funct. 14, 6828–6839.

Yin, S., Zhu, F., 2022. Probiotics for constipation in Parkinson’s: A systematic review and meta-analysis of randomized controlled trials. Front. Cell. Infect. Microbiol. 12, 1–11.

Zhao, N., Yang, Y., Zhang, L., Zhang, Q., Balbuena, L., Ungvari, G.S., Zang, Y.F., Xiang, Y.T., 2021. Quality of life in Parkinson’s disease: A systematic review and meta-analysis of comparative studies. CNS Neurosci. Ther. 27, 270–279.

Zhu, M., Liu, X., Ye, Y., Yan, X., Cheng, Y., Zhao, L., Chen, F., Ling, Z., 2022. Gut Microbiota: A Novel Therapeutic Target for Parkinson’s Disease. Front. Immunol. 13, 1–19.

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2024-05-28

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