Host-microbiome interactions in human type 2 diabetes following prebiotic fibre (galacto-oligosaccharide) intake. Effect of Probiotics on Lipid Profile, Glycemic Control, Insulin Action, Oxidative Stress, and Inflammatory Markers in Patients with Type 2 Diabetes: A Clinical Trial Effect of multi-strain probiotics (multi-strain microbial cell preparation) on glycemic control and other diabetes-related outcomes in people with type 2 diabetes: a randomized controlled trial The effects of probiotic supplementation on biomarkers of inflammation, oxidative stress and pregnancy outcomes in gestational diabetes Modulation of gut microbiota dysbioses in type 2 diabetic patients by macrobiotic Ma-Pi 2 diet Dietary modulation of the gut microbiota – a randomised controlled trial in obese postmenopausal women Structural Alteration of Gut Microbiota during the Amelioration of Human Type 2 Diabetes with Hyperlipidemia by Metformin and a Traditional Chinese Herbal Formula: a Multicenter, Randomized, Open Label Clinical Trial Supplementation of Diet With Galacto-oligosaccharides Increases Bifidobacteria, but Not Insulin Sensitivity, in Obese Prediabetic Individuals. Probiotic B420 and prebiotic polydextrose improve efficacy of antidiabetic drugs in mice Effects of probiotics in patients with diabetes mellitus type 2: study protocol for a randomized, double-blind, placebo-controlled trial Insight into the prebiotic concept: lessons from an exploratory, double blind intervention study with inulin-type fructans in obese women Combined effects of oligofructose and Bifidobacterium animalis on gut microbiota and glycemia in obese rats. Supplementation of Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032 in Diet-Induced Obese Mice Is Associated with Gut Microbial Changes and Reduction in Obesity Reduced Levels of D-dimer and Changes in Gut Microbiota Composition After Probiotic Intervention in HIV-Infected Individuals on Stable ART Impact of probiotic Saccharomyces boulardii on the gut microbiome composition in HIV-treated patients: A double-blind, randomised, placebo-controlled trial Two Healthy Diets Modulate Gut Microbial Community Improving Insulin Sensitivity in a Human Obese Population. Effect of alive probiotic on insulin resistance in type 2 diabetes patients: Randomized clinical trial.
Aberrant microbiota composition and function have been linked to several pathologies , including type 2 diabetes . In animal models , prebiotics induce favourable changes in the intestinal microbiota , intestinal permeability ( IP ) and endotoxaemia , which are linked to concurrent improvement in glucose tolerance . This is the first study to investigate the link between IP , glucose tolerance and intestinal bacteria in human type 2 diabetes . In all , twenty-nine men with well-controlled type 2 diabetes were r and omised to a prebiotic ( galacto-oligosaccharide mixture ) or placebo ( maltodextrin ) supplement ( 5·5 g/d for 12 weeks ) . Intestinal microbial community structure , IP , endotoxaemia , inflammatory markers and glucose tolerance were assessed at baseline and post intervention . IP was estimated by the urinary recovery of oral 51Cr-EDTA and glucose tolerance by insulin-modified intravenous glucose tolerance test . Intestinal microbial community analysis was performed by high-throughput next-generation sequencing of 16S rRNA amplicons and quantitative PCR . Prebiotic fibre supplementation had no significant effects on clinical outcomes or bacterial abundances  compared with placebo ; however , changes in the bacterial family Veillonellaceae correlated inversely with changes in glucose response and IL-6 levels ( r -0·90 , P=0·042 for both ) following prebiotic intake . The absence of significant changes to the microbial community structure at a prebiotic dosage/length of supplementation shown to be effective in healthy individuals is an important finding . We propose that concurrent metformin treatment and the high heterogeneity of human type 2 diabetes may have played a significant role . The current study does not provide evidence for the role of prebiotics in the treatment of type 2 diabetes Background : The dramatic increase in the incidence of diabetes and its associated complications require a natural and safe solution to control and delay such complications . The present study tested the hypothesis that probiotics may affect biochemical indices of diabetic patients Methods : Thirty four types 2 diabetic patients aged between 25 to 65 years , and diagnosed with diabetes for less than 15 years were selected for this single- blinded clinical trial . Using balanced block r and om sampling , the patients were divided into two groups of intervention ( probiotics ) and placebo . Blood sample s tested for baseline glucose , insulin , TG , total cholesterol , LDL-C , HDL-C , malondialdehyde , high sensitive CRP ( hs-CRP ) and IL-6 . After six weeks of experiment , fasting blood sample s were re-tested and the data obtained were analyzed using SPSS software . Results : There were no significant differences between anthropometric data including body mass index and waist to hip ratio in placebo and treatment groups . There was no significant difference in FBS , Serum TG concentration total cholesterol and LDL-C levels between placebo and treatment groups . HDL-C levels were slightly elevated after probiotic treatment , which were not statistically significant . Insulin , MDA and IL-6 levels were reduced and high sensitive CRP hs . CRP levels were elevated , although , not statistically significant . Conclusion : The result of this study indicates a non- significant declining trend in the level of TG , MDA and IL-6 and insulin resistance after consumption of probiotics Aim Evidence of a possible connection between gut microbiota and several physiological processes linked to type 2 diabetes is increasing . However , the effect of multi-strain probiotics in people with type 2 diabetes remains unclear . This study investigated the effect of multi-strain microbial cell preparation — also refers to multi-strain probiotics — on glycemic control and other diabetes-related outcomes in people with type 2 diabetes . Design A r and omized , double-blind , parallel-group , controlled clinical trial . Setting Diabetes clinic of a teaching hospital in Kuala Lumpur , Malaysia . Participants A total of 136 participants with type 2 diabetes , aged 30–70 years , were recruited and r and omly assigned to receive either probiotics ( n = 68 ) or placebo ( n = 68 ) for 12 weeks . Outcomes Primary outcomes were glycemic control-related parameters , and secondary outcomes were anthropomorphic variables , lipid profile , blood pressure and high-sensitivity C-reactive protein . The Lactobacillus and Bifidobacterium quantities were measured before and after intervention as an indicator of successful passage of the supplement through gastrointestinal tract . Statistical analysis Intention-to-treat ( ITT ) analysis was performed on all participants , while per- protocol ( PP ) analysis was performed on those participants who had successfully completed the trial with good compliance rate . Results With respect to primary outcomes , glycated hemoglobin decreased by 0.14 % in the probiotics and increased by 0.02 % in the placebo group in PP analysis ( p < 0.05 , small effect size of 0.050 ) , while these changes were not significant in ITT analysis . Fasting insulin increased by 1.8 µU/mL in placebo group and decreased by 2.9 µU/mL in probiotics group in PP analysis . These changes were significant between groups at both analyses ( p < 0.05 , medium effect size of 0.062 in PP analysis and small effect size of 0.033 in ITT analysis ) . Secondary outcomes did not change  significantly . Probiotics successfully passed through the gastrointestinal tract . Conclusion Probiotics modestly improved HbA1c and fasting insulin in people with type 2 diabetes Abstract Objective : This study was design ed to evaluate the effects of probiotic supplementation on biomarkers of inflammation , oxidative stress and pregnancy outcomes  among subjects with gestational diabetes ( GDM ) . Methods : This r and omized , double-blind , placebo-controlled clinical trial was done among 60 subjects with GDM who were not on oral hypoglycemic agents . Patients were r and omly allocated to intake either probiotic capsule containing Lactobacillus acidophilus , Lactobacillus casei and Bifidobacterium bifidum ( 2 × 109 CFU/g each ) ( n = 30 ) or placebo ( n = 30 ) for six weeks . Results : Compared with the placebo , probiotic supplementation result ed in significant decreases in fasting plasma glucose ( FPG ) ( −5.3 ± 6.7 vs. + 0.03 ± 9.0 mg/dL , p = .01 ) , serum high-sensitivity C-reactive protein ( hs-CRP ) ( −2.2 ± 2.7 vs. + 0.5 ± 2.4 μg/mL , p < .001 ) , plasma malondialdehyde ( MDA ) concentrations ( −0.1 ± 0.8 vs. + 0.5 ± 1.5 μmol/L , p = .03 ) and MDA/TAC ratio ( −0.0003 ± 0.0008 vs. + 0.0009 ± 0.002 , p = .004 ) , and a significant increase in total antioxidant capacity ( TAC ) levels ( + 65.4 ± 103.3 vs. −37.2 ± 143.7 mmol/L , p = .002 ) . Probiotic supplementation did not affect pregnancy outcomes . Conclusions : Overall , probiotic supplementation among women with GDM for six weeks had beneficial effects on FPG , serum hs-CRP , plasma TAC , MDA and oxidative stress index , but did not affect pregnancy outcomes The gut microbiota exerts a role in type 2 diabetes ( T2D ) , and deviations from a mutualistic ecosystem layout are considered a key environmental factor contributing to the disease . Thus , the possibility of improving metabolic control in T2D by correcting gut microbiome dysbioses through diet has been evaluated . Here , we explore the potential of two different energy-restricted dietary approaches – the fibre-rich macrobiotic Ma-Pi 2 diet or a control diet recommended by Italian professional societies for T2D treatment – to correct gut microbiota dysbioses in T2D patients . In a previous 21-d open-label MADIAB trial , fifty-six overweight T2D patients were r and omised to the Ma-Pi 2 or the control diet . For the present study , stools were collected before and after intervention from a subset of forty MADIAB participants , allowing us to characterise the gut microbiota by 16S rRNA sequencing and imputed metagenomics . To highlight microbiota dysbioses in T2D , the gut microbiota of thirteen normal-weight healthy controls were characterised . According to our findings , both diets were effective in modulating gut microbiome dysbioses in T2D , result ing in an increase of the ecosystem diversity and supporting the recovery of a balanced community of health-promoting SCFA producers , such as Faecalibacterium , Roseburia , Lachnospira , Bacteroides and Akkermansia .  The Ma-Pi 2 diet , but not the control diet , was also effective in counteracting the increase of possible pro-inflammatory groups , such as Collinsella and Streptococcus , in the gut ecosystem , showing the potential to reverse pro-inflammatory dysbioses in T2D , and possibly explaining the greater efficacy in improving the metabolic control The gut microbiota has been implicated in obesity and its progression towards metabolic disease . Dietary interventions that target the gut microbiota have been suggested to improve metabolic health . The aim of the present study was to investigate the effect of interventions with Lactobacillus paracasei F19 or flaxseed mucilage on the gut microbiota and metabolic risk markers in obesity . A total of fifty-eight obese postmenopausal women were r and omised to a single-blinded , parallel-group intervention of 6-week duration , with a daily intake of either L. paracasei F19 ( 9·4 × 1010 colony-forming units ) , flaxseed mucilage ( 10 g ) or placebo . Quantitative metagenomic analysis of faecal DNA was performed to identify the changes in the gut microbiota . Diet-induced changes in metabolic markers were explored using adjusted linear regression models . The intake of flaxseed mucilage over 6 weeks led to a reduction in serum C-peptide and insulin release during an oral glucose tolerance test ( P < 0·05 ) and improved insulin sensitivity measured by Matsuda index ( P < 0·05 ) . Comparison of gut microbiota composition at baseline and after 6 weeks of intervention with flaxseed mucilage  showed alterations in abundance of thirty-three metagenomic species ( P < 0·01 ) , including decreased relative abundance of eight Faecalibacterium species . These changes in the microbiota could not explain the effect of flaxseed mucilage on insulin sensitivity . The intake of L. paracasei F19 did not modulate metabolic markers compared with placebo . In conclusion , flaxseed mucilage  improves insulin sensitivity and alters the gut microbiota ; however , the improvement in insulin sensitivity was not mediated by the observed changes in relative abundance of bacterial species ABSTRACT Accumulating evidence implicates gut microbiota as promising targets for the treatment of type 2 diabetes mellitus ( T2DM ) . With a r and omized clinical trial , we tested the hypothesis that alteration of gut microbiota may be involved in the alleviation of T2DM with hyperlipidemia by metformin and a specifically design ed herbal formula ( AMC ) .  Four hundred fifty patients with T2DM and hyperlipidemia were r and omly assigned to either the metformin- or AMC-treated group . After 12 weeks of treatment , 100 patients were r and omly selected from each group and assessed for clinical improvement . The effects of the two drugs on the intestinal microbiota were evaluated by analyzing the V3 and V4 regions of the 16S rRNA gene by Illumina sequencing and multivariate statistical methods . Both metformin and AMC significantly alleviated hyperglycemia and hyperlipidemia and shifted gut microbiota structure in diabetic patients . They significantly increased a coabundant group represented by Blautia spp . , which significantly correlated with the improvements in glucose and lipid homeostasis . However , AMC showed better efficacies in improving homeostasis model assessment of insulin resistance ( HOMA-IR ) and plasma triglyceride and also exerted a larger effect on gut microbiota . Furthermore , only AMC increased the coabundant group represented by Faecalibacterium spp . , which was previously reported to be associated with the alleviation of T2DM in a r and omized clinical trial . Metformin and the Chinese herbal formula may ameliorate type 2 diabetes with hyperlipidemia via enriching beneficial bacteria , such as Blautia and Faecalibacterium spp . IMPORTANCE Metabolic diseases such as T2DM and obesity have become a worldwide public health threat . Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases , and thus the gut microbiota serves as a promising target for disease control . In this study , we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs : metformin and a specifically design ed Chinese herbal formula ( AMC ) for diabetic patients with hyperlipidemia . Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota . Blautia spp . were identified as being associated with improvements in glucose and lipid homeostasis for both drugs . AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels , which were associated with the enrichment of Faecalibacterium spp . In brief , these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula . Metabolic diseases such as T2DM and obesity have become a worldwide public health threat . Accumulating evidence indicates that gut microbiota can causatively arouse metabolic diseases , and thus the gut microbiota serves as a promising target for disease control . In this study , we evaluated the role of gut microbiota during improvements in hyperglycemia and hyperlipidemia by two drugs : metformin and a specifically design ed Chinese herbal formula ( AMC ) for diabetic patients with hyperlipidemia . Both drugs significantly ameliorated blood glucose and lipid levels and shifted the gut microbiota . Blautia spp . were identified as being associated with improvements in glucose and lipid homeostasis for both drugs . AMC exerted larger effects on the gut microbiota together with better efficacies in improving HOMA-IR and plasma triglyceride levels , which were associated with the enrichment of Faecalibacterium spp . In brief , these data suggest that gut microbiota might be involved in the alleviation of diabetes with hyperlipidemia by metformin and the AMC herbal formula BACKGROUND & AIMS The gut microbiota affects host lipid and glucose metabolism , satiety , and chronic low- grade inflammation to contribute to obesity and type 2 diabetes . Fermentation end products , in particular the short-chain fatty acid ( SCFA ) acetate , are believed to be involved in these processes . We investigated the long-term effects of supplementation with galacto-oligosaccharides ( GOS ) , an acetogenic fiber , on the composition of the human gut microbiota and human metabolism . METHODS We performed a double-blinded , placebo-controlled , parallel intervention study of 44 overweight or obese ( body mass index , 28 - 40 kg/m2 ) prediabetic men and women ( ages , 45 - 70 y ) from October 2014 through October 2015 in Maastricht , The Netherl and s. The participants were assigned r and omly to groups who ingested 15 g GOS or isocaloric placebo ( maltodextrin ) daily with their regular meals for 12 weeks . Before and after this period , we collected data on peripheral and adipose tissue insulin sensitivity , fecal microbiota composition , plasma and fecal SCFA , energy expenditure and substrate oxidation , body composition , and hormonal and inflammatory responses . The primary outcome was the effect of GOS on peripheral insulin sensitivity , measured by the hyperinsulinemic-euglycemic clamp method . RESULTS Supplementation of diets with GOS , but not placebo , increased the abundance of Bifidobacterium species in feces by 5-fold ( P = .009 ; q = 0.144 ) . Microbial richness or diversity in fecal sample s were not affected . We did not observe any differences in fecal or fasting plasma SCFA concentrations or in systemic concentrations of gut-derived hormones , incretins , lipopolysaccharide-binding protein , or other markers of inflammation . In addition , no significant alterations in peripheral and adipose tissue insulin sensitivity , body composition , and energy and substrate metabolism were found . CONCLUSIONS Twelve-week supplementation of GOS selectively increased fecal Bifidobacterium species abundance , but this did not produce significant changes in insulin sensitivity or related substrate and energy metabolism in overweight or obese prediabetic men and women . ClincialTrials.gov number , NCT02271776 Background Gut microbiota is now known to control glucose metabolism . Previous studies have shown that probiotics and prebiotics may improve glucose metabolism , but their effects have not been studied in combination with drug therapy . The aim of this study was to investigate whether probiotics and prebiotics combined with drug therapy affect diabetic outcomes . Methods Two different study design s were used to test gut microbiota modulating treatments with metformin ( MET ) or sitagliptin ( SITA ) in male C57Bl/6J mice . In Design 1 , diabetes was induced with four-week feeding with a ketogenic , 72 kcal% fat diet with virtually no carbohydrates . Mice were then r and omly divided into four groups ( n = 10 in each group ) : ( 1 ) vehicle , ( 2 ) Bifidobacterium animalis ssp . lactis 420 ( B420 ) ( 109 CFU/day ) , ( 3 ) MET ( 2 mg/mL in drinking water ) , or ( 4 ) MET + B420 ( same doses as in the MET and B420 groups ) . After another 4 weeks , glucose metabolism was assessed with a glucose tolerance test . Fasting glucose , fasting insulin and HOMA-IR were also assessed . In Design 2 , mice were fed the same 72 kcal% fat diet to induce diabetes , but they were simultaneously treated within their respective groups ( n = 8 in each group ) : ( 1 ) non-diabetic healthy control , ( 2 ) vehicle , ( 3 ) SITA [ 3 mg/(kg*day ) ] ( 4 ) SITA with prebiotic polydextrose ( PDX ) ( 0.25 g/day ) , ( 5 ) SITA with B420 ( 109 CFU/day ) , and ( 6 ) SITA + PDX + B420 . Glucose metabolism was assessed at 4 weeks , and weight development was monitored for 6 weeks . Results In Design 1 , with low-dose metformin , mice treated with B420 had a significantly lower glycemic response ( area under the curve ) ( factorial experiment , P = 0.002 ) and plasma glucose concentration ( P = 0.02 ) compared to mice not treated with B420 . In Design 2 , SITA + PDX  reduced glycaemia in the oral glucose tolerance test significantly more than SITA only ( area under the curve reduced 28 % , P < 0.0001 ) . In addition , B420 , PDX or B420+PDX , together with SITA , further decreased fasting glucose concentrations compared to SITA only ( −19.5 , −40 and −49 % , respectively , P < 0.01 for each comparison ) . The effect of PDX may be due to its ability to increase portal vein GLP-1 concentrations together with SITA ( P = 0.0001 compared to vehicle ) whereas SITA alone had no statistically significant effect compared to vehicle ( P = 0.14 ) . Conclusions This study proposes that combining probiotics and /or prebiotics with antidiabetic drugs  improves glycemic control and insulin sensitivity in mice . Mechanisms could be related to incretin secretion Background Low grade chronic inflammation is observed in patients with type 2 diabetes mellitus ( T2DM ) . Endotoxin derived from gut bacteria may act as a potent inflammatory stimulant . Probiotics , which are believed to contain health promoting live microorganisms , may influence circulating endotoxin levels . Ingestion of live probiotic cultures may alter gut microbiota in a beneficial manner to reduce inflammation ; no information is available whether or not they do so in patients with T2DM . Therefore , the aim of this study is to characterize the beneficial effects of probiotics on circulating endotoxin levels and other biomarkers related to systemic low- grade inflammation in patients with T2DM . Methods One hundred and twenty consenting adult Saudi T2DM patients ( naïve or newly diagnosed and without co-morbidities ) will be enrolled in this clinical trial and r and omized to receive daily placebo or probiotics ( Ecologic ® Barrier ) for 26 weeks in a double-blind manner . Inflammatory and metabolic markers will be measured and fecal sample s analyzed . Measurements / sample s will be obtained at baseline and after 4 , 8 , 12/13 and 26 weeks of treatment . Discussion It is expected that the probiotic product will induce beneficial changes in gut microbiota , reduce the systemic inflammatory state through altering systemic endotoxin levels and , as such , reduce the systemic inflammatory response observed in T2DM subjects . Trial registration Clinical Trials.gov Identifier : Objective To highlight the contribution of the gut microbiota to the modulation of host metabolism by dietary inulin-type fructans ( ITF prebiotics ) in obese women . Methods A double blind , placebo controlled , intervention study was performed with 30 obese women treated with ITF prebiotics ( inulin/oligofructose 50/50 mix ; n=15 ) or placebo ( maltodextrin ; n=15 ) for 3 months ( 16 g/day ) .  Blood , faeces and urine sampling , oral glucose tolerance test , homeostasis model assessment and impedancemetry were performed before and after treatment . The gut microbial composition in faeces was analysed by phylogenetic microarray and qPCR analysis of 16S rDNA . Plasma and urine metabolic profiles were analysed by 1H-NMR spectroscopy . Results Treatment with ITF prebiotics , but not the placebo , led to an increase in Bifidobacterium and Faecalibacterium prausnitzii ; both bacteria negatively correlated with serum lipopolysaccharide levels .  ITF prebiotics also decreased Bacteroides intestinalis , Bacteroides vulgatus and Propionibacterium , an effect associated with a slight decrease in fat mass and with plasma lactate and phosphatidylcholine levels . No clear treatment clustering could be detected for gut microbial analysis or plasma and urine metabolomic profile analyses . However , ITF prebiotics led to subtle changes in the gut microbiota that may importantly impact on several key metabolites implicated in obesity and /or diabetes . Conclusions ITF prebiotics selectively changed the gut microbiota composition in obese women , leading to modest changes in host metabolism , as suggested by the correlation between some bacterial species and metabolic endotoxaemia or metabolomic signatures OBJECTIVE Prebiotics and probiotics may be able to modify an obesity-associated gut microbiota . The aim of this study was to examine the individual and combined effects of the prebiotic oligofructose ( OFS ) and the probiotic Bifidobacterium animalis subsp . lactis BB-12 ( BB-12 ) on gut microbiota and host metabolism in obese rats . METHODS Adult male , diet-induced obese Sprague Dawley rats were r and omized to : ( 1 ) Control ( C ) ; ( 2 ) 10 % OFS ; ( 3 ) BB-12 ; ( 4 ) OFS + BB-12 for 8 weeks ( n = 9 - 10 rats/group ) . Body composition , glycemia , gut permeability , satiety hormones , cytokines , and gut microbiota were examined . RESULTS Prebiotic , but not probiotic  reduced energy intake , weight gain , and fat mass ( P < 0.01 ) . OFS , BB-12 , and the combined OFS + BB-12  improved glycemia ( P < 0.05 ) . Individually , OFS and BB-12  reduced insulin levels ( P < 0.05 ) . Portal GLP-1 was increased with OFS , whereas probiotic increased GLP-2 ( P < 0.05 ) . There was a marked increase in bifidobacteria and lactobacilli ( P < 0.01 ) with OFS that was not observed with probiotic alone . CONCLUSIONS The impact of prebiotic intake on body composition and gut microbiota was of greater magnitude than the probiotic BB-12 . Despite this , an improvement in glucose AUC with both prebiotic or probiotic demonstrates the beneficial role of each of these " biotic " agents in glycemic control Objective To investigate the functional effects of probiotic treatment on the gut microbiota , as well as liver and adipose gene expression in diet-induced obese mice . Design Male C57BL/6J mice were fed a high-fat diet ( HFD ) for 8 weeks to induce obesity , and then r and omized to receive HFD+probiotic ( Lactobacillus curvatus HY7601 and Lactobacillus plantarum KY1032 , n = 9 ) or HFD+placebo ( n = 9 ) for another 10 weeks . Normal diet ( ND ) fed mice ( n = 9 ) served as non-obese controls . Results Diet-induced obese mice treated with probiotics showed reduced body weight gain and fat accumulation as well as lowered plasma insulin , leptin , total-cholesterol and liver toxicity biomarkers . A total of 151,061 pyrosequencing reads for fecal microbiota were analyzed with a mean of 6,564 , 5,274 and 4,464 reads for the ND , HFD+placebo and HFD+probiotic groups , respectively . Gut microbiota species were shared among the experimental groups despite the different diets and treatments . The diversity of the gut microbiota and its composition were significantly altered in the diet-induced obese mice and after probiotic treatment . We observed concurrent transcriptional changes in adipose tissue and the liver . In adipose tissue , pro-inflammatory genes ( TNFα , IL6 , IL1β and MCP1 ) were down-regulated in mice receiving probiotic treatment . In the liver , fatty acid oxidation-related genes ( PGC1α , CPT1 , CPT2 and ACOX1 ) were up-regulated in mice receiving probiotic treatment . Conclusions The gut microbiota of diet-induced obese mice appears to be modulated in mice  receiving probiotic treatment . Probiotic treatment might reduce diet-induced obesity and modulate genes associated with metabolism and inflammation in the liver and adipose tissue Background : Microbial translocation and chronic inflammation may contribute to non-AIDS morbidity in patients with HIV . This study assessed the impact of probiotic intervention on microbial translocation and inflammation in patients on antiretroviral therapy with viral suppression and subnormal CD4 count . Methods : Thirty-two patients receiving antiretroviral therapy ( CD4 < 500 cells/&mgr;L ) were r and omized in a double-blind fashion to multistrain daily probiotics ( n = 15 ) , placebo ( n = 9 ) , or controls ( n = 8) for 8 weeks . Soluble inflammation markers , D-dimer , lipopolysaccharide ( LPS ) , sCD14 , T-cell activation , tryptophan metabolites , and gut microbiota composition were analyzed at baseline and end of study . Nonparametric statistics were applied . Results : Twenty-four participants completed the study and were included in as-treated analyses . In patients receiving probiotics , there was a significant reduction in D-dimer levels ( median change 33 % , P = 0.03 ) and a tendency to reduced levels of C-reactive protein ( CRP ) ( P = 0.05 ) and interleukin (IL)-6 ( P = 0.06 ) . The changes in CRP and IL-6 were highly correlated ( r = 0.95 , P < 0.01 ) , whereas changes in D-dimer did not correlate with changes in CRP or IL-6 . Increases in Bifidobacteria ( P = 0.04 ) and Lactobacilli ( P = 0.06 ) were observed in the probiotic group , whereas the relative abundance of Bacteroides decreased ( P ⩽ 0.01 ) . No significant changes were seen in markers of microbial translocation or T-cell activation . However , the expansion of Bifidobacteria correlated negatively with differences in LPS ( r = −0.77 , P = 0.01 ) , whereas the reduction in Bacteroides correlated positively with changes in LPS during the study period ( r = 0.72 , P = 0.02 ) . Conclusions : Probiotic intervention seemed to reduce markers of coagulation and inflammation without overt changes in microbial translocation . These findings warrant further studies in larger cohorts with long-term follow-up Dysbalance in gut microbiota has been linked to increased microbial translocation , leading to chronic inflammation in HIV- patients , even under effective HAART . Moreover , microbial translocation is associated with insufficient reconstitution of CD4+T cells , and contributes to the pathogenesis of immunologic non-response . In a double-blind , r and omised , placebo-controlled trial , we recently showed that , compared to placebo , 12 weeks treatment with probiotic Saccharomyces boulardii significantly reduced plasma levels of bacterial translocation ( Lipopolysaccharide-binding protein or LBP ) and systemic inflammation ( IL-6 ) in 44 HIV virologically suppressed patients , half of whom ( n = 22 ) had immunologic non-response to antiretroviral therapy ( < 270 CD4+Tcells/μL despite long-term suppressed viral load ) . The aim of the present study was to investigate if this beneficial effect of the probiotic Saccharomyces boulardii is due to modified gut microbiome composition , with a decrease of some species associated with higher systemic levels of microbial translocation and inflammation . In this study , we used 16S rDNA gene amplification and parallel sequencing to analyze the probiotic impact on the composition of the gut microbiome ( faecal sample s ) in these 44 patients r and omized to receive oral supplementation with probiotic or placebo for 12 weeks . Compared to the placebo group , in individuals treated with probiotic we observed lower concentrations of some gut species , such as those of the Clostridiaceae family , which were correlated with systemic levels of bacterial translocation and inflammation markers . In a sub- study of these patients , we observed significantly higher parameters of microbial translocation ( LBP , soluble CD14 ) and systemic inflammation in immunologic non-responders than in immunologic responders , which was correlated with a relative abundance of specific gut bacterial groups ( Lachnospiraceae genus and Proteobacteria ) . Thus , in this work , we propose a new therapeutic strategy using the probiotic yeast S. boulardii to modify gut microbiome composition . Identifying pro-inflammatory species in the gut microbiome could also be a useful new marker of poor immune response and a new therapeutic target CONTEXT Gut microbiota , which acts collectively as a fully integrated organ in the host metabolism , can be shaped by long-term dietary interventions after a specific diet . OBJECTIVE The aim was to study the changes in microbiota after 1 year 's consumption of a Mediterranean diet ( Med diet ) or a low-fat , high-complex carbohydrate diet ( LFHCC diet ) in an obese population . DESIGN Participants were r and omized to receive the Med diet ( 35 % fat , 22 % monounsaturated ) and the LFHCC diet ( 28 % fat , 12 % monounsaturated ) . SETTING AND PARTICIPANTS The study was conducted in 20 obese patients ( men ) within the Coronary Diet Intervention With Olive Oil and Cardiovascular Prevention ( CORDIOPREV ) study , an ongoing prospect i ve , r and omized , opened , controlled trial in patients with coronary heart disease . MAIN OUTCOME MEASURE We evaluated the bacterial composition and its relationship with the whole fecal and plasma metabolome . RESULTS The LFHCC diet increased the Prevotella and decreased the Roseburia genera , whereas the Med diet decreased the Prevotella and increased the Roseburia and Oscillospira genera ( P = .028 , .002 , and .016 , respectively ) . The abundance of Parabacteroides distasonis ( P = .025 ) and Faecalibacterium prausnitzii ( P = .020 ) increased after long-term consumption of the Med diet and the LFHCC diet , respectively . The changes in the abundance of 7 of 572 metabolites found in feces , including mainly amino acid , peptide , and sphingolipid metabolism , could be linked to the changes in the gut microbiota . CONCLUSIONS Our results suggest that long-term consumption of the Med and LFHCC diets exerts a protective effect on the development of type 2 diabetes by different specific changes in the gut microbiota , increasing the abundance of the Roseburia genus and F. prausnitzii , respectively BACKGROUND Probiotics have beneficial effect on obesity related disorders in animal models . Despite a large number of animal data , r and omized placebo-controlled trials ( RCT ) concluded that probiotics have a moderate effect on glycemic control-related parameters . However , effect of probiotics on insulin resistance are inconsistent . AIM In a double-blind single center RCT , effect of alive multistrain probiotic vs. placebo on insulin resistance in type 2 diabetes patient were assessed . METHODS A total of 53 patients met the criteria for inclusion . They were r and omly assigned to receive multiprobiotic " Symbiter " ( concentrated biomass of 14 probiotic bacteria genera Bifidobacterium , Lactobacillus , Lactococcus , Propionibacterium ) or placebo for 8-weeks administered as a sachet formulation . The primary main outcome was the change HOMA-IR ( homeostasis model assessment -estimated insulin resistance ) which calculated using Matthews et al. 's equation . Secondary outcomes were the changes in glycemic control-related parameters , anthropomorphic variables and cytokines . RESULTS Supplementation with alive multiprobiotic for 8 weeks was associated with significant reduction of HOMA-IR from 6.85 ± 0.76 to 5.13 ± 0.49 ( p = 0.047 ) , but remained static in the placebo group . With respect to our secondary outcomes , HbA1c insignificant decreased by 0.09 % ( p = 0.383 ) and 0.24 % ( p = 0.068 ) respectively in placebo and probiotics groups . However , in probiotic responders ( n = 22 , patient with decrease in HOMA-IR ) after supplementation a significant reduction in HbA1c by 0.39 % ( p = 0.022 ) as compared to non-responders was observed . In addition , from markers of chronic systemic inflammatory state only TNF-α and IL-1β changes significantly after treatment with probiotics . CONCLUSION Probiotic therapies modestly improved insulin resistance in patients with type 2 diabetes
The results of this systematic review and meta‐ analysis suggest that probiotic and synbiotic supplementation may help to improve biomarkers of inflammation and oxidative stress in diabetic patients .
Abstract The role of gut microbiota in the management of diabetes has been shown .
Several current trials are investigating the effect of probiotics and prebiotics , which are widely used to modulate intestinal microbiota , on inflammatory factors and biomarkers of oxidative stress in diabetic patients ; however , their findings are controversial .
The aim of the current meta‐ analysis was to evaluate the effects of probiotic and synbiotic supplementation on levels of serum high‐sensitivity C‐reactive protein ( hs‐CRP ) and biomarkers of oxidative stress in diabetic patients .