Stanley Research Program at Sheppard Pratt, Sheppard Pratt Health System, Baltimore, MD, USA.
Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Bipolar Disord. 2018 Nov;20(7):614-621. doi: 10.1111/bdi.12652. Epub 2018 Apr 25.
Immunological abnormalities play a role in the pathophysiology of mania and have been associated with relapse. Probiotic organisms such as Lactobacilli and Bifidobacteria modulate inflammation in humans and animal models. The trial examined whether the administration of probiotic organisms prevents psychiatric rehospitalizations in patients recently discharged following hospitalization for mania.
Patients hospitalized for mania (N = 66) were randomized after discharge to receive 24 weeks of adjunctive probiotics (Lactobacillus rhamnosus strain GG and Bifidobacterium animalis subsp. lactis strain Bb12) or adjunctive placebo in a parallel two-group design format. The effect of treatment group on the risk of rehospitalization was calculated using Cox regression models. The modulating effect of systemic inflammation was measured employing an inflammation score based on immunoglobulin levels directed at previously defined antigens.
During the 24-week observation period there were a total of 24 rehospitalizations in the 33 individuals who received placebo and eight rehospitalizations in the 33 individuals who received the probiotics (z = 2.63, P = .009). Hazard functions indicated that the administration of the probiotics was associated with a significant advantage in time to all psychiatric rehospitalizations (hazard ratio [HR] = 0.26, 95% confidence interval [CI] 0.10, .69; P = .007). Probiotic treatment also resulted in fewer days rehospitalized (mean 8.3 vs 2.8 days for placebo and probiotic treatment, respectively; χ = 5.17, P = .017). The effect of the probiotic treatment on the prevention of rehospitalization was increased in individuals with elevated levels of systemic inflammation at baseline.
Probiotic supplementation is associated with a lower rate of rehospitalization in patients who have been recently discharged following hospitalization for mania.
免疫异常在躁狂症的病理生理学中起作用，并与复发有关。益生菌如乳杆菌和双歧杆菌可调节人类和动物模型的炎症。该试验研究了在躁狂症住院治疗后出院的患者中，给予益生菌是否可以预防精神病再住院。
在出院后，将 66 名因躁狂症住院的患者随机分为两组，一组接受为期 24 周的益生菌（鼠李糖乳杆菌 GG 株和双歧杆菌动物亚种乳杆菌 BB12 株）辅助治疗，另一组接受辅助安慰剂治疗，采用平行两组设计。使用 Cox 回归模型计算治疗组对再住院风险的影响。采用基于针对先前定义抗原的免疫球蛋白水平的炎症评分来测量系统炎症的调节作用。
在 24 周的观察期内，接受安慰剂的 33 名患者中有 24 人再住院，接受益生菌的 33 名患者中有 8 人再住院（z = 2.63，P =.009）。危险函数表明，益生菌的给药与所有精神病再住院的时间显著延长相关（危险比[HR] = 0.26，95%置信区间[CI] 0.10，.69；P =.007）。益生菌治疗还导致再住院天数减少（分别为安慰剂和益生菌治疗的平均 8.3 天和 2.8 天；χ ² = 5.17，P =.017）。在基线时有较高系统炎症水平的个体中，益生菌治疗对预防再住院的效果增加。
在因躁狂症住院治疗后出院的患者中，益生菌补充与再住院率降低相关。
