School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Guangdong Provincial Key Laboratory of Food, Nutrition, and Health, Department of Nutrition, School of Public Health, Sun Yat-Sen University, Guangzhou, China.
Adv Nutr. 2020 Jul 1;11(4):979-988. doi: 10.1093/advances/nmaa003.
Dysbiosis of the human gut microbiome has been linked to various health conditions, including respiratory tract infections (RTIs) through the gut-lung axis. Several trials have reported that synbiotic therapy could help prevent RTIs or relieve symptoms of some diseases. This meta-analysis comprehensively evaluates the clinical effects of synbiotic supplements for preventing RTIs. PubMed and Google Scholar were searched by keywords for eligible clinical trials until April 2019. Sixty-two studies were retrieved, and 16 studies were selected for meta-analysis. The primary outcomes were defined as the proportion of participants with RTIs at least once or the times of RTI episodes during follow-up based on the intention-to-treat approach. Overall, synbiotic interventions reduced the incidence rate of RTIs by 16% (95% CI: 4%, 27%) and the proportion of participants experiencing RTIs by 16% (95% CI: 5%, 26%). There was no significant evidence of publication bias. A subgroup analysis suggested more prominent effects of synbiotics among adults than infants and children for RTI prevention. The sensitivity analysis excluding trials with prebiotics or probiotics as controls was consistent with our primary analysis. This meta-analysis of clinical trials involving >10,000 individuals showed that synbiotic interventions could be an alternative nutrition strategy for conferring human health and preventing RTIs. Future investigations on the clinical efficacy and safety of synbiotic interventions are warranted with strain-specific and dose-specific approaches.
人类肠道微生物群的失调与各种健康状况有关,包括通过肠道-肺部轴引起的呼吸道感染(RTIs)。几项试验报告称,合生素疗法有助于预防 RTIs 或缓解某些疾病的症状。这项荟萃分析全面评估了合生素补充剂预防 RTIs 的临床效果。通过关键词在 PubMed 和 Google Scholar 上搜索合格的临床试验,直到 2019 年 4 月。检索到 62 项研究,其中 16 项研究被纳入荟萃分析。主要结局定义为根据意向治疗方法,至少一次发生 RTIs 的参与者比例或随访期间 RTI 发作次数。总体而言,合生素干预可使 RTIs 的发生率降低 16%(95%CI:4%,27%),使发生 RTIs 的参与者比例降低 16%(95%CI:5%,26%)。没有明显的发表偏倚证据。亚组分析表明,合生素对预防 RTIs 的效果在成年人中比婴儿和儿童更为显著。排除以益生元或益生菌作为对照的试验的敏感性分析与我们的主要分析一致。这项涉及超过 10000 人的临床试验荟萃分析表明,合生素干预可能是赋予人类健康和预防 RTIs 的一种替代营养策略。需要采用特定菌株和特定剂量的方法进一步研究合生素干预的临床疗效和安全性。
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