Department of Microbiology and Virology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Anatomy, School of Medicine, Iranshahr University of Medical Sciences, Iranshahr, Iran.
BMC Infect Dis. 2024 Nov 4;24(1):1240. doi: 10.1186/s12879-024-10146-0.
In the new era, microbial-based medicine is one of the best strategies that try to modify the normal flora with the aim of treating some disorders. This systematic review and meta-analysis was performed to evaluate the use of probiotics in the treatment of the clinical outcomes in cases with traumatic brain injury..
In this regard, the search strategy was done using databases such as PubMed, Embase, Scopus, CENTRAL, and Google Scholar, from 2006 until April 2024. All studies about the efficacy of probiotic supplementation on the clinical outcomes in traumatic brain injury patients were retrieved. During the assessment process of the eligible studies, we evaluated clinical characteristics such as the Glasgow Coma Scale score, the Sequential Organ Failure Assessment score, the Acute Physiology and Chronic Health Evaluation II score, referral rate and hospitalization period in the intensive care unit, mortality rate, as well as opportunistic infections in both groups of case and control..
In this study, the authors analyzed data from 6 articles including 391 cases with traumatic brain injury. Our results showed that the probiotic therapy increases the Glasgow Coma Scale score in patients with the average age of more than 50 years. However, there was no a significant difference in the Sequential Organ Failure Assessment and the Acute Physiology and Chronic Health Evaluation scores between the group that had received probiotics and the control group. Although probiotic-based treatment did not significantly affect the intensive care unit admission (or length of stay), but, the risk of infection, and also mortality was significantly lower in the probiotic group (OR: 0.53; 95% CI: 0.3 to 0.8, as well as OR: 0.41; 95% CI: 0.2 to 0.7, respectively)..
Overall, due to the modification of microbial flora, probiotic supplements can balance microflora disturbances, which in turn leads to improvement the clinical outcomes in patients with brain injury. Therefore, probiotic-based therapy can be considered as a promising strategy for the treatment of the central nervous system disorders. However, given the limited evidence, more clinical trial studies need to strengthen our results..
在新时代，基于微生物的医学是试图通过改变正常菌群来治疗某些疾病的最佳策略之一。本系统评价和荟萃分析旨在评估益生菌在治疗创伤性脑损伤患者临床结局中的应用。
为此，我们使用了 PubMed、Embase、Scopus、CENTRAL 和 Google Scholar 等数据库进行搜索策略，检索时间从 2006 年到 2024 年 4 月。检索到的所有关于益生菌补充剂对创伤性脑损伤患者临床结局影响的研究都被纳入。在评估合格研究的临床特征时，我们评估了格拉斯哥昏迷评分、序贯器官衰竭评估评分、急性生理学和慢性健康评估 II 评分、重症监护病房的转诊率和住院时间、死亡率以及两组病例和对照中机会性感染。
本研究分析了包括 391 例创伤性脑损伤患者在内的 6 篇文章的数据。我们的结果表明，益生菌治疗可提高年龄大于 50 岁的患者的格拉斯哥昏迷评分。然而，益生菌组和对照组之间的序贯器官衰竭评估和急性生理学和慢性健康评估评分无显著差异。虽然益生菌治疗并未显著影响重症监护病房的入住（或住院时间），但益生菌组的感染风险和死亡率显著降低（OR：0.53；95%CI：0.3 至 0.8，以及 OR：0.41；95%CI：0.2 至 0.7）。
总的来说，由于微生物菌群的改变，益生菌补充剂可以平衡微生物群的紊乱，从而改善脑损伤患者的临床结局。因此，益生菌治疗可以被认为是治疗中枢神经系统疾病的有前途的策略。然而，由于证据有限，需要更多的临床试验研究来加强我们的结果。
