Darbandi Atieh, Navidifar Tahereh, Koupaei Maryam, Afifirad Roghayeh, Nezhad Reyhaneh Amin, Emamie Amir, Talebi Malihe, Kakanj Maryam
Molecular Microbiology Research Center Shahed University Theran Iran.
Department of Basic Sciences Shoushtar Faculty of Medical Sciences Shoushtar Iran.
Health Sci Rep. 2025 Mar 18;8(3):e70521. doi: 10.1002/hsr2.70521. eCollection 2025 Mar.
Probiotics usually have beneficial effects on the absorption of trace elements and detoxification of toxic metals in human. Hence, the aim of the systematic review was to evaluate various aspects of the effect of the combination of probiotics and heavy metals in human clinical trial studies.
Nine databases were searched for clinical trials up to June 2024 investigating probiotics for heavy metal exposure in humans. Two reviewers independently screened records and extracted data on study characteristics, interventions, outcomes, and results. Risk of bias was assessed.
The analysis included 31 clinical trials with a total of 4,611 participants, focusing on the effects of probiotics, prebiotics, and synbiotics. Among the trials, 23 investigated probiotics, five looked at prebiotics, and three explored synbiotics, with probiotic doses ranging from 10 to 2.5 × 10 CFU/day. Results indicated that probiotics combined with zinc significantly reduced the time to resolution of vomiting and diarrhea compared to zinc alone, improved the treatment efficacy of antibiotic-associated diarrhea linked to pneumonia, and shortened hospital stays relative to probiotics alone. Probiotics did not show significant effects on blood parameters compared to placebo; however, prebiotic galactooligosaccharides enhanced iron absorption in women and children. The addition of probiotics to bismuth quadruple therapy did not improve eradication rates but reduced side effects like diarrhea and vomiting. One trial reported a decrease in toxic metal levels in pregnant women due to probiotics, but no similar effects were observed in children.
Probiotics are one of the new methods employed to improve or eliminate the adverse effects of heavy metals in the body. Although many studies have investigated the effects of probiotics on heavy metals, there is still a need for more in-depth and extensive studies.
益生菌通常对人体微量元素的吸收及有毒金属的解毒具有有益作用。因此，本系统评价的目的是评估益生菌与重金属联合作用在人体临床试验研究中的各个方面。
检索了9个数据库，查找截至2024年6月研究益生菌对人体重金属暴露影响的临床试验。两名评价者独立筛选记录，并提取关于研究特征、干预措施、结局和结果的数据。评估偏倚风险。
分析纳入了31项临床试验，共4611名参与者，重点关注益生菌、益生元及合生元的作用。其中，23项研究了益生菌，5项研究了益生元，3项研究了合生元，益生菌剂量范围为10至2.5×10CFU/天。结果表明，与单独使用锌相比，益生菌联合锌显著缩短了呕吐和腹泻的缓解时间，提高了与肺炎相关的抗生素相关性腹泻的治疗效果，且相对于单独使用益生菌缩短了住院时间。与安慰剂相比，益生菌对血液参数无显著影响；然而，益生元低聚半乳糖可增强妇女和儿童对铁的吸收。铋四联疗法中添加益生菌并未提高根除率，但减少了腹泻和呕吐等副作用。一项试验报告称，益生菌可降低孕妇体内有毒金属水平，但在儿童中未观察到类似效果。
益生菌是用于改善或消除体内重金属不良反应的新方法之一。尽管许多研究已调查了益生菌对重金属的影响，但仍需要更深入和广泛的研究。
