Dipalma Gianna, Marinelli Grazia, Ferrante Laura, Di Noia Angela, Carone Claudio, Colonna Valeria, Marotti Pierluigi, Inchingolo Francesco, Palermo Andrea, Tartaglia Gianluca Martino, Del Fabbro Massimo, Inchingolo Angelo Michele, Inchingolo Alessio Danilo
Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", 70124 Bari, Italy.
Department of Experimental Medicine, University of Salento, 73100 Lecce, Italy.
Nutrients. 2025 Jul 9;17(14):2261. doi: 10.3390/nu17142261.
AIM: This systematic review aims to evaluate the effectiveness of microbiota-modulating interventions (such as probiotics, prebiotics, and fecal microbiota transplantation) in reducing cognitive symptoms, pain, and neuroinflammation in human studies relevant to fibromyalgia (FM). The review will investigate the role of gut-brain axis modulation through these interventions and explore the potential therapeutic benefits for FM management. MATERIALS AND METHODS: A comprehensive search was conducted in electronic databases including PubMed, Scopus, and the Cochrane Library for studies published from 1 January 2015 to 30 April 2025. Studies were eligible if they were randomized controlled trials (RCTs), pilot studies, or observational studies assessing the impact of microbiota-targeted interventions (probiotics, prebiotics, fecal microbiota transplantation) on cognitive function, pain, or neuroinflammation in patients with FM. Studies were excluded if they involved animal models, lacked relevant outcome measures, or were not peer-reviewed. Although only a subset of the included studies directly involved FM patients, all were selected for their relevance to symptom domains (e.g., pain, cognition, mood) and mechanisms (e.g., neuroinflammation, gut-brain axis dysfunction) that are central to FM. A total of 11 human studies were included in the final qualitative synthesis. RESULTS: Preliminary findings from the included studies suggest that microbiota-targeted interventions, particularly probiotics and prebiotics, show promise in reducing cognitive symptoms, pain, and neuroinflammation in FM patients. Improvements in mood and quality of life were also reported, indicating potential benefits for overall well-being. However, heterogeneity in study designs, sample sizes, and outcome measures limit the ability to draw definitive conclusions. CONCLUSIONS: This systematic review highlights the potential of microbiota modulation as a therapeutic strategy for managing FM symptoms, particularly cognitive dysfunction and neuroinflammation.
目的：本系统评价旨在评估微生物群调节干预措施（如益生菌、益生元及粪便微生物群移植）在与纤维肌痛（FM）相关的人体研究中减轻认知症状、疼痛和神经炎症的有效性。该评价将研究通过这些干预措施调节肠-脑轴的作用，并探索其对FM管理的潜在治疗益处。 材料与方法：在包括PubMed、Scopus和Cochrane图书馆在内的电子数据库中进行全面检索，查找2015年1月1日至2025年4月30日发表的研究。如果研究为随机对照试验（RCT）、试点研究或观察性研究，评估针对微生物群的干预措施（益生菌、益生元、粪便微生物群移植）对FM患者认知功能、疼痛或神经炎症的影响，则符合纳入标准。如果研究涉及动物模型、缺乏相关结局指标或未经同行评审，则予以排除。虽然纳入研究中只有一部分直接涉及FM患者，但所有研究均因其与FM核心的症状领域（如疼痛、认知、情绪）和机制（如神经炎症、肠-脑轴功能障碍）相关而被选中。最终的定性综合分析纳入了11项人体研究。 结果：纳入研究的初步结果表明，针对微生物群的干预措施，尤其是益生菌和益生元，在减轻FM患者的认知症状、疼痛和神经炎症方面显示出前景。还报告了情绪和生活质量的改善，表明对整体幸福感有潜在益处。然而，研究设计、样本量和结局指标的异质性限制了得出明确结论的能力。 结论：本系统评价强调了微生物群调节作为管理FM症状，特别是认知功能障碍和神经炎症的治疗策略的潜力。
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