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最常用益生菌菌株之一的安全性:对报告的不良事件的系统评价和荟萃分析

Safety of One of the Most Commonly Used Probiotic Strains: Systematic Review and Meta-analysis of Reported Adverse Events.

作者信息

Kumar Aneesha, Merenstein Daniel, Tan Tina, Obeng-Nyarkoh Peggy-Ita, Hojsak Iva, D'Amico Frank

机构信息

Department of Family Medicine, Georgetown University School of Medicine, 4000 Reservoir Rd. NW Building D Room 281, Washington, DC, 20007, USA.

Graduate School of Arts and Sciences, Georgetown University, Washington, DC, USA.

出版信息

Probiotics Antimicrob Proteins. 2025 Sep 2. doi: 10.1007/s12602-025-10740-x.


DOI:10.1007/s12602-025-10740-x
PMID:40892162
Abstract

Probiotics are defined as live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Probiotics are widely used in everyday foods and supplements but very few studies have thoroughly evaluated safety. We evaluated adverse events (AEs) for one of the most widely used strains, Bifidobacterium animalis subsp. lactis (BB-12). A systematic review (SR) and meta-analysis (MA) were conducted to evaluate adverse events in human trials using BB-12. Two independent reviewers separately searched for randomized controlled trials (RCTs) using the following mesh words for inclusion: English language, double-blinded, randomized or random allocation, and placebo-controlled trial of BB-12. One hundred and eighty-one studies were identified of which 35 qualified for inclusion. All authors of the 35 studies were contacted to perform an individual patient data meta-analysis (IPDMA). Results from the MA studies showed there was no statistical difference in the rates of AE between the probiotic (15.2%) and placebo (14%) groups, odds ratio = 1.10, 95% confidence interval (0.88, 1.36), p = .40. Further, results from the IPDMA showed statistically similar unadjusted (27% vs. 25%) and adjusted rates of AE (43% vs. 41%) between BB-12 and placebo, with the relative risk of AE being 1.05, 95% confidence interval (.94, 1.15). Both meta-analysis approaches showed no difference in the rates of AE for the BB-12 and placebo groups. The data support the safety of wide usage of BB-12. However, half of the RCTs analyzed for the MA did not report AE data. This is a major limitation of published literature. This study has been registered in PROSPERO: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023434556.

摘要

益生菌被定义为一类活的微生物,当给予足够数量时,能给宿主带来健康益处。益生菌广泛应用于日常食品和补充剂中,但很少有研究对其安全性进行全面评估。我们评估了最广泛使用的菌株之一动物双歧杆菌乳亚种(BB - 12)的不良事件(AE)。进行了一项系统评价(SR)和荟萃分析(MA),以评估在使用BB - 12的人体试验中的不良事件。两名独立评审员分别使用以下主题词搜索随机对照试验(RCT)以纳入研究:英文、双盲、随机或随机分配以及BB - 12的安慰剂对照试验。共识别出181项研究,其中35项符合纳入标准。联系了这35项研究的所有作者以进行个体患者数据荟萃分析(IPDMA)。荟萃分析研究结果显示,益生菌组(15.2%)和安慰剂组(14%)的不良事件发生率无统计学差异,优势比 = 1.10,95%置信区间(0.88,1.36),p = 0.40。此外,个体患者数据荟萃分析结果显示,BB - 12组和安慰剂组未经调整的不良事件发生率(27%对25%)和调整后的不良事件发生率(43%对41%)在统计学上相似,不良事件的相对风险为1.05,95%置信区间(0.94,1.15)。两种荟萃分析方法均显示BB - 12组和安慰剂组的不良事件发生率无差异。这些数据支持广泛使用BB - 12的安全性。然而,纳入荟萃分析的随机对照试验中有一半未报告不良事件数据。这是已发表文献的一个主要局限性。本研究已在国际前瞻性系统评价注册库(PROSPERO)注册:https://www.crd.york.ac.uk/PROSPERO/view/CRD42023434556 。

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本文引用的文献

[1]
Effectiveness of Bivalent mRNA COVID-19 Vaccines in Preventing SARS-CoV-2 Infection in Children and Adolescents Aged 5 to 17 Years.

JAMA. 2024-2-6

[2]
subsp. BB-12 Protects against Antibiotic-Induced Functional and Compositional Changes in Human Fecal Microbiome.

Nutrients. 2021-8-17

[3]
The methodological quality of individual participant data meta-analysis on intervention effects: systematic review.

BMJ. 2021-4-19

[4]
Adverse event reporting in intervention research for young autistic children.

Autism. 2021-2

[5]
Safety of Probiotics: Functional Fruit Beverages and Nutraceuticals.

Foods. 2020-7-17

[6]
Effects of the Consumption of Probiotic Yogurt Containing Bifidobacterium lactis Bb12 on the Levels of Streptococcus mutans and Lactobacilli in Saliva of Students with Initial Stages of Dental Caries: A Double-Blind Randomized Controlled Trial.

Caries Res. 2019-12-10

[7]
The therapeutic efficacy of Bifidobacterium animalis subsp. lactis BB-12 in infant colic: A randomised, double blind, placebo-controlled trial.

Aliment Pharmacol Ther. 2019-12-3

[8]
The pros, cons, and many unknowns of probiotics.

Nat Med. 2019-5-6

[9]
Exercise for rheumatoid arthritis of the hand.

Cochrane Database Syst Rev. 2018-7-31

[10]
Effects of Probiotics, Prebiotics, and Synbiotics on Human Health.

Nutrients. 2017-9-15

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