probiotic
Previous randomized controlled trials (RCTs) suggested that gut microbiota-based therapies may be effective in treating autoimmune diseases, but a systematic summary is lacking. This systematic review was aimed at filling the gap.
The literature searches identified total of 80 RCTs. They related to 14 types of autoimmune disease:
- celiac sprue,
- SLE,
- lupus nephritis (LN),
- RA,
- juvenile idiopathic arthritis (JIA),
- spondyloarthritis,
- psoriasis,
- fibromyalgia syndrome,
- MS,
- systemic sclerosis,
- type 1 diabetes mellitus (T1DM),
- oral lichen planus (OLP),
- Crohn’s disease,
- ulcerative colitis.
The results showed that gut microbiota-based therapies may improve the symptoms and/or inflammatory factor of:
- celiac sprue,
- SLE,
- LN,
- JIA,
- psoriasis,
- PSS,
- MS,
- systemic sclerosis,
- Crohn’s disease,
- ulcerative colitis.
However, gut microbiota-based therapies may not improve the symptoms and/or inflammatory factor of spondyloarthritis and RA. Gut microbiota-based therapies may relieve the pain of fibromyalgia syndrome, but the effect on fibromyalgia impact questionnaire score is not significant. Gut microbiota-based therapies may improve HbA1c in T1DM, but its effect on total insulin requirement does not seem to be significant. Probiotics did not seem to increase the incidence of adverse events.
The authors concluded that gut microbiota-based therapies may improve several autoimmune diseases (celiac sprue, SLE and LN, JIA, psoriasis, fibromyalgia syndrome, PSS, MS, T1DM, Crohn’s disease, and ulcerative colitis).
This sounds promissing, perhaps even a bit too good to be true?
To answer this question, It seems important to look at the quality of the primary studies:
- Twenty-nine RCTs failed to describe the random sequence generation methods.
- Seventeen RCTs were not blinded and their results contained subjective indicators.
- Seven RCTs were rated as high risk of bias.
And what about other caveats?
- The effect sizes vary but are often small.
- There is much heterogeneity.
- For some of the conditions there are only very few trials
- There is no uniform, plausible mode of action.
In summary, while these findings are no doubt interesting, I recommend taking them with a pinch of salt.
Kourtney Kardashian believes that vaginal health is an important but not sufficiently talked about part of women’s well-being. So, why not make a bit of money on the subject? A recent article explains in more detail:
The reality TV star recently launched a vitamin sweet called Lemme Purr to boost the health of your vagina. On her Instagram channel, she says these gummies use pineapple, vitamin C, and probiotics to target vaginal health and pH levels that “support freshness and taste”.
Kourtney continues with the selling words “Give your vagina the sweet treat it deserves (and turn it into a sweet treat)”. One of the claims she makes is that the vitamin sweet supports a healthy vaginal microflora. As a researcher specialising in the role of vaginal microflora for women’s health, I was curious and wanted to find out which active ingredients this claim is based on.
Lemme Purr contains pineapple extract (probably for its taste), vitamin C (not really needed if you have a balanced diet), and a clinically tested probiotic (Bacillus coagulans). According to the product description, the probiotic has been shown in clinical studies to support vaginal health, freshness, and odour. This surprised me – I should know about these studies and effects as this is my primary research field.
A healthy vaginal microflora is composed of lactobacilli that keep the pH low and protect us from infections. My colleagues and I never identified Bacillus coagulans as being important for the health of vaginas, even though we have analysed thousands of samples during recent years. From other research groups and our own results, we know that Lactobacillus crispatus is the species that is associated with vaginal health and female fertility.
As I may have missed something important, I immediately checked what has been published on that probiotic in scientific journals. I found one systematic review and meta-analysis (a type of analysis where many individual studies are taken together) that mentions Bacillus coagulans. Apparently, it may improve stool frequency and symptoms of constipation, although the authors conclude that more research is needed.
On the topic of women’s vaginal health, I could only find a single study. There, 70 women with vaginal discomfort reported symptom relief after direct vaginal administration of the probiotic. There is nothing published on the oral administration of the probiotic that could support the claims made by Kourtney.
__________________________
I was not entirely sure where women are supposed to put Kourtney’s gummies. So, I watched a video where Kourtney applies one of these items herself. I am very pleased to report that, in the video, she put one in her mouth!
After this relief, I ran a few Medline searches to get an impression of what the evidence tells us. In contrast to the author of the above article, I found plenty of literature on the subject and quite a few clinical trials. So, maybe Kourtney is on to something?
Somehow, I doubt it. I did not find a study with her product. Call me a skeptic, but I do get the feeling after looking at Kourtney’s website that she is much more interested in money than vaginal health.
