Oral Administration of Probiotics Reduces Chemotherapy-Induced Diarrhea and Oral Mucositis: A Systematic Review and Meta-Analysis
BackgroundChemotherapy generally causes serious diarrhea and oral mucositis in cancer patients, and subsequently affects treatment. Oral administration of probiotics provides a therapeutic choice to address these limitations. This study aims to conduct a systematic review and meta-analysis on the ef...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-02-01
|
| Series: | Frontiers in Nutrition |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnut.2022.823288/full |
| _version_ | 1818199773697540096 |
|---|---|
| author | Jing Feng Jing Feng Min Gao Chengcheng Zhao Jian Yang Haiyan Gao Xin Lu Rong Ju Xiuwei Zhang Yunlei Zhang Yunlei Zhang Yunlei Zhang |
| author_facet | Jing Feng Jing Feng Min Gao Chengcheng Zhao Jian Yang Haiyan Gao Xin Lu Rong Ju Xiuwei Zhang Yunlei Zhang Yunlei Zhang Yunlei Zhang |
| author_sort | Jing Feng |
| collection | DOAJ |
| description | BackgroundChemotherapy generally causes serious diarrhea and oral mucositis in cancer patients, and subsequently affects treatment. Oral administration of probiotics provides a therapeutic choice to address these limitations. This study aims to conduct a systematic review and meta-analysis on the efficacy of oral probiotic use in the management of the chemotherapy-induced adverse reactions, and to summarize the mechanisms underlying the action.MethodsWe searched PubMed, Embase, ClinicalTrials.gov, and Web of Science from the start of the study to its completion on Dec. 31, 2021. Risk of bias was assessed using Cochrane Collaboration's Tool. Statistical analysis of the acquired data was performed via the RevMan and the Stata Statistical Software. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number: CRD42020220650).ResultsTwelve randomized controlled trials including 1,013 patients were recruited and analyzed via the standard procedure of meta-analysis. In contrast to the control group, orally taking probiotics significantly decreased the risk of chemotherapy-induced diarrhea (≥ 1 grade) (RR = 0.70; 95% Cl: 0.56, 0.88; P = 0.002) and oral mucositis (≥ 1 grade) (RR: 0.84; 95% Cl: 0.78, 0.91; P < 0.00001) at all grades. Further analysis found that severe diarrhea (≥ 2 grades) (RR: 0.50; 95% Cl: 0.32, 0.78; P = 0.002) and severe oral mucositis also significantly declined (≥ 3 grades) (RR: 0.66; 95% Cl: 0.55, 0.79; P < 0.00001) after oral probiotic use. Interestingly, the beneficial effects of probiotics displayed statistically significant only in Asian patients. Importantly, the more species of bacteria they took, the lower the incidences of the adverse reactions occurred. We used Egger's test P value to confirm that there is no publication bias.ConclusionsThis meta-analysis demonstrated that orally administrated probiotics has a potential to decrease chemotherapy-induced diarrhea and oral mucositis incidences. However, the efficacy of oral probiotic use against the adverse reactions needs to be further verified through more clinical trials, and the species and number of probiotics have to be optimized and standardized prior to clinical applications.Systematic Review Registrationhttps://www.crd.york.ac.uk, identifier: 220650. |
| first_indexed | 2024-12-12T02:27:06Z |
| format | Article |
| id | doaj.art-91fdad778d58472f979bc5d0d2642a73 |
| institution | Directory Open Access Journal |
| issn | 2296-861X |
| language | English |
| last_indexed | 2024-12-12T02:27:06Z |
| publishDate | 2022-02-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Nutrition |
| spelling | doaj.art-91fdad778d58472f979bc5d0d2642a732022-12-22T00:41:31ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2022-02-01910.3389/fnut.2022.823288823288Oral Administration of Probiotics Reduces Chemotherapy-Induced Diarrhea and Oral Mucositis: A Systematic Review and Meta-AnalysisJing Feng0Jing Feng1Min Gao2Chengcheng Zhao3Jian Yang4Haiyan Gao5Xin Lu6Rong Ju7Xiuwei Zhang8Yunlei Zhang9Yunlei Zhang10Yunlei Zhang11Department of Respiratory and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Biomedical Engineering, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, ChinaCentral Laboratory, Translational Medicine Research Center, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Obstetrics and Gynecology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Respiratory and Critical Care Medicine, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, ChinaDepartment of Biomedical Engineering, School of Biomedical Engineering and Informatics, Nanjing Medical University, Nanjing, ChinaCentral Laboratory, Translational Medicine Research Center, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, ChinaBackgroundChemotherapy generally causes serious diarrhea and oral mucositis in cancer patients, and subsequently affects treatment. Oral administration of probiotics provides a therapeutic choice to address these limitations. This study aims to conduct a systematic review and meta-analysis on the efficacy of oral probiotic use in the management of the chemotherapy-induced adverse reactions, and to summarize the mechanisms underlying the action.MethodsWe searched PubMed, Embase, ClinicalTrials.gov, and Web of Science from the start of the study to its completion on Dec. 31, 2021. Risk of bias was assessed using Cochrane Collaboration's Tool. Statistical analysis of the acquired data was performed via the RevMan and the Stata Statistical Software. The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number: CRD42020220650).ResultsTwelve randomized controlled trials including 1,013 patients were recruited and analyzed via the standard procedure of meta-analysis. In contrast to the control group, orally taking probiotics significantly decreased the risk of chemotherapy-induced diarrhea (≥ 1 grade) (RR = 0.70; 95% Cl: 0.56, 0.88; P = 0.002) and oral mucositis (≥ 1 grade) (RR: 0.84; 95% Cl: 0.78, 0.91; P < 0.00001) at all grades. Further analysis found that severe diarrhea (≥ 2 grades) (RR: 0.50; 95% Cl: 0.32, 0.78; P = 0.002) and severe oral mucositis also significantly declined (≥ 3 grades) (RR: 0.66; 95% Cl: 0.55, 0.79; P < 0.00001) after oral probiotic use. Interestingly, the beneficial effects of probiotics displayed statistically significant only in Asian patients. Importantly, the more species of bacteria they took, the lower the incidences of the adverse reactions occurred. We used Egger's test P value to confirm that there is no publication bias.ConclusionsThis meta-analysis demonstrated that orally administrated probiotics has a potential to decrease chemotherapy-induced diarrhea and oral mucositis incidences. However, the efficacy of oral probiotic use against the adverse reactions needs to be further verified through more clinical trials, and the species and number of probiotics have to be optimized and standardized prior to clinical applications.Systematic Review Registrationhttps://www.crd.york.ac.uk, identifier: 220650.https://www.frontiersin.org/articles/10.3389/fnut.2022.823288/fullprobioticscancerchemotherapydiarrheaoral mucositis |
| spellingShingle | Jing Feng Jing Feng Min Gao Chengcheng Zhao Jian Yang Haiyan Gao Xin Lu Rong Ju Xiuwei Zhang Yunlei Zhang Yunlei Zhang Yunlei Zhang Oral Administration of Probiotics Reduces Chemotherapy-Induced Diarrhea and Oral Mucositis: A Systematic Review and Meta-Analysis Frontiers in Nutrition probiotics cancer chemotherapy diarrhea oral mucositis |
| title | Oral Administration of Probiotics Reduces Chemotherapy-Induced Diarrhea and Oral Mucositis: A Systematic Review and Meta-Analysis |
| title_full | Oral Administration of Probiotics Reduces Chemotherapy-Induced Diarrhea and Oral Mucositis: A Systematic Review and Meta-Analysis |
| title_fullStr | Oral Administration of Probiotics Reduces Chemotherapy-Induced Diarrhea and Oral Mucositis: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Oral Administration of Probiotics Reduces Chemotherapy-Induced Diarrhea and Oral Mucositis: A Systematic Review and Meta-Analysis |
| title_short | Oral Administration of Probiotics Reduces Chemotherapy-Induced Diarrhea and Oral Mucositis: A Systematic Review and Meta-Analysis |
| title_sort | oral administration of probiotics reduces chemotherapy induced diarrhea and oral mucositis a systematic review and meta analysis |
| topic | probiotics cancer chemotherapy diarrhea oral mucositis |
| url | https://www.frontiersin.org/articles/10.3389/fnut.2022.823288/full |
| work_keys_str_mv | AT jingfeng oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT jingfeng oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT mingao oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT chengchengzhao oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT jianyang oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT haiyangao oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT xinlu oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT rongju oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT xiuweizhang oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT yunleizhang oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT yunleizhang oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis AT yunleizhang oraladministrationofprobioticsreduceschemotherapyinduceddiarrheaandoralmucositisasystematicreviewandmetaanalysis |