From the Guidelines
The most effective probiotic for reducing inflammation is Lactobacillus plantarum, as demonstrated by a systematic review and meta-analysis published in 2016 1. This study found that probiotics, particularly L. plantarum, significantly reduced the incidence of infectious complications in critically ill patients. The evidence suggests that L. plantarum has the most significant effect on reducing infections, which is a key aspect of inflammation. Some key points to consider when using probiotics for inflammation include:
- The use of a multi-strain supplement containing Lactobacillus and Bifidobacterium species, such as Lactobacillus plantarum, Lactobacillus acidophilus, Lactobacillus casei, Bifidobacterium longum, and Bifidobacterium bifidum, at concentrations of 1-10 billion CFU per day.
- Taking the probiotics daily for at least 4-8 weeks to observe potential benefits, preferably on an empty stomach or 30 minutes before meals.
- The mechanisms by which these probiotics work include strengthening the intestinal barrier, producing short-chain fatty acids with anti-inflammatory properties, modulating immune system responses, and competing with harmful bacteria that might trigger inflammation. However, it's essential to note that the quality of evidence for probiotics in reducing inflammation is generally low to moderate, and more research is needed to confirm these findings. Additionally, the 2020 AGA clinical practice guidelines on the role of probiotics in the management of gastrointestinal disorders suggest the use of an 8-strain combination of probiotics, including L. plantarum, in patients with pouchitis, but the evidence is still limited 1. In general, when considering the use of probiotics for inflammation, it's crucial to consult with a healthcare professional to determine the best course of treatment.
From the Research
Probiotics that Reduce Inflammation
- VSL#3, a probiotic preparation, has been shown to reduce active inflammation in adult patients with ulcerative colitis 2
- The probiotic compound VSL#3 modulates mucosal, peripheral, and systemic immunity, exerting beneficial anti-inflammatory effects in intestinal and systemic compartments 3
- Bifidobacterium lactis, a probiotic, attenuates the onset of inflammation in a murine model of colitis 4
- VSL#3 has a therapeutic or preventive effect in various systemic diseases, including digestive systemic diseases, obesity and diabetes, allergic diseases, nervous systemic diseases, atherosclerosis, bone diseases, and female reproductive systemic diseases 5
Mechanisms of Action
- VSL#3 regulates the intestinal barrier function, including improving tight junction protein function, balancing intestinal microbial composition, and regulating immune-related cytokine expression 5
- VSL#3 recolonization results in restored CD4+ and CD8+ cell numbers in the small and large intestinal lamina propria, as well as in B220+ cell numbers in the former 3
- Bifidobacterium lactis reduces inflammatory and T cell mediators and promotes regulatory T cells specific markers in a mouse model of colitis 4
Limitations and Contradictions
- VSL#3 interventional treatment does not protect against inflammation or tumorigenesis in the azoxymethane (AOM)/Il10⁻/⁻ mouse model of colitis-associated colorectal cancer 6
- VSL#3 significantly enhances tumor penetrance, multiplicity, histologic dysplasia scores, and adenocarcinoma invasion relative to VSL#3-untreated mice in the same model 6