The effect of synbiotics pomegranate juice on cardiovascular risk factors in PCOS patients: a randomized, triple-blinded, controlled trial Effect of synbiotic pomegranate juice on glycemic, sex hormone profile and anthropometric indices in PCOS: A randomized, triple blind, controlled trial. The effects of probiotic and selenium co-supplementation on parameters of mental health, hormonal profiles, and biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome The effects of synbiotic supplementation on hormonal status, biomarkers of inflammation and oxidative stress in subjects with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial Consumption of Synbiotic Bread Decreases Triacylglycerol and VLDL Levels While Increasing HDL Levels in Serum from Patients with Type-2 Diabetes Failure of Synbiotic 2000 to Prevent Postoperative Recurrence of Crohn’s Disease Randomised clinical trial of synbiotic therapy in elective surgical patients Effects of Probiotic Supplementation on Hormonal Profiles, Biomarkers of Inflammation and Oxidative Stress in Women With Polycystic Ovary Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial. The propre-save study: effects of probiotics and prebiotics alone or combined on necrotizing enterocolitis in very low birth weight infants. Preoperative synbiotic bowel conditioning for elective colorectal surgery A human, double-blind, placebo-controlled, crossover trial of prebiotic, probiotic, and synbiotic supplementation: effects on luminal, inflammatory, epigenetic, and epithelial biomarkers of colorectal cancer. Inulin and probiotics in newly weaned piglets: effects on intestinal morphology, mRNA expression levels of inflammatory marker genes and haematology Beneficial Effects of Probiotic Bifidobacterium and Galacto-Oligosaccharide in Patients with Ulcerative Colitis: A Randomized Controlled Study Long-Term Safety and Impact on Infection Rates of Postnatal Probiotic and Prebiotic (Synbiotic) Treatment: Randomized, Double-Blind, Placebo-Controlled Trial Synbiotic therapy (Bifidobacterium longum/Synergy 1) initiates resolution of inflammation in patients with active ulcerative colitis: a randomised controlled pilot trial Effect of a New Synbiotic Mixture on Atopic Dermatitis in Children: a Randomized-Controlled Trial Dietary Changes Involving Bifidobacterium longum and Other Nutrients Delays Chronic Kidney Disease Progression Effect of pre- and probiotics on liver regeneration after resection: a randomised, double-blind pilot study. The Consumption of Synbiotic Bread Containing Lactobacillus sporogenes and Inulin Affects Nitric Oxide and Malondialdehyde in Patients with Type 2 Diabetes Mellitus: Randomized, Double-Blind, Placebo-Controlled Trial Synbiotic Food Consumption Reduces Levels of Triacylglycerols and VLDL, but not Cholesterol, LDL, or HDL in Plasma from Pregnant Women Effects of synbiotic food consumption on glycemic status and serum hs-CRP in pregnant women: a randomized controlled clinical trial A synbiotic-containing amino-acid-based formula improves gut microbiota in non-IgE-mediated allergic infants A randomized, double blind, placebo-controlled trial of an oral synbiotic (AKSB) for prevention of travelers' diarrhea.
Purpose Polycystic ovarian syndrome ( PCOS ) is one of the most common metabolic and endocrine disorders . Functional foods like pomegranate and probiotics are those that are considered to have beneficial effects on metabolic diseases beyond their basic nutritional value . So , we aim ed to evaluate the effect of synbiotic pomegranate juice ( SPJ ) on cardiovascular risk factors on PCOS patients . Methods This was a r and omized , triple-blinded , 8-week trial . Participants were r and omly assigned to receive 300 mL/day of pomegranate juice ( PJ ) , synbiotic beverage ( SB ) , synbiotic pomegranate juice ( SPJ ) , or placebo beverage ( PB ) . Biochemical indices ( lipid profile , Total Antioxidant Capacity ( TAC ) , Malondialdehyde ( MDA ) , high sensitive C-Reactive Protein ( hs-CRP ) ) and blood pressure were assessed before and after the intervention . Results Participants in the PJ , SB , and SPJ groups experienced improvement in their lipid profile , oxidative stress , inflammation , and blood pressure during the time . Compared to placebo , Total Cholesterol ( TC ) was lower in the SB group ( P < 0.01 ) , LDL-c was lower in the SPJ and SB groups ( P < 0.01 ) , and HDL-c was higher in the SPJ and PJ groups ( P < 0.01 ) . With regards to oxidative stress and inflammation , when compared with placebo , MDA was lower in the SPJ , SB , and PJ groups ( P < 0.001 ) , TAC was increased in the SPJ and PJ groups ( P $ $ < $ $ < 0.001 ) , and hs-CRP was decreased in the PJ group ( P = 0.02 ) . Blood pressure ( BP ) was lower in the SPJ and PJ groups compared to placebo ( P < 0.001 ; P < 0.01 , respectively ) . Conclusions Consuming daily SPJ for 8 weeks improved metabolic , oxidative , inflammatory , and BP outcomes in females with PCOS . This trial was registered in the Iranian Registry of Clinical Trials ( I RCT 20170207032439N2 ) BACKGROUND AND AIMS Polycystic Ovarian Syndrome is a common reproductive , endocrine , and metabolic disease in women .  Pomegranate juice , known as a rich source of phytochemicals with high antioxidant activity , enriched with probiotic may improve PCOS . METHODS AND RESULTS A r and omized , controlled , triple-blinded , parallel trial study was performed in PCOS patients ( n = 92 ) . Three treatment groups ( 23 patients each ) received 2 L of synbiotic pomegranate juice ( SPJ ) , pomegranate juice ( PJ ) , and synbiotic beverage ( SB ) weekly . The control group ( 23 patients ) received 2 L of placebo beverage weekly . Primary outcome was any change in insulin resistance and secondary outcomes were fasting blood sugar ( FBS ) , insulin sensitivity , testosterone , luteinizing hormone ( LH ) , follicle stimulating hormone ( FSH ) , body mass index ( BMI ) , waist and hip circumference , from baseline to the end of the trial . At the end of the study , 86 patients were analyzed . There was significant change in insulin resistance in the SPJ and SB groups . Insulin sensitivity increased significantly in the SPJ and SB groups . Insulin also changed significantly in the SPJ and SB groups . BMI , weight and waist circumference decreased significantly in the SPJ and SB groups . Testosterone level also decreased significantly in the SPJ and SB groups . There was no significant change in FPG , LH and FSH in any of the groups . CONCLUSION SPJ in the form of a new beverage can improve insulin resistance , insulin , testosterone level , BMI , weight and waist circumference in PCOS . This trial was registered in Iranian Registry of Clinical Trials , with number : 25272 Background The aim of this study was to evaluate the effect of the co-administration of probiotic and selenium on parameters of mental health , hormonal profiles , and biomarkers of inflammation and oxidative stress in women with PCOS . Data on the effects of selenium and probiotic co-supplementation on mental health , hormonal and inflammatory parameters of patients with polycystic ovary syndrome ( PCOS ) are scarce . This investigation was carried out to evaluate the effects of selenium and probiotic co-supplementation on mental health , hormonal and inflammatory parameters in women with PCOS . Methods This r and omized , double-blinded , placebo-controlled clinical trial was conducted on 60 subjects , aged 18–40 years old . Participants were r and omly allocated into two groups to intake 8 × 109 CFU/day probiotic plus 200 μg/day selenium supplements ( n = 30 ) or placebo ( n = 30 ) for 12 weeks . Hormonal and inflammatory parameters were measured at baseline and after the 12-week intervention . Results Probiotic and selenium co-supplementation result ed in a significant improvement in beck depression inventory ( β − 0.76 ; 95 % CI , − 1.26 , − 0.26 ; P = 0.003 ) , general health question naire scores ( β − 1.15 ; 95 % CI , − 1.97 , − 0.32 ; P = 0.007 ) and depression anxiety and stress scale scores ( β − 1.49 ; 95 % CI , − 2.59 , − 0.39 ; P = 0.009 ) compared with the placebo . Furthermore , probiotic and selenium co-supplementation  significantly reduced total testosterone ( β − 0.26 ng/mL ; 95 % CI , − 0.51 , − 0.02 ; P = 0.03 ) , hirsutism ( β − 0.43 ; 95 % CI , − 0.74 , − 0.11 ; P = 0.008 ) , high-sensitivity C-reactive protein ( hs-CRP ) ( β − 0.58 mg/L ; 95 % CI , − 0.97 , − 0.19 ; P = 0.004 ) and malondialdehyde ( MDA ) levels ( β − 0.29 μmol/L ; 95 % CI , − 0.56 , − 0.02 ; P = 0.03 ) , and significantly increased total antioxidant capacity ( TAC ) ( β + 84.76 mmol/L ; 95 % CI , + 48.08 , + 121.44 ; P < 0.001 ) and total glutathione ( GSH ) levels ( β + 26.78 μmol/L ; 95 % CI , + 4.33 , + 49.23 ; P = 0.02 ) compared with the placebo . Conclusions Overall , the co-administration of probiotic and selenium for 12 weeks to women with PCOS had beneficial effects on mental health parameters , serum total testosterone , hirsutism , hs-CRP , TAC , GSH and MDA levels . This study was prospect ively registered in the Iranian website ( www.i rct .ir ) for registration of clinical trials ( http://www.i rct .ir : I RCT 20170513033941N22).Trial registration I RCT 20170513033941N22 Background To our knowledge , no reports are available indicating the effects of synbiotic supplementation on hormonal status , biomarkers of inflammation and oxidative stress in subjects with polycystic ovary syndrome ( PCOS ) . This research was done to assess the effects of synbiotic supplementation on hormonal status , biomarkers of inflammation and oxidative stress in subjects with PCOS . Methods This r and omized double-blind , placebo-controlled trial was conducted on 60 subjects diagnosed with PCOS according to the Rotterdam criteria . Subjects were r and omly assigned into two groups to take either synbiotic ( n = 30 ) or placebo ( n = 30 ) for 12 weeks . Endocrine , inflammation and oxidative stress biomarkers were quantified at baseline and after the 12-week intervention . Results After the 12-week intervention , compared with the placebo , synbiotic supplementation significantly increased serum sex hormone-binding globulin ( SHBG ) ( changes from baseline in synbiotic group : + 19.8 ± 47.3 vs. in placebo group : + 0.5 ± 5.4 nmol/L , p = 0.01 ) , plasma nitric oxide ( NO ) ( changes from baseline in synbiotic group : + 5.5 ± 4.8 vs. in placebo group : + 0.3 ± 9.1 μmol/L , p = 0.006 ) , and decreased modified Ferriman Gallwey ( mF-G ) scores ( changes from baseline in synbiotic group : − 1.3 ± 2.5 vs. in placebo group : − 0.1 ± 0.5 , p = 0.01 ) and serum high-sensitivity C-reactive protein ( hs-CRP ) ( changes from baseline in synbiotic group : − 950.0 ± 2246.6 vs. in placebo group : + 335.3 ± 2466.9 ng/mL , p = 0.02 ) . We did not observe any significant effect of synbiotic supplementation on other hormonal status and biomarkers of oxidative stress . Conclusions Overall , synbiotic supplementation for 12 weeks in PCOS women had beneficial effects on SHBG , mFG scores , hs-CRP and NO levels , but did not affect other hormonal status and biomarkers of oxidative stress . Trial registration This study was retrospectively registered in the Iranian website ( www.i rct .ir ) for registration of clinical trials ( I RCT 201509115623N53 ) , on 2015–09 - 27 To our knowledge , no reports are available indicating the favorable effects of synbiotic bread consumption on blood lipid profiles among patients with type 2 diabetes mellitus ( T2DM ) . This study was conducted to evaluate the effects of the daily consumption of synbiotic bread on blood lipid profiles of patients with T2DM . This r and omized double-blinded controlled clinical trial was performed with 78 diabetic patients , aged 35–70 years . After a 2-week run-in period , subjects were r and omly assigned to consume either synbiotic ( n = 26 ) , probiotic ( n = 26 ) or control bread ( n = 26 ) for 8 weeks . The synbiotic bread contained viable and heat-resistant probiotic Lactobacillus sporogenes ( 1 × 108 CFU ) and 0.07 g inulin ( HPX ) as prebiotic per 1 g. The probiotic bread contained L. sporogenes ( 1 × 108 CFU ) per 1 g. Patients were asked to consume the synbiotic , probiotic and control breads three times a day in a 40 g package for a total of 120 g/day . Biochemical measurements including blood lipid profiles were conducted before and after 8 weeks of intervention . Consumption of the synbiotic bread , compared to the probiotic and control breads , led to a significant decrease in serum TAG ( P = 0.005 ) , VLDL-C ( P = 0.005 ) , TC/HDL-C ( P = 0.002 ) and a significant increase in serum HDL-C levels ( P = 0.01 ) . No significant effect of synbiotic bread consumption on FPG , TC , LDL-C and non-HDL-C levels was seen compared to the probiotic and control breads ( P > 0.05 ) . Trial registry code : http://www.i rct .ir I RCT 201311215623N13 Complications of Crohn ’s disease ( CD ) lead to surgery in about 70–90 % of patients . The majority of patients suffer from relapse of the disease . Colonic bacteria are essential to the development of CD . Therefore , a rationale exists in trying to prevent relapse by manipulation of gut microflora . This is feasible by treatment with probiotics or antibiotics . Synbiotic 2000 is a cocktail containing 4 probiotic species and 4 prebiotics . It is rational to pursue that it could be effective in preventing postoperative disease . We sought to check weather treatment with Synbiotic 2000 could prevent postoperative recurrence in patients with CD . This was a prospect i ve multicenter , r and omized study . Patients were r and omized to active treatment or placebo in a 2:1 ratio . Follow-up consisted of endoscopic , clinical , and laboratory parameters . Thirty patients were enrolled . No differences were found between the 2 treatment groups regarding gender , age at diagnosis , age at surgery , weight , smoking status , type of disease , length of the resected segment , or medical treatment prior to surgery . No difference in either endoscopic or clinical relapse rate was found between patients treated with once daily dose of Synbiotic 2000 or placebo . In our small study , Synbiotic 2000 had no effect on postoperative recurrence of patients with CD . Larger studies in patients with the inflammatory type of CD undergoing surgery , using higher doses of probiotics cocktail might prove effective Background : It is possible to manipulate the composition of the gastrointestinal microflora by administration of pre- and probiotics . This may help to preserve gut barrier function and reduce the incidence of septic morbidity . Aims : To assess the effects of a combination of pre- and probiotics ( synbiotic ) on bacterial translocation , gastric colonisation , systemic inflammation , and septic morbidity in elective surgical patients . Patients : Patients were enrolled two weeks prior to elective abdominal surgery . Seventy two patients were r and omised to the synbiotic group and 65 to the placebo group . Patients were well matched regarding age and sex distribution , diagnoses , and POSSUM scores . Methods : Patients in the synbiotic group received a two week preoperative course of Lactobacillus acidophilus La5 , Bifidobacterium lactis Bb-12 , Streptococcus thermophilus , and Lactobacillus bulgaricus , together with the prebiotic oligofructose . Patients in the placebo group received placebo capsules and sucrose powder . At surgery , a nasogastric aspirate , mesenteric lymph node , and scrapings of the terminal ileum were harvested for microbiological analysis . Serum was collected preoperatively and on postoperative days 1 and 7 for measurement of C reactive protein , interleukin 6 , and antiendotoxin antibodies . Septic morbidity and mortality were recorded . Results : There were no significant differences between the synbiotic and control groups in bacterial translocation ( 12.1 % v 10.7 % ; p = 0.808 , χ2 ) , gastric colonisation ( 41 % v 44 % ; p = 0.719 ) , systemic inflammation , or septic complications ( 32 % v 31 % ; p = 0.882 ) . Conclusions : In this study , synbiotics had no measurable effect on gut barrier function in elective surgical patients . Further studies investigating the place of pre- and probiotics in clinical practice are required BACKGROUND To the best of our knowledge , data on effects of probiotic administration on hormonal profiles , biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome ( PCOS ) are scarce . This investigation was conducted to assess the effects of probiotic supplementation on hormonal profiles , biomarkers of inflammation and oxidative stress in women with PCOS . METHODS This r and omized , double-blind , placebo-controlled trial was conducted on 60 women with PCOS , aged 18 - 40 years old . Subjects were r and omly assigned into 2 groups to receive either probiotics or placebo ( n = 30 each group ) for 12 weeks . Metabolic profiles were quantified at baseline and after a 12-week intervention . RESULTS After the 12-week intervention , compared with placebo , probiotic supplementation significantly increased serum sex hormone-binding globulin ( SHBG ) ( + 25.9 ± 32.5 vs. + 0.5 ± 15.6 nmol/L , P < 0.001 ) and plasma total antioxidant capacity ( TAC ) ( + 8.8 ± 120.5 vs. -98.3 ± 246.4 mmol/L , P = 0.04 ) , and significantly decreased serum total testosterone ( -0.2 ± 0.7 vs. + 0.2 ± 0.6 ng/mL , P = 0.03 ) , modified Ferriman-Gallwey ( mF-G ) scores ( -1.7 ± 1.5 vs. -0.2 ± 1.0 , P < 0.001 ) , serum high-sensitivity C-reactive protein ( hs-CRP ) ( -1150.0 ± 1295.2 vs. + 202.5 ± 1426.3 ng/mL , P < 0.001 ) and plasma malondialdehyde ( MDA ) concentrations ( -0.2 ± 0.6 vs. + 0.9 ± 1.3 µmol/L , P < 0.001 ) . We did not observe any detrimental effect of probiotic supplementation on other metabolic profiles . CONCLUSION Overall , probiotic supplementation of PCOS women for 12 weeks had beneficial effects on total testosterone , SHBG , mFG scores , hs-CRP , TAC and MDA levels but did not affect other metabolic profiles OBJECTIVE To test the efficacy of probiotic and prebiotic , alone or combined ( synbiotic ) , on the prevention of necrotizing enterocolitis ( NEC ) in very low birth weight ( VLBW ) infants . STUDY DESIGN A prospect i ve , r and omized , controlled trial was conducted at 5 neonatal intensive care units in Turkey . VLBW infants ( n = 400 ) were assigned to a control group and 3 study groups that were given probiotic ( Bifidobacterium lactis ) , prebiotic ( inulin ) , or synbiotic ( Bifidobacterium lactis plus inulin ) added to breastmilk or formula for a maximum of 8 weeks before discharge or death . The primary outcome was NEC ( Bell stage ≥2 ) . RESULTS The rate of NEC was lower in probiotic ( 2.0 % ) and synbiotic ( 4.0 % ) groups compared with prebiotic ( 12.0 % ) and placebo ( 18.0 % ) groups ( P < .001 ) . The times to reach full enteral feeding were faster ( P < .001 ) , the rates of clinical nosocomial sepsis were lower ( P = .004 ) , stays in the neonatal intensive care unit were shorter , ( P = .002 ) , and mortality rates were lower ( P = .003 ) for infants receiving probiotics , prebiotics , or synbiotic than controls . The use of antenatal steroid ( OR 0.5 , 95 % CI 0.3 - 0.9 ) and postnatal probiotic ( alone or in synbiotic ) ( OR 0.5 , 95 % CI 0.2 - 0.8 ) decreased the risk of NEC , and maternal antibiotic exposure increased this risk ( OR 1.9 , 95 % CI 1.1 - 3.6 ) . CONCLUSIONS In VLBW infants  , probiotic ( Bifidobacterium lactis ) and synbiotic ( Bifidobacterium lactis plus inulin ) but not prebiotic ( inulin ) alone decrease NEC Summary BACKGROUND : Preoperative bowel cleaning for elective colorectal surgery is a routine procedure . Synbiotics ( probiotics plus prebiotics ) are known for their beneficial effects on gut immune function and maintenance of the gut barrier . The main purpose of this study was to replace preoperative mechanical bowel cleaning with synbiotics and to assess the systemic inflammatory response and clinical outcome in patients undergoing colorectal surgery . PATIENTS AND METHODS : A prospect i ve double-blind r and omized placebo-controlled trial was conducted in 68 patients . The first group of 20 patients received synbiotics , the second group of 28 patients prebiotics and heat-deactivated probiotics , and the third ( control ) group of 20 patients mechanical bowel cleaning prior to the operation . RESULTS : Significantly higher values of interleukin 6 ( IL-6 ) were detected 72 h after the operation in the synbiotic group ( P = 0.025 ) , as well as an increase of fibrinogen at 24 h postoperatively ( P = 0.030 ) . No statistical differences were found in leukocytes count , C-reactive protein or the lymphocyte/granulocyte ratio . There were no differences in postoperative complications between the groups . Mean hospital stay was 9.2 days in the prebiotic group , 9.5 days in the control group , and 10.95 days in the synbiotic group . CONCLUSIONS : Preoperative administration of prebiotics in elective colorectal surgery appears to have the same protective effect in preventing a postoperative inflammatory response as mechanical bowel cleaning . Further prospect i ve studies are needed to verify the effects of synbiotics BACKGROUND Diet is an important factor in colorectal carcinogenesis ; thus , dietary supplements may have a role in colorectal cancer prevention . OBJECTIVE The objective was to establish the relative luminal , epithelial , and epigenetic consequences of prebiotic , probiotic , and synbiotic dietary supplementation in humans . DESIGN This was a r and omized , double-blind , placebo-controlled , 4-wk crossover trial of resistant starch and Bifidobacterium lactis , either alone or as a combined synbiotic preparation , in 20 human volunteers . Rectal biopsy , feces , and serum sample s were collected . The rectal mucosal endpoints were DNA methylation at 16 CpG isl and loci and LINE-1 , epithelial proliferation ( Ki67 immunohistochemistry ) , and crypt cellularity . The fecal endpoints were short-chain fatty acid concentrations , pH , ammonia , and microbiological profiles ( by denaturing gradient gel electrophoresis and sequencing ) . Serum endpoints were a panel of cytokines and high-sensitivity C-reactive protein . RESULTS Seventeen subjects completed the entire study . The synbiotic intervention fostered a significantly different fecal stream bacterial community than did either the prebiotic ( P = 0.032 ) or the probiotic ( P = 0.001 ) intervention alone , in part because of a greater proportion of patients harboring fecal Lachnospiraceae spp . These changes developed in the absence of any significant differences in fecal chemistry . There were no differences in epithelial kinetics . CONCLUSIONS This synbiotic supplementation with B. lactis and resistant starch , in the doses used , induced unique changes in fecal microflora but did not significantly alter any other fecal , serum , or epithelial variables . This trial was registered in the Australian New Zeal and Clinical Trials Registry at www.anzctr.org.au as ACTRN012606000115538 The study aim ed at determining the effect of inulin and /or a multispecies probiotic formulation on  gastrointestinal tract ( GIT ) morphology , immunological and haematological parameters . Forty-eight newly weaned piglets were assigned to four feeding groups , receiving a st and ard basal diet ( control ) , supplemented with 0.4 % inulin , probiotics ( 1 · 109 CFU/kg as fed , enterococci , lactobacilli , bifidobacteria ) or a combination of both ( synbiotic ) . After four weeks of ad libitum feeding piglets were slaughtered and intestinal tissue sample s were obtained for histometry . Additional tissue sample s of the GIT , mesenteric lymph nodes , blood , liver and spleen were taken for mRNA expression analysis of cell turnover ( CDK4 , caspase3 , IGF I ) , transcription factor NFκB and inflammatory marker genes ( TNFα , TGFβ ) . Changes in histometry occurred predominantly in the small intestine , showing higher jejunal villi when probiotics were administered alone ( p < 0.10 ) . Inulin  decreased the number of acidic goblet cells in jejunal villi ( p < 0.05 ) , whereas probiotics increased neutral goblet cells in ileal villi ( p < 0.05 ) . Though inflammatory marker genes were uninfluenced by treatment in the proximal GIT , the colon showed downregulations induced by inulin ( TNFα : p < 0.10 , TGFβ : p < 0.05 ) . Gene expression of CDK4 was upregulated in the jejunum and of TGFβ in the mesenteric lymph nodes in the probiotic groups . Interestingly , the probiotic group alone exhibited upregulations in cell turnover marker genes in the colon and blood . Furthermore , for numerous parameters , inulin and probiotics led to no synergistic but antagonistic interactions Background / Aim : In previous studies , we described the beneficial effects of bifidobacteria-fermented milk in patients with ulcerative colitis ( UC ) . Here , we examined the effects of a live Bifidobacterium breve strain Yakult , a probiotic contained in bifidobacteria-fermented milk , and galacto-oligosaccharide ( GOS ) as synbiotics in UC patients . Methods : Forty-one patients with mild to moderate UC were assigned to two groups ; one group was treated with the synbiotics and the other was not ( control ) . The treatment group ingested 1 g of the probiotic powder ( 109 CFU/g ) three times a day , and 5.5 g of GOS once a day for one year . At the start and the end of this study , colonoscopic index and the amount of myeloperoxidase in a lavage solution were used as disease activity indices . Bacterial counts in the feces at the start and the end of this study were also examined . Results : After a one-year treatment with the synbiotics , the clinical status of the UC patients as assessed by colonoscopy , significantly improved . Furthermore , the amount of myeloperoxidase in the lavage also decreased in these patients after the synbiotic treatment . The synbiotics significantly reduced the fecal counts of Bacteroidaceae and fecal pH. Conclusion : Administration of live B. breve strain Yakult and GOS can improve the clinical condition of patients with UC . These results encouraged us to perform a large-scale r and omized , placebo-controlled trial OBJECTIVE . Live probiotic bacteria and dietary prebiotic oligosaccharides ( together termed synbiotics ) increasingly are being used in infancy , but evidence of long-term safety is lacking . In a r and omized , placebo-controlled , double-blind trial , we studied the safety and long-term effects of feeding synbiotics to newborn infants . METHODS . Between November 2000 and March 2003 , pregnant mothers carrying infants at high risk for allergy were r and omly assigned to receive a mixture of 4 probiotic species ( Lactobacillus rhamnosus GG and LC705 , Bifidobacterium breve Bb99 , and Propionibacterium freudenreichii ssp shermanii ) or a placebo for 4 weeks before delivery . Their infants received the same probiotics with 0.8 g of galactooligosaccharides , or a placebo , daily for 6 months after birth . Safety data were obtained from clinical examinations and interviews at follow-up visits at ages 3 , 6 , and 24 months and from question naires at ages 3 , 6 , 12 , and 24 months . Growth data were collected at each time point . RESULTS . Of the 1018 eligible infants , 925 completed the 2-year follow-up assessment . Infants in both groups grew normally . We observed no difference in neonatal morbidity , feeding-related behaviors ( such as infantile colic ) , or serious adverse events between the study groups . During the 6-month intervention , antibiotics were prescribed less often in the synbiotic group than in the placebo group ( 23 % vs 28 % ) . Throughout the follow-up period , respiratory infections occurred less frequently in the synbiotic group ( geometric mean : 3.7 vs 4.2 infections ) . CONCLUSION . Feeding synbiotics to newborn infants was safe and seemed to increase resistance to respiratory infections during the first 2 years of life Background and aims : Ulcerative colitis ( UC ) is an acute and chronic inflammatory disease of the large bowel with unknown aetiology . The immune response against normal commensal microorganisms is believed to drive inflammatory processes associated with UC . Therefore , modulation of bacterial communities on the gut mucosa , through the use of probiotics and prebiotics , may be used to modify the disease state . Methods : A synbiotic was developed for use in UC patients combining a probiotic , Bifidobacterium longum , isolated from healthy rectal epithelium , and a prebiotic ( Synergy 1 ) , a preferential inulin-oligofructose growth substrate for the probiotic strain . Treatment was employed in a double blinded r and omised controlled trial using 18 patients with active UC for a period of one month . Clinical status was scored and rectal biopsies were collected before and after treatment , and transcription levels of epithelium related immune markers were measured . Results : Sigmoidoscopy scores ( scale 0–6 ) were reduced in the test group ( start 4.5 ( 1.4 ) , end 3.1 ( 2.5 ) ) compared with placebo ( start 2.6 ( 2.1 ) , end 3.2 ( 2.2 ) ) ( p = 0.06 ) . mRNA levels for human beta defensins 2 , 3 , and 4 , which are strongly upregulated in active UC , were significantly reduced in the test group after treatment ( p = 0.016 , 0.038 , and 0.008 , respectively ) . Tumour necrosis factor α and interleukin 1α , which are inflammatory cytokines that drive inflammation and induce defensin expression , were also significantly reduced after treatment ( p = 0.018 and 0.023 , respectively ) . Biopsies in the test group had reduced inflammation and regeneration of epithelial tissue . Conclusions : Short term synbiotic treatment of active UC result ed in improvement of the full clinical appearance of chronic inflammation in patients receiving this therapy Objective Atopic dermatitis ( AD ) is the most common chronic relapsing skin disease seen in infancy and childhood . The intestinal microbiota play an important role in immune development and may play a role in the development of allergic disorders . Manipulation of the intestinal microbiota by synbiotics may therefore offer an approach to the prevention or treatment of AD and allergic diseases . We studied the clinical and immunologic effects of a new symbiotic ( a mixture of seven probiotic strains of bacteria and Fructooligosaccharide ) in infants and children with AD . Methods In a r and omized , double-blind , placebo-controlled study , 40 infants and children aged 3 months to 6 years with AD received either a synbiotic or placebo for 8 weeks . The Severity Scoring of Atopic Dermatitis ( SCORAD ) index was recorded at baseline and also at 4 and 8 weeks of treatment . Findings There was no significant difference between the probiotic and placebo group in baseline characteristics including sex , age , family history , corticosteroid usage and prick testing . Mean age was 23 months . The synbiotic group showed a significantly greater reduction in SCORAD than did the placebo group ( P=0.001 ) . No specific effect was demonstrated of the probiotics employed on cytokine profile ( P=0.4 , P=0.6 ) . Egg white was the most common ( 45 % ) allergen followed by peanut and cow 's milk . Conclusion This study provides evidence that a mixture of seven strains of probiotics and Fructooligosaccharide can clinical ly improve the severity of  AD in young children . Further studies are needed to investigate the effects on underlying immune responses and the potential long term benefits for patients with AD Background : Recent studies suggest that prebiotic and /or probiotic treatments ameliorate kidney function in humans and animals by improving the gut environment . However , the gut microbiota and kidney disease interactions remain to be determined . This study investigated whether synbiotics modulate the gut microbiota and ameliorate kidney function using a rat model of chronic kidney disease ( CKD ) . As uremic toxins are associated with CKD-related mineral and bone disorder , the secondary aim was to evaluate the relationship between synbiotics and secondary hyperparathyroidism ( SHPT ) . Methods : 5/6 nephrectomy ( Nx ) rats were developed as the CKD model . Sham-operated ( sham ) rats were used as the control . To investigate the effectiveness of prebiotics ( glutamine , dietary fiber , and oligosaccharide ) and probiotics ( Bifidobacterium longum strain ; GFOB diet ) , rats were r and omly assigned to 4 groups : Nx group fed the GFOB diet ( n = 10 ) ; Nx group fed the control ( CON ) diet ( n = 10 ) ; sham group fed the GFOB diet ( n = 5 ) ; and sham group fed the control diet ( n = 5 ) . Blood , feces , and kidney sample s were collected and analyzed . Results : Serum creatinine ( Cre ) and blood urea nitrogen in the Nx GFOB group were significantly lower than those in the Nx CON group . Serum indoxyl sulfate in the Nx GFOB group was lower than that in the Nx CON group , and significantly correlated with serum Cre . Inorganic phosphorus and intact parathyroid hormone in the Nx GFOB group were significantly lower than those in the Nx CON group . Conclusion : Improving the gut environment using synbiotics ameliorated kidney function and might be a pharmacological treatment for SHPT without any serious adverse events Liver regeneration is a prerequisite for extended liver surgery . Several studies have shown that the bacterial gut flora is able to modulate liver function . Previously we observed that synbiotics could partly reverse the impaired mitosis rate of hepatocytes in a rat model of synchronous liver resection and colon anastomosis . The effect of synbiotics on liver function after hepatic resection has not been analysed yet . A prospect i ve r and omised double-blind pilot trial was undertaken in 19 patients scheduled for right hepatectomy . All patients received enteral nutrition immediately post-operatively . Comparison was made between a group receiving a combination of four probiotics and four fibres and a placebo group receiving the fibres only starting the day before surgery and continuing for 10 days . Primary study endpoint was the liver function capacity measured by 13C-methacetin breath test and indocyanine green plasma disappearance rate . Portal vein flow , liver volumetry , laboratory parameters for liver function , length of hospital stay , post-operative complications and side effects of synbiotic therapy  were recorded . Liver function capacity was comparable in both groups . Complications had a negative impact on liver function . Because complications were more severe in the verum group , a sub- analysis was performed . In case of an uncomplicated course , liver function capacity was better in the patients with synbiotics . No severe side effects occurred . Synbiotics might be able to increase liver function capacity in patients after liver resection , but patient numbers were too small and the clinical courses too heterogeneous to draw any definite conclusions Objectives : To our knowledge , no reports are available indicating the effects of synbiotic bread consumption on nitric oxide ( NO ) , biomarkers of oxidative stress , and liver enzymes among patients with type 2 diabetes mellitus ( T2DM ) . This study was performed to determine the effects of the daily consumption of synbiotic bread on NO , biomarkers of oxidative stress , and liver enzymes in patients with T2DM . Methods : This r and omized , double-blind , placebo-controlled trial was performed among 81 patients with diabetes , aged 35–70 years old . After a 2-week run-in period , patients were r and omly divided into 3 groups : group A ( n = 27 ) received synbiotic bread containing viable and the heat-resistant probiotic Lactobacillus sporogenes ( 1 × 108 CFU ) and 0.07 g inulin per 1 g , group B ( n = 27 ) received probiotic bread containing Lactobacillus sporogenes ( 1 × 108 CFU ) , and group C ( n = 27 ) received control bread for 8 weeks . Patients were asked to consume the synbiotic , probiotic , or control breads 3 times a day in 40 g packages for a total of 120 g/day . Fasting blood sample s were taken at baseline and after an 8-week intervention for quantificationof related markers . Results : After 8 weeks , the consumption of synbiotic bread compared to the probiotic and control breads result ed in a significant rise in plasma NO ( 40.6 ± 34.4 vs 18.5 ± 36.2 and −0.8 ± 24.5 µmol/L , respectively , p < 0.001 ) and a significant reduction in malondialdehyde ( MDA ) levels ( −0.7 ± 0.7 vs 0.6 ± 1.7 and 0.5 ± 1.5 µmol/L , respectively , p = 0.001 ) . We did not find any significant effect of the synbiotic bread consumption on plasma total antioxidant capacity ( TAC ) , plasma glutathione ( GSH ) , catalase , serum liver enzymes , calcium , iron , magnesium levels , and blood pressure compared to the probiotic and control breads . Conclusion : In conclusion , consumption of the synbiotic bread for 8 weeks among patients with T2DM had beneficial effects on plasma NO and MDA levels ; however , it did not affect plasma TAC , GSH , catalase levels , serum liver enzymes , calcium , iron , magnesium levels , and blood pressure To our knowledge , no reports are available indicating the effects of synbiotic food consumption on blood lipid profiles and biomarkers of oxidative stress among pregnant women . This study was conducted to evaluate the effects of daily consumption of a synbiotic food on blood lipid profiles and biomarkers of oxidative stress in pregnant women . This r and omized , double-blind , controlled clinical trial was performed among 52 primigravida pregnant women , aged 18 to 35-year-old at their third trimester . After a 2-week run-in period , subjects were r and omly assigned to consume either a synbiotic ( n = 26 ) or control food ( n = 26 ) for 9 weeks . The synbiotic food consisted of a probiotic viable and heat-resistant Lactobacillus sporogenes ( 1 × 107 CFU ) and 0.04 g inulin (HPX)/g as the prebiotic . Patients were asked to consume the synbiotic and control foods two times a day . Biochemical measurements including blood lipid profiles , plasma total antioxidant capacity ( TAC ) and total glutathione ( GSH ) were conducted before and after 9 weeks of intervention . Consumption of a synbiotic food for 9 weeks result ed in a significant reduction in serum TAG ( P = 0.04 ) , VLDL ( P = 0.04 ) and a significant rise in plasma GSH levels ( P = 0.004 ) compared to the control food . No significant effects of the synbiotic food consumption on serum TC , LDL , HDL and plasma TAC levels ( P > 0.05 ) were observed . Trial registry code : http://www.i rct .ir . I RCT 201212105623N3 OBJECTIVE : The aim of this study was to determine the effects of synbiotic food consumption on glycemic status and serum high sensitivity C-reactive protein ( hs-CRP ) levels of Iranian pregnant women . DESIGN : This r and omized placebo-controlled clinical trial was performed among 52 pregnant women , primigravida , aged 18–35 year old , in their third trimester . After a 2-wk run-in period , subjects were r and omly assigned to consume either a synbiotic ( n=26 ) or control food ( n=26 ) for 9 weeks . The synbiotic food consisted of a probiotic Lactobacillus sporogenes ( 1 × 107 CFU ) , 0.04 g inulin as prebiotic with 0.38 g isomalt , 0.36 g sorbitol and 0.05 g stevia as sweetener per 1 g. Control food ( the same substance without probiotic bacteria and inulin ) was packed in identical 9-gram packages . Patients were asked to consume the synbiotic and control foods two times a day . Fasting blood sample s were taken at baseline and after a 9-wk intervention for quantification of related factors . RESULTS : Consumption of a synbiotic food did not show any significant change regarding the impact of insulin actions in the synbiotic group ; nonetheless , compared to the control food , it result ed in a significant decrease in serum insulin levels ( −0.26 vs. 6.34 µIU/mL , P=0.014 ) and HOMA-IR ( −0.13 vs. 1.13 , P=0.033 ) , a significant difference in HOMA-B ( 5.30 vs. 34.22 , P=0.040 ) and a significant rise in QUICKI score ( 0.002 vs. −0.02 , P=0.022 ) . CONCLUSIONS : Consumption of a synbiotic food for 9 weeks by pregnant women had beneficial effects on insulin actions compared to the control food , but did not affect FPG and serum hs-CRP concentrations Background Prebiotics and probiotics ( synbiotics ) can modify gut microbiota and have potential in allergy management when combined with amino-acid-based formula ( AAF ) for infants with cow ’s milk allergy ( CMA ) . Methods This multicenter , double-blind , r and omized controlled trial investigated the effects of an AAF-including synbiotic blend on percentages of bifidobacteria and Eubacterium rectale/Clostridium coccoides group ( ER/CC ) in feces from infants with suspected non-IgE-mediated CMA . Feces from age-matched healthy breastfed infants were used as reference ( healthy breastfed reference ( HBR ) ) for primary outcomes . The CMA subjects were r and omized and received test or control formula for 8 weeks . Test formula was a hypoallergenic , nutritionally complete AAF including a prebiotic blend of fructo-oligosaccharides and the probiotic strain Bifidobacterium breve M-16V . Control formula was AAF without synbiotics . Results A total of 35 ( test ) and 36 ( control ) subjects were r and omized ; HBR included 51 infants . At week 8 , the median percentage of bifidobacteria was higher in the test group than in the control group ( 35.4 % vs. 9.7 % , respectively ; P<0.001 ) , whereas ER/CC was lower ( 9.5 % vs. 24.2 % , respectively ; P<0.001 ) . HBR levels of bifidobacteria and ER/CC were 55 % and 6.5 % , respectively . Conclusion AAF including specific synbiotics , which results in levels of bifidobacteria and ER/CC approximating levels in the HBR group , improves the fecal microbiota of infants with suspected non-IgE-mediated CMA BACKGROUND Travelers ' diarrhea ( TD )  is a significant problem for travelers . TD is treatable once it occurs , but few options for prevention exist . Probiotics have been studied for prevention or treatment of TD ; however , very few combination probiotics have been studied . Therefore , the purpose of this study was to determine if prophylactic use of an oral synbiotic could reduce the risk of acquiring TD and reduce antibiotic use if TD occurred . METHODS Healthy subjects traveling to an area of the world with an increased risk of TD were eligible . All subjects received pre-travel counseling and were provided antibiotics and antidiarrheals ( loperamide ) for use only if TD developed . The subjects were blinded and r and omized to take two capsules of placebo or oral synbiotic ( a combination of two probiotics and a prebiotic ) called Agri-King Synbiotic ( AKSB ) beginning 3 days prior to departure , daily while traveling , and for 7 days after return . All subjects kept symptom and medication diaries and su bmi tted a stool sample for pathogen carriage within 7 days of return . The study was powered to detect a 50 % reduction in the incidence of TD . RESULTS Of the 196 adults ( over 18 years of age ) enrolled in the study , 54.3 % were female and 80.9 % were younger than 60 years . The study r and omized 94 people to the AKSB arm and 102 to placebo . The incidence of TD was 54.5 % in the overall group with 55.3 % in the AKSB arm and 53.9 % in the placebo ( p = 0.8864 ) . Among the subjects who experienced diarrhea ( n = 107 ) there was no significant difference in the proportion of subjects that took antibiotics versus those that did not take antibiotics ( 35 % vs 29 % , p = 0.68 ) . AKSB was safe with no difference in toxicity between the two arms . CONCLUSIONS The prophylactic oral synbiotic was safe but did not reduce the risk of developing TD among travelers , nor did it decrease the duration of TD or the use of antibiotics when TD occurred
The administration of probiotic/synbiotic were associated with a significant improvement in FPG , FBI , HOMA I-R , BMI .
It also modified Ferriman-Gallway , serum triglycerides , serum testosterone , hs-CRP , NO , TAC , GSH , and MDA .
Subgroup analysis of the type of intervention showed that probiotics were associated with greater testosterone and FPG reduction ;  synbiotics administration result ed in a more pronounced decrease of the FBI .
Subgroup analyses on the duration of therapy showed that , probiotic/synbiotic administration had a significantly greater effect on QUICK-I in the case of women with 12-weeks of therapy than in the 8-weeks therapy group .
Nevertheless , we did not observe any significant difference was observed in terms of FBI , HOMA-IR , and FPG .
Probiotics and synbiotics seem to either an effect on/influence metabolic , hormonal and inflammatory parameters , or can influence them .
Consequently , it could lead to an improvement of fertility in PCOS
Several r and omized controlled trials ( RCTs ) have investigated the use of probiotic/synbiotic in PCOS patients , without clarifying the real use in clinical practice .
The aim of this meta- analysis was to evaluate the effectiveness of probiotics and synbiotics on metabolic , hormonal and inflammatory parameters of PCOS  .