title: Probiotic supplementation improves inflammatory status in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is an inflammatory autoimmune disease in which the gut microbiota is altered. Probiotics are microorganisms that can normalize gut microbiota; thus, they may help to alleviate RA symptoms. The objective of the present clinical trial was to assess the effects of probiotic supplementation on disease activity and inflammatory cytokines in patients with RA.
  
  
  METHODS
  Forty-six patients with RA were assigned into two groups in this randomized, double-blind, placebo-controlled clinical trial. The patients in the probiotic group received a daily capsule that contained a minimum of 10(8) colony-forming units of Lactobacillus casei 01 for 8 wk. The placebo group took capsules filled with maltodextrin for the same time period. Questionnaires, anthropometric measurements, and fasting blood samples were collected, and the participants were assessed by a rheumatologist at baseline and at the end of the trial.
  
  
  RESULTS
  Disease activity score was significantly decreased by the intervention, and there was a significant difference between the two groups at the end of the study (P < 0.01). Three of the assessed serum proinflammatory cytokines (tumor necrosis factor-α, interleukin-6, and interleukin-12) significantly decreased in the probiotic group (P < 0.05); however, serum levels of interleukin-1 β were not significantly affected by the probiotic (P = 0.22). The serum level of regulatory cytokine (interleukin-10) was increased by the supplementation (P < 0.05). The proportion of interleukin-10 to interleukin-12 was significantly increased in the probiotic group as well.
  
  
  CONCLUSIONS
  L. casei 01 supplementation improved the disease activity and inflammatory status of patients with RA. Further studies are warranted to confirm these results, and such confirmation may lead to the introduction of probiotics as adjunctive therapy for this population.
authors.affiliation: Department of Nutrition, Biochemistry and Diet Therapy, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Elnaz
authors.initials: E
authors.lastname: Vaghef-Mehrabany
authors.affiliation: Department of Community Nutrition, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Beitullah
authors.initials: B
authors.lastname: Alipour
authors.affiliation: Department of Food Science and Technology, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: Homayounia@tbzmed.ac.ir.
authors.forename: Aziz
authors.initials: A
authors.lastname: Homayouni-Rad
authors.affiliation: Rheumatology Department, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Sakineh-Khatoon
authors.initials: SK
authors.lastname: Sharif
authors.affiliation: Road Traffic Injury Prevention Research Center, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Asghari-Jafarabadi
authors.affiliation: Department of Public Health and Management, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Sema
authors.initials: S
authors.lastname: Zavvari
mesh_terms: D000328:Adult; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D015415:Biomarkers / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000517:prevention & control*; D007378:Interleukins / Q000097:blood*; D007780:Lacticaseibacillus casei; D008875:Middle Aged; D019936:Probiotics / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015415:Biomarkers; D007378:Interleukins; D014409:Tumor Necrosis Factor-alpha
keywords: Cytokines; Disease activity; Inflammation; Lactobacillus casei 01; Randomized clinical trial; Rheumatoid arthritis