title: Clinical and metabolic response to probiotic supplementation in patients with rheumatoid arthritis: a randomized, double-blind, placebo-controlled trial.
abstract: OBJECTIVE
  This study was performed to determine the effects of probiotic supplementation on clinical and metabolic status of patients with rheumatoid arthritis (RA).
  
  
  METHODS
  Sixty patients with RA aged 25-70 years were assigned into two groups to receive either probiotic capsules (n = 30) or placebo (n = 30) in this randomized, double-blind, placebo-controlled trial. The patients in the probiotic group received a daily capsule that contained three viable and freeze-dried strains: Lactobacillus acidophilus (2 × 10(9) colony-forming units [CFU]/g), Lactobacillus casei (2 × 10(9) CFU/g) and Bifidobacterium bifidum (2 × 10(9) CFU/g) for 8 weeks. The placebo group took capsules filled with cellulose for the same time period. Fasting blood samples were taken at the beginning and the end of the study to quantify related markers.
  
  
  RESULTS
  After 8 weeks of intervention, compared with the placebo, probiotic supplementation resulted in improved Disease Activity Score of 28 joints (DAS-28) (-0.3 ± 0.4 vs. -0.1 ± 0.4, P = 0.01). In addition, a significant decrease in serum insulin levels (-2.0 ± 4.3 vs. +0.5 ± 4.9 μIU/mL, P = 0.03), homeostatic model assessment-B cell function (HOMA-B) (-7.5 ± 18.0 vs. +4.3 ± 25.0, P = 0.03) and serum high-sensitivity C-reactive protein (hs-CRP) concentrations (-6.66 ± 2.56 vs. +3.07 ± 5.53 mg/L, P < 0.001) following the supplementation of probiotics compared with the placebo. Subjects who received probiotic capsules experienced borderline statistically significant improvement in total- (P = 0.09) and low-density lipoprotein-cholesterol levels (P = 0.07) compared with the placebo.
  
  
  CONCLUSIONS
  Overall, the results of this study indicated that taking probiotic supplements for 8 weeks among patients with RA had beneficial effects on DAS-28, insulin levels, HOMA-B and hs-CRP levels.
authors.affiliation: Department of Internal Medicine, Autoimmune diseases research center, Kashan University of Medical Sciences, Kashan, I.R. Iran.
authors.forename: Batol
authors.initials: B
authors.lastname: Zamani
authors.affiliation: Department of Internal Medicine, Autoimmune diseases research center, Kashan University of Medical Sciences, Kashan, I.R. Iran.
authors.forename: Hamid R
authors.initials: HR
authors.lastname: Golkar
authors.affiliation: Department of Genetics, School of Basic Sciences, Shahrekord University, Shahrekord, I.R. Iran.|Research Institute of Biotechnology, School of Basic Sciences, Shahrekord University, Shahrekord, I.R. Iran.
authors.forename: Shima
authors.initials: S
authors.lastname: Farshbaf
authors.affiliation: Department of Genetics, School of Basic Sciences, Shahrekord University, Shahrekord, I.R. Iran.|Research Institute of Biotechnology, School of Basic Sciences, Shahrekord University, Shahrekord, I.R. Iran.
authors.forename: Modjtaba
authors.initials: M
authors.lastname: Emadi-Baygi
authors.affiliation: Science Department, Science Faculty, Islamic Azad University, Tehran Central Branch, Tehran, I.R. Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Tajabadi-Ebrahimi
authors.affiliation: Department of Microbiology, Science Faculty, Islamic Azad University, Arak Branch, Arak, I.R. Iran.
authors.forename: Parvaneh
authors.initials: P
authors.lastname: Jafari
authors.affiliation: Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran.
authors.forename: Reyhaneh
authors.initials: R
authors.lastname: Akhavan
authors.affiliation: Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Taghizadeh
authors.affiliation: Barij Medicinal Plants Research Center, Kashan, I.R. Iran.
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Memarzadeh
authors.affiliation: Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran. asemi_r@yahoo.com.
authors.forename: Zatollah
authors.initials: Z
authors.lastname: Asemi
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D000069985:Bifidobacterium bifidum / Q000502:physiology*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D008078:Cholesterol, LDL / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D000069196:Gastrointestinal Microbiome; D006801:Humans; D007328:Insulin / Q000097:blood; D007422:Intestines / Q000382:microbiology*; D007492:Iran; D007779:Lactobacillus acidophilus / Q000502:physiology*; D007780:Lacticaseibacillus casei / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D019936:Probiotics / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008078:Cholesterol, LDL; D007328:Insulin; D002097:C-Reactive Protein
keywords: metabolic profiles; probiotic; rheumatoid arthritis; supplementation