Microbiota shaping - the effects of probiotics, prebiotics, and fecal microbiota transplant on cognitive functions: A systematic review

被引:39
作者
Baldi, Simone [1 ]
Mundula, Tiziana [1 ]
Nannini, Giulia [1 ]
Amedei, Amedeo [1 ,2 ]
机构
[1] Univ Florence, Dept Expt & Clin Med, Largo Brambilla 3, I-50134 Florence, Italy
[2] Azienda Osped Univ Careggi, SOD Interdisciplinary Internal Med, I-50134 Florence, Italy
关键词
Dementia; Cognitive disorders; Gut microbiota; Probiotics; Prebiotics; Fecal microbiota transplant; HYDROCARBON RECEPTOR PATHWAY; GUT MICROBIOTA; FERMENTED MILK; DOUBLE-BLIND; BRAIN; MOOD; MECHANISMS; DEPRESSION; STRESS; IMPACT;
D O I
10.3748/wjg.v27.i39.6715
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
BACKGROUND Dementia is a chronic progressive neurological disease affecting millions of people worldwide, and represents a relevant economic burden for healthcare systems. Although its pathogenesis is still unknown, recent findings have reported that a dysregulated gut-brain axis communication, a fundamental relationship mediated by several host and microbial molecules, is associated with cognitive disorders. In addition, gut microbiota manipulation reduces neuroinflammation, improving cognitive function by restoring the functional gut-brain axis. AIM To better define the effects of probiotics, prebiotics, synbiotics, and fecal microbiota transplant (FMT) on cognitive function. METHODS We performed a literature search of human randomized clinical trials to examine the effects of the administration of probiotics, prebiotics, synbiotics, or FMT on cognition outcomes in healthy or sick people of every age, sex, and nationality. We systematically searched Embase, Medline/PubMed, Cochrane Library, central and clinicaltrials.gov databases with a combination of comprehensive terms related to cognition and gut microbiota manipulation. Then we carefully reviewed and synthesized the data by type of study design and setting, characteristics of the studied population, kind of intervention (strain type or mixture type, dosage, and frequency of administration), control treatment, inclusion and exclusion criteria, follow-up duration, and cognitive or memory outcomes. RESULTS After examining the titles and abstracts, the initial literature screening identified 995 articles, but we added 23 papers in our systematic review. The analyses of these selected studies highlighted that both probiotic supplementation and FMT improved cognitive function regardless of the type and posology of administration and the adopted cognitive tests and questionnaires. We found that most of the studies conducted in healthy people showed a significant positive effect of the intervention on at least one of the performed cognitive tests. Regarding unhealthy subjects, while FMT and especially probiotic administration had multiple beneficial effects on different cognitive functions, supplementation with prebiotics did not provide any cognitive improvement. CONCLUSION Probiotic supplementation and FMT may represent a promising strategy to restore gut eubiosis and enhance the cognitive functions of healthy people and patients with neurological disorders.
引用
收藏
页码:6715 / 6732
页数:18
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