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, 2019, 1684198
eCollection

Modification of Immunological Parameters, Oxidative Stress Markers, Mood Symptoms, and Well-Being Status in CFS Patients After Probiotic Intake: Observations From a Pilot Study

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Modification of Immunological Parameters, Oxidative Stress Markers, Mood Symptoms, and Well-Being Status in CFS Patients After Probiotic Intake: Observations From a Pilot Study

Letizia Venturini et al. Oxid Med Cell Longev.

Abstract

The present study discusses about the effects of a combination of probiotics able to stimulate the immune system of patients affected by Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). To this purpose, patients diagnosed according to Fukuda's criteria and treated with probiotics were analyzed by means of clinical and laboratory evaluations, before and after probiotic administrations. Probiotics were selected considering the possible pathogenic mechanisms of ME/CFS syndrome, which has been associated with an impaired immune response, dysregulation of Th1/Th2 ratio, and high oxidative stress with exhaustion of antioxidant reserve due to severe mitochondrial dysfunction. Immune and oxidative dysfunction could be related with the gastrointestinal (GI) chronic low-grade inflammation in the lamina propria and intestinal mucosal surface associated with dysbiosis, leaky gut, bacterial translocation, and immune and oxidative dysfunction. Literature data demonstrate that bacterial species are able to modulate the functions of the immune and oxidative systems and that the administration of some probiotics can improve mucosal barrier function, modulating the release of proinflammatory cytokines, in CFS/ME patients. This study represents a preliminary investigation to verifying the safety and efficacy of a certain combination of probiotics in CFS/ME patients. The results suggest that probiotics can modify the well-being status as well as inflammatory and oxidative indexes in CFS/ME patients. No adverse effects were observed except for one patient, which displayed a flare-up of symptoms, although all inflammatory parameters (i.e., cytokines, fecal calprotectin, ESR, and immunoglobulins) were reduced after probiotic intake. The reactivation of fatigue symptoms in this patient, whose clinical history reported the onset of CFS/ME following mononucleosis, could be related to an abnormal stimulation of the immune system as suggested by a recent study describing an exaggerated immune activation associated with chronic fatigue.

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Health status indexes. Chadler's scale score and PCS and MCS indexes, respectively, for physical and mental condition before and after probiotic protocol. T0: mean basal values; T1: mean values after 4 weeks of probiotic protocol; T2: mean values after 8 weeks of probiotic protocol (n = 9).
Figure 2
Figure 2
Mood indexes. Mean values of Beck Depression Inventory tests (BDI-I and BDI-II) before and after probiotic protocol. T0: mean basal values; T1: mean values after 4 weeks of probiotic protocol; T2: mean values after 8 weeks of probiotic protocol (n = 9).
Figure 3
Figure 3
Inflammatory parameters. Inflammatory indexes (fold change values) following probiotic administration. UC: urinary free cortisol; CAL: fecal calprotectin; ESR: erythrocyte sedimentation rate; CRP: C-reactive protein; DHEA-S: dehydroepiandrosterone sulfate (n = 9).
Figure 4
Figure 4
Immunological parameters. Immunoglobulin levels and CD4+/CD8+ lymphocytes ratio (fold change values) following probiotic intake (n = 9).
Figure 5
Figure 5
Oxidative stress. Oxidative stress index (d-ROMs) in each patient following probiotic intake. T2 levels compared to T0 levels (baseline) (fold change values, T0/T2 ratio). MV: mean values (n = 9).
Figure 6
Figure 6
Oxidative stress index (d-ROMs) in the two groups of patients at T0 and at T2. Group A: very low d-ROM values at T0; Group B: normal d-ROM values at T0 (n = 9). Patients with very low d-ROM values in T0 (Group A) increase oxidative production in T2; patients with normal d-ROM values at T0 (Group B) decrease oxidative production after probiotic intake.
Figure 7
Figure 7
Inflammatory parameters, health status indexes, and mood indexes. Group A at T0 and Group B at T0 compared (n = 9). Lower d-ROM in T0 is associated with greater degree of depression (BDI) and fatigue (Chadler's scale score), higher levels of UC, and lower physical and psychological quality of life (PCS and MCS lower level). UC level is higher in Group A than in Group B in T0.
Figure 8
Figure 8
Inflammatory parameters, health status indexes, and mood indexes. Group A at T0 and at T2 compared (fold change values, T0/T2 ratio) (n = 9).
Figure 9
Figure 9
Inflammatory parameters, health status indexes, and mood indexes. Group B at T0 and at T2 compared (fold change values, T0/T2 ratio) (n = 9).

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