Probiotics offer little in terms of GI symptoms in systemic sclerosis
Treatment with probiotics falls short of improving gastrointestinal (GI) symptoms in patients with systemic sclerosis (SSc), a study has shown.
The study randomized 73 SSc patients with a moderate–severe total score on the University of California Los Angeles Scleroderma Clinical Trials Consortium Gastrointestinal Tract 2.0 (UCLA GIT 2.0) instrument to receive a daily dose of probiotics (Lactobacillus paracasei, Lactobacillus rhamnosus, Lactobacillus acidophillus and Bifidobacterium lactis, 109 colony-forming units per capsule; n=37) or placebo (n=36) for 8 weeks.
After 8 weeks of treatment, the primary outcome of change in UCLA GIT 2.0 total score did not significantly differ between the two treatment groups.
However, probiotics treatment produced a significant decrease in the proportion of Th17 cells compared with placebo (p=0.003). There was no between-group difference observed in the proportion of Th1, Th2 and regulatory T cells or in the Health Assessment Questionnaire-Disability Index (HAQ-DI) score.
Although probiotics did not improve GI symptoms in SSc patients, the improvement in Th17 cell levels suggests that the treatment exerts an immunomodulatory effect on SSc, researchers pointed out.
SSc is a multisystem connective tissue disorder of unknown aetiology, and the GI tract is affected in the vast majority (90 percent) of patients. Gut involvement—with symptoms ranging from gastro-oesophageal reflux to faecal incontinence—is the leading cause of morbidity and the third most common cause of mortality in patients with SSc. [Rheumatology 2019;49:1770-1775]