Probiotic supplementation: A universal solution or a case of limited efficacy?
Éliás Anna Júlia
Health Sciences
Dr. Nagy Zoltán Zsolt
SE ETK Dr. Szél Éva tanterem
2025-07-04 13:00:00
Theoretical and preclinical health sciences
Dr. Lenti Katalin
Dr. Földvári-Nagy Lászlóné Dr. Lenti Katalin és Dr. Földvári-Nagy László
Dr. Micsik Tamás
Dr. Nagy-Grócz Gábor
Dr. Balogh Zoltán
Dr. Pálfi Erzsébet
Dr. Kanizsai Péter
Probiotics are widely used to support gut health, particularly in maintaining microbiome diversity and intestinal barrier integrity. However, their effectiveness remains uncertain. Three recent systematic reviews and meta-analyses examined the impact of probiotics on gut microbiome composition during antibiotic therapy, in healthy individuals, and on intestinal permeability measured by blood zonulin levels.
The systematic review and meta-analysis of randomized controlled trials assessed whether concurrent probiotic supplementation mitigates antibiotic-induced microbiome alterations. Among 11,769 screened articles, 15 were eligible for qualitative synthesis, and five were included in the meta-analysis. The pooled results for Shannon, Chao1, and Observed OTUs indices showed no statistically significant differences between probiotic-supplemented and control groups. Additionally, most studies reported no meaningful differences in other α- and β-diversity indices. Although taxonomic shifts varied, microbiome composition tended to return to baseline levels in both groups after 3–8 weeks. The limited number of studies and variations in antibiotic and probiotic regimens were key limitations.
In the second meta-analysis, we evaluated the effect of probiotics on microbiome diversity in healthy individuals. A systematic search identified 47 eligible studies, with 22 (1,068 individuals) included in the meta-analysis. No statistically significant effects were observed for Shannon, Observed OTUs, Chao1, or Simpson’s Diversity Index. These findings suggest that probiotic supplementation does not alter microbiome diversity in healthy populations.
The third meta-analysis explored the potential of probiotics to improve intestinal barrier integrity by assessing blood zonulin levels. A systematic search identified 9,217 articles, with data from 307 individuals across five studies included in the meta-analysis. The results revealed no significant difference in blood zonulin concentrations between probiotic and control groups, indicating that probiotic supplementation does not affect intestinal permeability.
Collectively, these findings challenge the widespread assumption that probiotics significantly modulate microbiome diversity or enhance intestinal barrier function. Further studies are needed to determine the contexts in which probiotics may provide meaningful benefits, particularly regarding strain-specific and condition-specific effects.
