Table 1.
Summary of Various Intestinal Microecological Interventions in the Literature
| Intervention | Publication Year | Specific Intervention Strategies | Type of Article | Author | Number of Studies | Diseases/Outcome | Quality of Evidence | Intervention Groups | Main Conclusions |
|---|---|---|---|---|---|---|---|---|---|
| Diet | 2024 | Dietary intervention | Systematic review | Linli Cai159 | 36 meta-analyses | Diabetic nephropathy | Moderate to low | Adult | Probiotics, vitamin D, soy isoflavones, coenzyme Q10, polyphenols, antioxidant vitamins, or salt-restricted diets may improve outcomes in diabetic nephropathy patients. |
| 2023 | Honey, glutamine, and propolis | Systematic review | Reza Amiri Khosroshahi160 | 26 meta-analyses | Cancer therapy-induced oral mucositis | Moderate | Adult | Honey, glutamine, and propolis can significantly reduce the incidence of severe oral mucositis. | |
| 2024 | Mediterranean diet | Network meta-analysis | Ioannis Doundoulakis161 | 17 RCTs | Cardiovascular disease | Unknown | Adult | Mediterranean diet may play a protective role against cardiovascular disease and death in primary and secondary prevention. | |
| 2024 | Mediterranean diet | Systematic review | Armin Khavandegar162 | 17 observational and 20 interventional studies | Gut microbiota composition | Unknown | Adult | Adherence to the Mediterranean diet improves gut microbiota diversity and composition, leading to significant clinical benefits. | |
| 2024 | Low FODMAP diet | Systematic review | Sandra Jent163 | 19 real-world studies | Irritable bowel syndrome | Unknown | Adult | Low FODMAP diet improves outcomes compared to a control diet (efficacy studies) or baseline data (real-world studies). | |
| 2024 | Intermittent fasting | Network meta-analysis | Mohamed T Abuelazm164 | 8 RCTs | Metabolic dysfunction-associated steatotic liver disease | Unknown | Adult | Alternate-day fasting improved anthropometric measures, including lean body mass, waist circumference, fat mass, and weight loss. | |
| 2023 | Intermittent Fasting | Systematic review | Theodoro Pérez-Gerdel165 | 9 studies (all with longitudinal design) | Gut microbiota | Unknown | Adult | Firmicutes and Bacteroidetes increased, with 16 genera varying due to intermittent fasting, linked to clinical predictors like weight change and metabolic variables, boosting gut microbiota diversity. | |
| 2023 | Ketogenic diet | Systematic review | Mahdi Mazandarani166 | 9 clinical trials and cohorts | Gut microbiota, metabolites | Unknown | Neurological patients | A ketogenic diet reduces disease severity and recurrence, alters gut bacteria by increasing Proteobacteria and decreasing Firmicutes, and changes metabolite levels. | |
| Exercise | 2024 | Exercise | Systematic review | Leizi Min119 | 25 controlled trials | Gut microbiota | Unknown | Adult | Exercise can improve gut microbiota in adults, with a significant increase in the Shannon index; however, responses vary by sex and age, indicating a need for further research. |
| 2023 | Exercise | Systematic review | ML Lavilla-Lerma167 | 13 RCTs | Gut microbiota | Unknown | Adult | Modulating gut microbiota depends on exercise type, intensity, and duration, affecting specific microbial populations more than richness and diversity. | |
| 2023 | Exercise | Systematic review | Alexander N Boytar168 | 28 trials (randomised controlled trials, cohort studies and case-control studies) | Gut microbiota | Unknown | Adult | Regular moderate to high-intensity exercise for 30–90 min at least 3 times a week can change gut microbiota in 8 weeks, benefiting both clinical and healthy individuals. | |
| Probiotics/prebiotics/synbiotics/postbiotics | 2024 | Probiotics supplementation | Systematic review | Zihan Yang169 | 534 RCTs | Helicobacter pylori infection | High | Adult | Probiotic supplementation improved eradication rates (risk ratio 1.10) and reduced side effects (risk ratio 0.54) compared to standard therapy. |
| 2024 | Probiotics | Systematic review | Minjuan Han170 | 13 systematic reviews/meta-analyses | Ventilator-associated pneumonia | Low | Adult | Probiotics may be associated with a reduced incidence of ventilator-associated pneumonia. | |
| 2024 | Probiotics | Systematic review | Yunxin Zhang171 | 7 systematic reviews/meta-analyses | Functional constipation | Low | Children | Probiotics may be beneficial in improving functional constipation in children. | |
| 2023 | Probiotics | Systematic review | Reza Amiri Khosroshahi172 | 13 systematic reviews/meta-analyses | Chemotherapy- and radiotherapy-related diarrhoea | Low | Adult | Probiotics use can reduce the incidence of diarrhoea induced by chemotherapy and radiotherapy in cancer patients. | |
| 2023 | Probiotics | Systematic review | Qingrui Yang173 | 20 systematic reviews | Antibiotic-associated diarrhoea | Moderate to low | Children | Probiotics prevent and treat antibiotic-associated diarrhoea in children, possibly showing a dose-response effect. | |
| 2023 | Probiotics/prebiotics/and synbiotics | Systematic review | Pooneh Angoorani174 | 8 systematic reviews/meta-analyses | Polycystic ovarian syndrome | High to low | Adult | Probiotic supplementation may benefit some polycystic ovarian syndrome parameters like BMI, glucose, and lipids, but synbiotics are less effective. | |
| 2022 | Probiotics | Systematic review | Haissan Iftikhar175 | 3 systematic reviews | Allergic rhinitis | Moderate to low | Adult | Probiotics are useful in treating allergic rhinitis. | |
| 2022 | Prebiotics/probiotics/synbiotics/FMT | Systematic review | Nathalie Michels176 | 57 meta-analyses | Metabolic disorders | Moderate to low | Adult | Meta-evidence was the highest for probiotics and lowest for FMT. | |
| 2021 | Probiotics | Systematic review | E Earp177 | 3 systematic reviews | Atopic eczema | Low | Pregnancy of infancy | Probiotics during pregnancy or infancy were analyzed, but low-quality evidence indicates limited benefits of combined probiotics. | |
| 2019 | Probiotics | Systematic review | Mikołaj Kamiński178 | 8 systematic reviews/meta-analyses | Chronic idiopathic constipation | Low | Adult | Probiotics are recommended, but their effectiveness for adult constipation is unclear. | |
| 2020 | Probiotics | Systematic review | Tao Xiong179 | 98 meta-analyses of RCTs | Necrotising enterocolitis | Very low to moderate | Preterm Infants | Decreased risk of necrotising enterocolitis is observed with probiotics. | |
| 2019 | Probiotics | Systematic review | Rachel Perry180 | 16 systematic reviews | Infantile colic | Low | Infant | A particular focus on probiotics in non-breastfed infants is pertinent. | |
| 2019 | Probiotics | Systematic review | Ibrahim Nadeem181 | 7 systematic reviews | Depression | Unknown | Adult | Probiotics seem to produce a significant therapeutic effect in individuals with pre-existing depressive symptoms. | |
| 2018 | Probiotics | Systematic review | Rebecca A Abbott182 | 55 RCTs | Recurrent abdominal pain | Unknown | Children | He evidence for treatment decisions is poor; probiotics, cognitive behavioural therapy, and hypnotherapy may aid in managing children’s recurrent abdominal pain. | |
| 2016 | Probiotics | Systematic review | Jinpei Dong183 | 36 systematic reviews/meta-analyses | Inflammatory bowel disease and pouchitis | Moderate to low | Adult | Probiotics may help ulcerative colitis but not Crohn disease remission; VSL#3 may aid pouchitis. | |
| 2016 | Probiotics | Systematic review | YA McKenzie184 | 9 systematic reviews and 35 RCTs | Irritable bowel syndrome | Unknown | Adult | Symptom outcomes for dose-specific probiotics varied, making specific recommendations for irritable bowel syndrome management in adults impossible now. | |
| 2024 | Probiotics/prebiotics | Systematic review | Md. Nannur Rahman185 | 29 RCTs | Colonisation resistance in the gut | Moderate | Human and animal | Probiotics and prebiotics may reduce pathogens by modulating gut diversity, but more clinical data on specific strains is needed to confirm this. | |
| TCM | 2022 | Herbal medicine | Systematic review | Hyejin Jun186 | 18 systematic reviews | Irritable bowel syndrome | Low | Adult | Herbal medicines can be considered as an effective and safe treatment for irritable bowel syndrome. |
| 2019 | Fennel extract | Systematic review | Rachel Perry180 | 16 systematic reviews | Infantile colic | Low | Infant | Fennel extract shows potential in alleviating colic symptoms. | |
| FMT | 2024 | Chemical drugs/FMT/Probiotics/Dietary fibre/Acupuncture | Network meta-analysis | Shufa Tan187 | 45 RCTs | Chronic functional constipation | Unknown | Adult | FMT shows the best clinical efficacy and stool form scores, along with improved patient quality of life. |
| 2024 | Probiotics/Prebiotics/Synbiotics/FMT | Systematic review | Mahmoud Yousef188 | 27 RCTs | COVID-19-induced gut dysbiosis | Unknown | Adult | The review enhances our understanding of biotics’ therapeutic potential for COVID-19-related intestinal issues and multi-organ complications. | |
| 2024 | FMT | Systematic review | Yan Yang189 | 4 RCTs | Type 2 diabetes mellitus | Unknown | Adult | FMT treatment in Type 2 diabetes reduces postprandial glucose, triglycerides, insulin resistance, cholesterol, ALT, and diastolic blood pressure, particularly with combined therapy, while also reshaping gut microbiota. | |
| 2023 | FMT | Systematic review | Azin Pakmehr190 | 11 clinical trials | Cardiometabolic risk | Unknown | Adult | While some articles noted FMT’s benefits on metabolic parameters, we found no significant changes. | |
| 2024 | FMT | Meta-analysis | Shafquat Zaman191 | 17 observational studies and 2 RCTs | Chronic refractory pouchitis | Low | Adult | Current evidence from low-quality studies suggests a variable clinical response and remission rate. | |
| 2023 | FMT | Systematic review and meta-analysis | Serena Porcari192 | 15 clinical trials | rCDI | Unknown | Adult | FMT showed high cure rates for rCDI in inflammatory bowel disease patients, with overall FMT outperforming single FMT, similar to non-inflammatory bowel disease data, supporting FMT’s use for rCDI treatment in these patients. | |
| 2023 | FMT | Systematic review and meta-analysis | Parnian Jamshidi193 | 7 RCTs | Irritable bowel syndrome | Unknown | Adult | Lower gastrointestinal administration of multiple-donor FMT significantly improves patient complaints over autologous FMT as a placebo. | |
| 2023 | FMT | Systematic Review and meta-analysis | Jing Feng194 | 13 RCTs | Ulcerative colitis | Unknown | Adult | FMT shows potential for inducing remission in ulcerative colitis, but achieving and maintaining endoscopic remission is challenging. | |
| 2023 | FMT | Systematic review and meta-analysis | Li Zecheng195 | 10 RCTs | Obesity metabolism | Unknown | Adult | FMT benefits obese patients with high blood pressure, glucose issues, and elevated lipids; studying metabolic factors in these patients will be our future focus. | |
| Prokinetic agents/Digestive enzyme supplements/Antidepressants | 2023 | Psychotropic medications | Systematic review and meta-analysis | Amedeo Minichino196 | 19 longitudinal and cross-sectional studies | Gut microbiota | Unknown | Adult | Psychotropic medications alter gut microbiota, which may affect their efficacy and tolerability. |
| Nutritional preparations | 2022 | Antioxidants, probiotics, prebiotics, camel milk, and vitamin D | Systematic review | Cecilia N Amadi197 | 21 clinical trails | Autism | Unknown | Children | Dietary supplements like antioxidants, probiotics, prebiotics, vitamin D, and camel milk may reduce inflammation and improve autism symptoms by targeting the cerebral-intestinal axis safely. |
| 2023 | Vitamin B12 | Systematic review | Heather M Guetterman198 | 22 studies (3 in vitro, 8 animal, 11 human observational studies) | Gut microbiota | Unknown | Vitro, animal, human | Few prospective observational studies but no RCTs have been conducted to examine the effects of vitamin B-12 on the human gut microbiota. | |
| 2021 | Vitamin D | Systematic review | Federica Bellerba199 | 14 interventional and 11 observational studies | Gut microbiota | Unknown | Adult | Vitamin D supplementation changed microbiome composition, notably Firmicutes, Actinobacteria, and Bacteroidetes, correlating with serum vitamin D levels, reducing Veillonellaceae and Oscillospiraceae families. | |
| Antibiotics | 2021 | Oral fidaxomycin | Systematic review | Adelina Mihaescu200 | 2 RCTs/2 Non-RCTs | CDI | Unknown | Adult | Treatment with oral fidaxomycin is more effective than oral vancomycin for the initial episode of CDI in patients with chronic kidney disease. |
| 2021 | Azithromycin + metronidazole | Systematic review | Charlotte M Verburgt201 | 2 RCTs | Crohn disease | Unknown | Children | In mild-to-moderate Crohn disease, azithromycin + metronidazole (n = 35) showed no significant response difference from metronidazole alone (n = 38) (p = 0.07), but was more effective for remission induction (p = 0.025). |
Abbreviations: FODMAP, Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols; TCM, Traditional Chinese Medicine; FMT, Faecal microbiota transplantation; RCTs, Randomised controlled trials; COVID-19, Coronavirus disease 2019; rCDI, Recurrent Clostridioides difficile infection; PCDI, pediatric Crohn's disease activity index.