Table 2.
Main evidence on the use of probiotics in patients with celiac disease.
| Author | RCT | Population | Used Strain | Time of Administration | Findings in Probiotics Group |
|---|---|---|---|---|---|
| Smecuol et al. [63] | Yes | 22 A-CD (12 probiotic vs. 10 placebo) | Bifidobacterium infantis Natren life start | 3 weeks | Improvement in GI symptoms (indigestion, constipation, and gastroesophageal reflux) ↓ Final/baseline IgA tTG and IgA DGP antibody concentration ratios ↑ Serum macrophage inflammatory protein-1β No differences in intestinal permeability No significant changes in cytokines and chemokines production |
| Pinto-Sánchez et al. [64] | No | 24 A-CD no treatment vs. 12 A-CD probiotic treatment vs. 5 CD-GFD | Bifidobacterium infantis Natren life start | 3 weeks | ↓ Paneth cell counts ↓ α-defensin-5 |
| Olivares et al. [65] | Yes | 36 A-CD (18 B. longum + GFD vs. 18 placebo + GFD) |
Bifidobacterium longum CECT 7347 |
3 months | ↑ Height percentile ↓ Peripheral CD3+ T lymphocytes concentration ↓ TNF-α levels ↓ Bacteroides fragilis and Enterobacteriaceae ↑ Harmless to potentially harmful bacteria ratio No differences in GI symptoms |
| Quagliarello et al. [50] | Yes | 40 A-CD children (20 probiotic and 20 placebo) vs. 16 HC | Bifidobacterium breve strains (B632 and BR03) | 3 months | ↑ Actinobacteria Re-establishment Firmicutes/Bacteroidetes ratio. |
| Harnett et al. [66] | Yes | 45 CD-GFD with symptoms (23 probiotic and 22 placebo) | multispecies probiotic VSL#3 (450 billion viable lyophilized bacteria Streptococcus thermophilus, Bifidobacterium breve, Bifidobacterium longum, Bifidobacterium infantis, Lactobacillus acidophilus, Lactobacillus plantarum, Lactobacillus paracasei, and Lactobacillus delbrueckii subsp. Bulgaricus) | 12 weeks | No differences in the fecal microbiota counts No differences in symptoms severity |
| Klemenak et al. [67] | Yes | 49 CD-GFD (24 probiotic and 25 placebo) 18 HC | Bifidobacterium breve strains (BR03 and B632) | 3 months | ↓ TNF-alpha levels (not persistent) |
| Primec et al. [68] | Yes | 40 CD (20 probiotic and 20 placebo) 16 HC | Bifidobacterium breve strains (BR03 and B632) | 3 months | Negative relationship between Firmicutes and pro-inflammatory TNF-α. |
| Francavilla et al. [69] | Yes | 109 CD-GFD with IBS symptoms (54 probiotic vs. 55 placebo) | mixture of 5 Lactobacillus casei LMG 101/37 P-17504 Lactobacillus plantarum CECT 4528, Bifidobacterium animalis subsp. lactis Bi1 LMG P-17502, Bifidobacterium breve Bbr8 LMG P-17501 Bifidobacterium breve Bl10 LMG P-17500 | 6 weeks | Improvement in GI symptoms ↑ Bifidobacteria (persistent) |
A-CD: active celiac disease; CD-GFD: celiac disease on gluten-free diet; HC: healthy controls; GI: gastrointestinal, IgA: immunoglobulin A; tTG: antitransglutaminase; DGP: deamidated gliadin peptide; TNF: tumor necrosis factor; ↓ Decrease; ↑ Increase.