The Effects of Probiotic/Synbiotic on Serum Level of Zonulin As a Biomarker of Intestinal Permeability: A Systematic Review and Meta-Analysis Publisher



Ramezani Ahmadi A¹ ; Sadeghian M¹ ; Alipour M² ; Ahmadi Taheri S³ ; Rahmani S³ ; Abbasnezhad A⁴ Show Affiliations
Source: Iranian Journal of Public Health Published:2020

Abstract

Background: This systematic review and meta-analysis was conducted to obtain a conclusive result on the influence of probiotics/synbiotic on serum levels of zonulin. Data related to serum levels of zonulin were extract-ed to determine the effects of probiotic/synbiotic on intestinal permeability. Methods: The literature search was conducted across the Cochrane Central Register of Controlled Trials, Pub-Med, Scopus and ISI Web of Science, Search up to Nov 2018. Clinical trials evaluating the effect of probi-otic/synbiotic on serum zonulin levels of all human subjects were included. Results: Nine studies (including 496 intervention and 443 control subjects) met the inclusion criteria for the meta-analysis. According to the meta-analysis, probiotic/synbiotic has a significant effect on serum zonulin re-duction (WMD=-10.55 [95% CI:-17.76,-3.34]; P=0.004). However, the high level of heterogeneity was ob-served among the studies (I2=97.8, P<0.001). The subgroup analysis suggested study quality, blinding, study duration, Participants age, subject's health status and supplement type as sources of heterogeneity. Conclusion: Probiotic/synbiotic have favorable effects on serum levels of zonulin as a measure of intestinal permeability. However, the results should be interpreted with caution due to the high heterogeneity and further evidence is required before definitive recommendations can be made. © 2020, Iranian Journal of Public Health. All rights reserved.