Probiotic Supplementation Improves Glucose Homeostasis and Modulates Interleukin (IL)-21 and IL-22 Levels in Pediatric Patients with Type 1 Diabetes: A Randomized Placebo-Controlled Trial
<b>Background:</b> Probiotics alter gut microbiota and have beneficial effects on immune homeostasis. The role of probiotics in diabetes has been shown in some studies. Interleukin (IL)-21 and IL-22 have been implicated in the pathogenesis of type 1 diabetes mellitus (T1DM). Objectives:...
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2025-04-01
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| author | Amira Abdel Moneam Adly Eman Abdel Rahman Ismail Mahasen Mohamed Abd-Elgawad Nouran Yousef Salah |
| author_facet | Amira Abdel Moneam Adly Eman Abdel Rahman Ismail Mahasen Mohamed Abd-Elgawad Nouran Yousef Salah |
| author_sort | Amira Abdel Moneam Adly |
| collection | DOAJ |
| description | <b>Background:</b> Probiotics alter gut microbiota and have beneficial effects on immune homeostasis. The role of probiotics in diabetes has been shown in some studies. Interleukin (IL)-21 and IL-22 have been implicated in the pathogenesis of type 1 diabetes mellitus (T1DM). Objectives: This study aimed to assess the effect of oral supplementation with probiotics on glycemic control and IL-21 and IL-22 levels in pediatric patients with T1DM. <b>Methods:</b> This randomized controlled trial was registered in ClinicalTrials (NCT04579341) and included 70 children and adolescents with T1DM. They were randomly assigned into two groups to receive either an oral probiotic tablet containing 0.5 mg <i>Lactobacillus acidophilus</i> once daily or a matching placebo. Both groups were followed up for 6 months with assessment of fasting blood glucose (FBG), lipids, hemoglobin A1c (HbA1c), and IL-21 and IL-22 levels. <b>Results:</b> Baseline clinical characteristics and laboratory parameters were similar between both groups (<i>p</i> > 0.05). After six months, probiotic supplementation for the intervention group resulted in significant decreases in FBG, HbA1c, total cholesterol, and IL-21 levels, while IL-22 was increased compared with baseline levels (<i>p</i> < 0.001) and compared with the placebo group (<i>p</i> < 0.001). No adverse reactions were reported. Baseline IL-21 was positively correlated to FBG, HbA1c, and total cholesterol while there were negative correlations between these variables and IL-22 levels. <b>Conclusions:</b> Probiotic supplementation improved glucose homeostasis and glycemic control, possibly through their immunomodulatory effects on cytokines IL-21 and IL-22. Thus, probiotics could be a safe adjuvant therapy to intensive insulin in pediatric patients with T1DM. |
| format | Article |
| id | doaj-art-f4cdc8a7e16e4b118353b32953fa64a5 |
| institution | Kabale University |
| issn | 2218-1989 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Metabolites |
| spelling | doaj-art-f4cdc8a7e16e4b118353b32953fa64a52025-08-20T03:47:57ZengMDPI AGMetabolites2218-19892025-04-0115528810.3390/metabo15050288Probiotic Supplementation Improves Glucose Homeostasis and Modulates Interleukin (IL)-21 and IL-22 Levels in Pediatric Patients with Type 1 Diabetes: A Randomized Placebo-Controlled TrialAmira Abdel Moneam Adly0Eman Abdel Rahman Ismail1Mahasen Mohamed Abd-Elgawad2Nouran Yousef Salah3Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo 11591, EgyptDepartment of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo 11591, EgyptGeneral Practitioner, Ministry of Health, Cairo 11591, EgyptDepartment of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo 11591, Egypt<b>Background:</b> Probiotics alter gut microbiota and have beneficial effects on immune homeostasis. The role of probiotics in diabetes has been shown in some studies. Interleukin (IL)-21 and IL-22 have been implicated in the pathogenesis of type 1 diabetes mellitus (T1DM). Objectives: This study aimed to assess the effect of oral supplementation with probiotics on glycemic control and IL-21 and IL-22 levels in pediatric patients with T1DM. <b>Methods:</b> This randomized controlled trial was registered in ClinicalTrials (NCT04579341) and included 70 children and adolescents with T1DM. They were randomly assigned into two groups to receive either an oral probiotic tablet containing 0.5 mg <i>Lactobacillus acidophilus</i> once daily or a matching placebo. Both groups were followed up for 6 months with assessment of fasting blood glucose (FBG), lipids, hemoglobin A1c (HbA1c), and IL-21 and IL-22 levels. <b>Results:</b> Baseline clinical characteristics and laboratory parameters were similar between both groups (<i>p</i> > 0.05). After six months, probiotic supplementation for the intervention group resulted in significant decreases in FBG, HbA1c, total cholesterol, and IL-21 levels, while IL-22 was increased compared with baseline levels (<i>p</i> < 0.001) and compared with the placebo group (<i>p</i> < 0.001). No adverse reactions were reported. Baseline IL-21 was positively correlated to FBG, HbA1c, and total cholesterol while there were negative correlations between these variables and IL-22 levels. <b>Conclusions:</b> Probiotic supplementation improved glucose homeostasis and glycemic control, possibly through their immunomodulatory effects on cytokines IL-21 and IL-22. Thus, probiotics could be a safe adjuvant therapy to intensive insulin in pediatric patients with T1DM.https://www.mdpi.com/2218-1989/15/5/288probioticstype 1 diabetesglucose homeostasisinterleukin-21interleukin-22 |
| spellingShingle | Amira Abdel Moneam Adly Eman Abdel Rahman Ismail Mahasen Mohamed Abd-Elgawad Nouran Yousef Salah Probiotic Supplementation Improves Glucose Homeostasis and Modulates Interleukin (IL)-21 and IL-22 Levels in Pediatric Patients with Type 1 Diabetes: A Randomized Placebo-Controlled Trial Metabolites probiotics type 1 diabetes glucose homeostasis interleukin-21 interleukin-22 |
| title | Probiotic Supplementation Improves Glucose Homeostasis and Modulates Interleukin (IL)-21 and IL-22 Levels in Pediatric Patients with Type 1 Diabetes: A Randomized Placebo-Controlled Trial |
| title_full | Probiotic Supplementation Improves Glucose Homeostasis and Modulates Interleukin (IL)-21 and IL-22 Levels in Pediatric Patients with Type 1 Diabetes: A Randomized Placebo-Controlled Trial |
| title_fullStr | Probiotic Supplementation Improves Glucose Homeostasis and Modulates Interleukin (IL)-21 and IL-22 Levels in Pediatric Patients with Type 1 Diabetes: A Randomized Placebo-Controlled Trial |
| title_full_unstemmed | Probiotic Supplementation Improves Glucose Homeostasis and Modulates Interleukin (IL)-21 and IL-22 Levels in Pediatric Patients with Type 1 Diabetes: A Randomized Placebo-Controlled Trial |
| title_short | Probiotic Supplementation Improves Glucose Homeostasis and Modulates Interleukin (IL)-21 and IL-22 Levels in Pediatric Patients with Type 1 Diabetes: A Randomized Placebo-Controlled Trial |
| title_sort | probiotic supplementation improves glucose homeostasis and modulates interleukin il 21 and il 22 levels in pediatric patients with type 1 diabetes a randomized placebo controlled trial |
| topic | probiotics type 1 diabetes glucose homeostasis interleukin-21 interleukin-22 |
| url | https://www.mdpi.com/2218-1989/15/5/288 |
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