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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Main Authors: Amira Abdel Moneam Adly, Eman Abdel Rahman Ismail, Mahasen Mohamed Abd-Elgawad, Nouran Yousef Salah
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Metabolites
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Online Access:https://www.mdpi.com/2218-1989/15/5/288
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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.
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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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