Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Study.
Evaluation of an Immunomodulatory Probiotic Intervention for Veterans With Co-occurring Mild Traumatic Brain Injury and Posttraumatic Stress Disorder: A Pilot Study.
复制标题
DOI：
10.3389/fneur.2020.01015
复制
发表时间：
2020
影响因子：
3.4
通讯作者：
Lowry CA
中科院分区：
文献类型：
--
作者：
Brenner LA;Forster JE;Stearns-Yoder KA;Stamper CE;Hoisington AJ;Brostow DP;Mealer M;Wortzel HS;Postolache TT;Lowry CA
背景资料：从持久自由行动/伊拉克自由行动/新黎明行动（OEF/OIF/OND）返回的美国退伍军人具有与轻度创伤性脑损伤相关的症状[mTBI;即，持续性脑震荡（PPC）症状]和创伤后应激障碍（PTSD）。旨在解决与身体和心理压力源相关的症状的干预措施（例如，PPC和PTSD症状）。本研究旨在评估益生菌干预的可行性、可接受性和安全性，以及开始评估潜在生物学结果的过程。方法：在最近伊拉克和阿富汗冲突中的美国退伍军人中进行了一项初步随机对照试验。这些参与者具有临床显著的PPC和PTSD症状。参与者以1：1的比例随机接受干预（罗伊氏乳杆菌DSM 17938）或安慰剂补充（每天8周+/- 2周），并按肠易激综合征状态分层。31名退伍军人入组并随机分组（15名接受安慰剂治疗，16名接受益生菌治疗）。结果：符合可行性、可接受性和安全性的要求。与安慰剂组相比，益生菌补充导致血浆C反应蛋白（CRP）浓度降低，接近统计学显著性（p = 0.056）。尽管在特里尔社会压力测试中（TSST;补充后给药）在压力反应的主观测量上没有发现组间差异（视觉模拟量表），与益生菌组相比，安慰剂组在基线和数学任务之间每分钟平均心跳的增加显著更大（估计的平均变化，益生菌组为5.3 [95%置信区间：-0.55，11.0]，安慰剂组为16.9 [11.0，22.7]，p = 0.006）。结论：这项试验的结果支持了补充抗炎/免疫调节益生菌L。reuteri DSM 17938，在有PPC和PTSD症状的退伍军人中。此外，结果表明，CRP可能是一个可行的炎症标志物的利益。一个更大的随机对照试验，旨在衡量生物学和临床结局。临床试验注册：ClinicalTrials.gov，标识符NCT 02723344。
Background: US military Veterans returned from Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) with symptoms associated with mild traumatic brain injury [mTBI; i.e., persistent post-concussive (PPC) symptoms] and posttraumatic stress disorder (PTSD). Interventions aimed at addressing symptoms associated with both physical and psychological stressors (e.g., PPC and PTSD symptoms) are needed. This study was conducted to assess the feasibility, acceptability, and safety of a probiotic intervention, as well as to begin the process of evaluating potential biological outcomes. Methods: A pilot randomized controlled trial was implemented among US military Veterans from recent conflicts in Iraq and Afghanistan. Those enrolled had clinically significant PPC and PTSD symptoms. Participants were randomized to intervention (Lactobacillus reuteri DSM 17938) or placebo supplementation (daily for 8 weeks +/- 2 weeks) at a 1:1 ratio, stratified by irritable bowel syndrome status. Thirty-one Veterans were enrolled and randomized (15 to the placebo condition and 16 to the probiotic condition). Results: Thresholds for feasibility, acceptability, and safety were met. Probiotic supplementation resulted in a decrease in plasma C-reactive protein (CRP) concentrations relative to the placebo group that approached statistical significance (p = 0.056). Although during the Trier Social Stress Test (TSST; administered post-supplementation) no between-group differences were found on a subjective measure of stress responsivity (Visual Analog Scale), there was a significantly larger increase in mean heart beats per minute between baseline and the math task for the placebo group as compared with the probiotic group (estimated mean change, probiotic 5.3 [95% Confidence Interval: −0.55, 11.0], placebo 16.9 [11.0, 22.7], p = 0.006). Conclusions: Findings from this trial support the feasibility, acceptability, and safety of supplementation with an anti-inflammatory/immunoregulatory probiotic, L. reuteri DSM 17938, among Veterans with PPC and PTSD symptoms. Moreover, results suggest that CRP may be a viable inflammatory marker of interest. A larger randomized controlled trial aimed at measuring both biological and clinical outcomes is indicated. Clinical Trial Registration: ClinicalTrials.gov, Identifier NCT02723344.
登录
查看更多内容
DOI：
10.1038/ismej.2012.8
发表时间：
2012-08
期刊：
The ISME journal
影响因子：
--
作者：
通讯作者：
--
影响因子：
48
作者：
Callahan BJ;McMurdie PJ;Rosen MJ;Han AW;Johnson AJ;Holmes SP
通讯作者：
Holmes SP
影响因子：
3.7
作者：
Hellhammer, Juliane;Schubert, Melanie
通讯作者：
Schubert, Melanie
影响因子：
25.8
作者：
Eraly, Satish A.;Nievergelt, Caroline M.;Maihofer, Adam X.;Barkauskas, Donald A.;Biswas, Nilima;Agorastos, Agorastos;O'Connor, Daniel T.;Baker, Dewleen G.
通讯作者：
Baker, Dewleen G.
影响因子：
3.6
作者：
Atkinson, Mark J;Sinha, Anusha;Rowland, Clayton R
通讯作者：
Rowland, Clayton R