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Page 6 of 18 Stuivenberg et al. Microbiome Res Rep 2025;4:11 https://dx.doi.org/10.20517/mrr.2024.22

Effects of probiotic supplementation on inflammatory biomarkers ● Streptococcus ● Stage III and IV CKD patients
and uremic toxins in non-dialysis chronic kidney patients: a thermophilus ● Daily probiotics for 3 months
double-blind, randomized, placebo-controlled trial ● Lactobacillus acidophilus ● Increased IL-6 levels
● Bifidobacterium longum
Randomized controlled trial of strain-specific probiotic ● Lactobacillus, ● Patients undergoing maintenance hemodialysis
formulation (Renadyl) in dialysis patients Streptococcus ● Two 2-month treatment periods with washout
● Bifidobacterium species ● No significant efficacy confirmed due to the
small sample size
Effect of short-term synbiotic treatment on plasma p-cresol levels ● Not specified ● Patients with CKD stages 3-4
in patients with chronic renal failure: a randomized clinical trial (synbiotic formulation) ● Synbiotic or placebo for 4 weeks
● Synbiotic lowered plasma p-cresol but did not
affect gastrointestinal symptoms
An innovative synbiotic formulation decreases free serum indoxyl ● Lactobacillus plantarum ● CKD stage IIIb-IV patients
sulfate, small intestine permeability and ameliorates ● Lactobacillus acidophilus ● Synbiotics administered for 2 months
gastrointestinal symptoms in a randomized pilot trial in stage IIIb- ● Bifidobacterium longum ● Reduced serum indoxyl sulfate and intestinal
IV CKD patients ● Bifidobacterium lactis permeability
● Streptococcus ● Improved gastrointestinal symptoms
thermophilus
Effects of probiotics, prebiotics, and synbiotics on uremic toxins, ● Various strains ● Systematic review and meta-analysis of 23 RCTs
inflammation, and oxidative stress in hemodialysis patients: a (review/meta-analysis on probiotics, prebiotics, and synbiotics in
systematic review and meta-analysis of randomized controlled of RCTs) hemodialysis patients
trials ● Decreased PCS, endotoxins, and inflammatory
markers
● Improved antioxidant capacity
A randomized double-blind placebo-controlled trial of probiotics ● Lactobacillus acidophilus ● 52 post-surgical colorectal cancer patients
in post-surgical colorectal cancer BCMC 12,130 ● Randomized to receive placebo or probiotics for
● Lactobacillus lactis 6 months
BCMC 12,451 ● Reduced pro-inflammatory cytokines (TNF-α, IL-
● Lactobacillus casei 6, IL-10, IL-12, IL-17A, IL-17C, IL-22) in the
BCMC 12,313 probiotic group
● Bifidobacterium longum ● No significant effect on IFN-γ
BCMC 02120
● Bifidobacterium bifidum
BCMC 02290
● Bifidobacterium infantis
BCMC 02129
Vitamin D and probiotic co-supplementation affects mental ● Lactobacillus acidophilus ● 60 women with polycystic ovary syndrome
health, hormonal, inflammatory and oxidative stress parameters ● Bifidobacterium bifidum ● Randomized to receive Vitamin D + probiotics or
in women with polycystic ovary syndrome ● Lactobacillus reuteri placebo for 12 weeks
● Lactobacillus fermentum ● Significant improvements in mental health (BDI,
GHQ, DASS)
● Reduction in total testosterone, hirsutism, hs-
CRP, MDA
● Improvement in TAC and GSH levels in the
treatment group
Lp299v: Lactobacillus plantarum 299v; LcS: Lactobacillus casei Shirota; CKD: chronic kidney disease; PCS: p-cresyl sulfate; IS: indoxyl sulfate;
TMAO: trimethylamine n-oxide; RCTs: randomized controlled trials; BCMC: registered probiotic trademark name from B-Crobes Laboratories
Sdn. Bhd., Malaysia; BDI: beck depression inventory; GHQ-28: general health questionnaire-28; DASS: depression anxiety and stress scale; CRP:
C-reactive protein; MDA: malondialdehyde; TAC: antioxidant capacity; GSH: glutathione.

health, such as TMAO, taurine, and sphingolipids [3,25] . Ultimately, these microbial and functional alterations
may contribute to the development and progression of atherosclerosis through various mechanisms [3,25,26] ,
which are described in greater detail throughout this perspective. Considering that one method of action of
probiotics is to increase the relative abundance of certain beneficial microbes to shift the microbiome
toward a composition more similar to that of healthy control , it is not surprising that probiotics are being
[27]
considered therapeutic for atherosclerosis.

Strains of lactobacilli and bifidobacteria are common in probiotic formulations and tend to be the first
bacteria investigated for new microbial therapies, including those for atherosclerosis. Treatment with oral
Lactobacillus acidophilus NCFM or L. acidophilus BG2F04 decreased dimethylamines, potential precursors
for trimethylamine production . There is also evidence that some lactobacilli can directly mitigate the
[28]