Journal Article Randomized Controlled Trial Epublish 1 citation
PubMed: 39599626 DOI: 10.3390/nu16223840
Alteration of the Gut-Lung Axis After Severe COVID-19 Infection and Modulation Through Probiotics: A Randomized, Controlled Pilot Study.
Nutrients 16(22)
Authors: Angela Horvath, Hansjörg Habisch, Barbara Prietl, Verena Pfeifer, Irina Balazs, Gabor Kovacs, Vasile Foris, Nikolaus John, Daniela Kleinschek, Nicole Feldbacher, Henning Grønbæk, Holger Jon Møller, Kristina Žukauskaitė, Tobias Madl, Vanessa Stadlbauer
Affiliations
- Center for Biomarker Research in Medicine (CBmed), Division of Translational Precision Medicine, Division of Precision Medicine Technologies, 8010 Graz, Austria.
- Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria.
- Otto Loewi Research Center, Medicinal Chemistry, Medical University of Graz, 8010 Graz, Austria.
- BioTechMed-Graz, 8010 Graz, Austria.
- Division of Endocrinology and Diabetes, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria.
- Division of Pulmonology, Department of Internal Medicine, Medical University of Graz, 8010 Graz, Austria.
- Ludwig Boltzmann Institute for Lung Vascular Research, 8010 Graz, Austria.
- Departments of Hepatology and Gastroenterology, Aarhus University Hospital, 8200 Aarhus, Denmark.
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark.
- Department of Clinical Biochemistry, Aarhus University Hospital, 8200 Aarhus, Denmark.
- Institute of Biosciences, Life Sciences Center, Vilnius University, 01513 Vilnius, Lithuania.
Abstract
BACKGROUND
The gut-lung axis could be a potential therapeutic target for improving post-acute COVID-19 symptoms, and probiotics have been proposed as possible modulators.
AIM
We conducted a pilot study to understand alterations in the gut-lung axis and to explore the effects of a probiotic in post-acute COVID-19 disease.
METHODS
We included patients after severe COVID-19 disease (sCOV, n = 21) in a randomized, placebo-controlled trial to test the effect of a probiotic (Pro-Vi 5, Institute Allergosan, Graz, Austria) in a six-month intervention and used patients after mild disease (mCOV, n = 10) as controls, to compare the intestinal microbiome, metabolome, and patient-reported outcomes and biomarkers along the gut-lung axis at baseline and throughout probiotic intervention.
RESULTS
Compared to mCOV patients, sCOV patients showed lower microbial richness, which was significantly improved by probiotic intervention. A reorganization of Ruminococcaceae and Lachnospiraceae taxa was observed in sCOV patients but remained unaffected by the intervention. Serum metabolome showed a dysregulation of lipoproteins in accordance with higher BMI and comorbidities in sCOV patients. HDL and LDL fractions/components were temporarily decreased in the probiotic group. Stool metabolome was altered at baseline in sCOV patients and an increase in L-DOPA after 3 months and butyrate after 6 months of intervention could be observed. Probiotics partially improved reduced quality of life and modulated altered immune responses in sCOV patients. Increased intestinal permeability at baseline remained unaffected.
CONCLUSION
The study provides evidence of long-term alterations of the gut-lung axis after severe COVID-19 infection and suggests that probiotics can modulate the biomarkers of the gut-lung axis.
MeSH
Pilot Projects, Quality Of Life, Pilots, Lung, Biomarkers, Food, Covid-19, Probiotics, Gastrointestinal Microbiome, Infections