SYSTEMATIC REVIEW article
Front. Microbiol.
Sec. Microorganisms in Vertebrate Digestive Systems
Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1577898
This article is part of the Research TopicBifidobacteria: Exploring the Roles of These Microbiome Guardians and Their Effects on Human HealthView all 18 articles
Bifidobacterium compound preparations as a supplementary treatment for severe ischemic stroke: a systematic review and meta-analysis
Provisionally accepted
- 1The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
- 2Hunan University of Chinese Medicine, Changsha, Anhui Province, China
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Background: The benefits and risks of Bifidobacterium compound preparations (BCP) for patients with severe ischemic stroke (SIS) remain unclear. This study aimed to evaluate the efficacy and safety of BCP combined with enteral nutrition (EN) for SIS. Methods: Eight databases were systematically searched for relevant literature up to January 1, 2025. Two researchers independently screened the records, extracted data, and assessed the risk of bias using the Cochrane Risk of Bias Tool 1.0 (RoB 1.0). Meta-analysis, sensitivity analyses, subgroup analyses, and publication bias assessments were conducted with RevMan 5.4 software. Results: Nine randomized controlled trials and 777 patients were included in the analysis. Meta-analysis showed that regarding nutritional status, compared with the EN group, the BCP combination group significantly increased albumin (mean difference [MD]=4.55, 95% confidence interval [CI], 3.66 to 5.45, P<0.00001), total protein (MD=7.40, 95% CI 3.64 to 11.17, P=0.0001), prealbumin (MD=46.29, 95% CI 39.60 to 52.97, P<0.00001), hemoglobin (MD=10.26, 95% CI 8.09 to 12.43, P<0.00001), and transferrin (MD=0.67, 95% CI 0.32 to 1.03, P=0.0002). Regarding neurological function, the BCP combination group significantly increased the Glasgow Coma Scale score (MD=1.86, 95% CI 1.17 to 2.56, P<0.00001) and decreased the National Institutes of Health Stroke Scale score (MD=-2.17, 95% CI -3.35 to -0.99, P=0.0003). Regarding intestinal barrier function, the BCP combination group significantly reduced diamine oxidase (MD=-0.69, 95% CI -0.87 to -0.50, P<0.00001) and D-lactate (MD=-0.09, 95% CI -0.11 to -0.08, P<0.00001). Regarding immune function, the BCP combination group significantly increased IgA (MD=0.50, 95% CI 0.36 to 0.63, P<0.00001) and IgG (MD=3.00, 95% CI 2.03 to 3.97, P<0.00001). Safety analysis revealed that the BCP combination group significantly reduced the incidence of total adverse events (risk ratio [RR]=0.28, 95% CI 0.13 to 0.62, P=0.002), pulmonary infections (RR=0.51, 95% CI 0.33 to 0.79, P=0.003), reflux (RR=0.21, 95% CI 0.05 to 0.92, P=0.04), and diarrhea (RR=0.28, 95% CI 0.12 to 0.67, P=0.005). Conclusion: BCP combined with EN can improve nutritional status, neurological function, intestinal barrier function, and immune function and reduce adverse events for patients with SIS. This approach represents a potential adjuvant treatment strategy for SIS.
Keywords: Probiotics, Bifidobacterium compound preparations, Bifidobacterium triple viable preparations, Bifidobacterium quadruple viable preparations, severe ischemic stroke, Meta-analysis
Received: 17 Feb 2025; Accepted: 22 Sep 2025.
Copyright: © 2025 Lu, Yu, Liu, Zhang, Liu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shenghua Lu, 20222022@stu.hnucm.edu.cn
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