Validation of Probiotics as a Microbiome-Targeted Intervention for Polycystic ovary syndrome (PCOS)

Overview

Probiotics supplementation targets the microbial imbalances and inflammation mechanisms underlying Polycystic Ovary Syndrome (PCOS). The use of probiotics, such as Lactobacillus species, has been shown to modulate the gut microbiome by improving gut barrier integrity and reducing inflammatory cytokines like TNF-α and IL-6. This intervention provides beneficial effects on metabolic parameters, including improved insulin sensitivity and reduced testosterone levels in PCOS patients.^[1] These effects reinforce the validity of the microbiome signature associated with PCOS, further supporting the accuracy of using probiotics as a microbiome-targeted intervention (MBTI) for this condition. The intervention thus plays a dual role by addressing microbial dysbiosis and managing associated metabolic and inflammatory disruptions, thereby validating its role in modulating both microbial and host factors.

Validation of Probiotic Supplementation as an MBTI

Probiotics, defined as live microorganisms that confer health benefits to the host, operate through several molecular mechanisms. Probiotic administration has been linked to improved metabolic profiles by reducing fasting plasma glucose (FPG), serum insulin levels, and insulin resistance (HOMA-IR), which are critical biomarkers in PCOS.^[2][3] Specific probiotics like Lactobacillus acidophilus and Bifidobacterium bifidum help modulate gut microbiota by promoting beneficial bacteria such as Faecalibacterium prausnitzii and Bifidobacterium while decreasing pro-inflammatory microbes like Bacteroides and Escherichia.^[4] This modulation leads to the reduction of endotoxins like Lipopolysaccharide (LPS), which are associated with inflammation, insulin resistance, and obesity. Preclinical and clinical studies have demonstrated the efficacy of probiotics in reducing testosterone levels and improving Sex Hormone Binding Globulin (SHBG) levels, which are commonly disrupted in PCOS patients.

Microbial Effects Summary Table

Validation of the Microbiome Signature of PCOS

PCOS is associated with dysbiosis, where a decrease in beneficial microbiota like Faecalibacterium prausnitzii, Bifidobacterium, and Lactobacillus is observed. On the other hand, an overgrowth of pro-inflammatory bacteria such as Bacteroides and Escherichia is seen, which contributes to insulin resistance and obesity, hallmark features of PCOS. Probiotic supplementation directly targets these microbial shifts, particularly by promoting the growth of beneficial bacteria and reducing the abundance of harmful microbes.^[5][6] This action aligns with the microbiome signature of PCOS, reinforcing the role of gut microbiota in the pathophysiology of the syndrome​.

Dual Validation

The observed microbial shifts following probiotic supplementation and the associated clinical improvements in metabolic and inflammatory parameters strongly validate both the intervention as a microbiome-targeted therapy (MBTI) and the microbiome signature of PCOS. Probiotics not only restore microbial diversity but also correct the dysbiotic changes that are characteristic of PCOS, such as the depletion of beneficial species and the overgrowth of inflammatory taxa.^[7] These findings demonstrate the potential of microbiome-targeted interventions to modify both microbial populations and host physiological outcomes, supporting their clinical application in PCOS treatment

References

1. Effects of Probiotic Supplementation on Pancreatic β-cell Function and C-reactive Protein in Women with Polycystic Ovary Syndrome: A Randomized Double-blind Placebo-controlled Clinical Trial. Shoaei T, Heidari-Beni M, Tehrani HG, Feizi A, Esmaillzadeh A, Askari G.. (Int J Prev Med. 2015 Mar 24;6:27)
2. A New Approach to Polycystic Ovary Syndrome: The Gut Microbiota. Yurtdaş Depboylu, Gamze & Akdevelioğlu, Yasemin. (2019). (Journal of the American College of Nutrition. 39. 1-12)
3. Effects of Probiotic Supplementation on Pancreatic β-cell Function and C-reactive Protein in Women with Polycystic Ovary Syndrome: A Randomized Double-blind Placebo-controlled Clinical Trial. Shoaei T, Heidari-Beni M, Tehrani HG, Feizi A, Esmaillzadeh A, Askari G.. (Int J Prev Med. 2015 Mar 24;6:27)
4. A New Approach to Polycystic Ovary Syndrome: The Gut Microbiota. Yurtdaş Depboylu, Gamze & Akdevelioğlu, Yasemin. (2019). (Journal of the American College of Nutrition. 39. 1-12)
5. Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics. Singh S, Pal N, Shubham S, Sarma DK, Verma V, Marotta F, Kumar M.. (J Clin Med. 2023 Feb 11;12(4):1454)
6. A New Approach to Polycystic Ovary Syndrome: The Gut Microbiota. Yurtdaş Depboylu, Gamze & Akdevelioğlu, Yasemin. (2019). (Journal of the American College of Nutrition. 39. 1-12)
7. Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics. Singh S, Pal N, Shubham S, Sarma DK, Verma V, Marotta F, Kumar M.. (J Clin Med. 2023 Feb 11;12(4):1454)