{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T01:24:38Z","timestamp":1792027478567,"version":"4.4.0"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T00:00:00Z","timestamp":1781308800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":67,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/501100018764","name":"Semnan University of Medical Sciences and Health Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018764","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pulm Med"],"DOI":"10.1186\/s12890-026-04423-8","type":"journal-article","created":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T01:45:08Z","timestamp":1781315108000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Probiotic supplementation reduces IL-6 and improves clinical outcomes in patients with mild-to-moderate COPD: a randomized placebo-controlled trial"],"prefix":"10.1186","volume":"26","author":[{"given":"Sharareh","family":"Ebrahimi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samaneh","family":"Mohammadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasoul","family":"Baharlou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Memarian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,13]]},"reference":[{"key":"4423_CR1","doi-asserted-by":"crossref","unstructured":"Cronin E, Cushen B. Diagnosis and management of comorbid disease in COPD. Breathe. 2025;21(1).","DOI":"10.1183\/20734735.0099-2024"},{"issue":"2","key":"4423_CR2","doi-asserted-by":"publisher","first-page":"e784","DOI":"10.1002\/iid3.784","volume":"11","author":"R Ma","year":"2023","unstructured":"Ma R, Su H, Jiao K, Liu J. Role of Th17 cells, Treg cells, and Th17\/Treg imbalance in immune homeostasis disorders in patients with chronic obstructive pulmonary disease. Immun Inflamm Dis. 2023;11(2):e784.","journal-title":"Immun Inflamm Dis"},{"issue":"1","key":"4423_CR3","doi-asserted-by":"publisher","first-page":"78","DOI":"10.5114\/ceji.2016.58819","volume":"41","author":"R Baharlou","year":"2016","unstructured":"Baharlou R, Atashzar MR, Vasmehjani AA, Rahimi E, Khoshmirsafa M, Seif F, et al. Reduced levels of T-helper 17-associated cytokines in the serum of patients with breast cancer: indicators for following the course of disease. Cent Eur J Immunol. 2016;41(1):78\u201385.","journal-title":"Cent Eur J Immunol"},{"issue":"2","key":"4423_CR4","first-page":"172","volume":"14","author":"T Poordast","year":"2017","unstructured":"Poordast T, Najib FS, Baharlou R, Bijani A, Alamdarloo SM, Poordast A. Assessment of T helper 17-associated cytokines in third trimester of pregnancy. Iran J Immunol. 2017;14(2):172\u20139.","journal-title":"Iran J Immunol"},{"issue":"7","key":"4423_CR5","doi-asserted-by":"publisher","first-page":"1306","DOI":"10.1080\/02770903.2022.2144353","volume":"60","author":"S Sadrifar","year":"2023","unstructured":"Sadrifar S, Abbasi-Dokht T, Forouzandeh S, Malek F, Baharlou R. The impact of multistrains of probiotics on Th17-related cytokines in patients with asthma: a randomized, double-blind, placebo-controlled trial. J Asthma. 2023;60(7):1306\u201315.","journal-title":"J Asthma"},{"issue":"1","key":"4423_CR6","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1186\/s12890-019-0899-2","volume":"19","author":"W Xu","year":"2019","unstructured":"Xu W, Li R, Sun Y. Increased IFN-\u03b3-producing Th17\/Th1 cells and their association with lung function and current smoking status in patients with chronic obstructive pulmonary disease. BMC Pulm Med. 2019;19(1):137.","journal-title":"BMC Pulm Med"},{"key":"4423_CR7","doi-asserted-by":"publisher","first-page":"427","DOI":"10.32622\/ijrat.71201987","volume":"7","author":"S Vora","year":"2019","unstructured":"Vora S, Shah P. A review on COPD treatment and management strategies. Int J Res Advent Technol. 2019;7:427\u201331.","journal-title":"Int J Res Advent Technol"},{"issue":"3","key":"4423_CR8","doi-asserted-by":"publisher","first-page":"e132836","DOI":"10.1172\/jci.insight.132836","volume":"5","author":"S Ouyang","year":"2020","unstructured":"Ouyang S, Liu C, Xiao J, Chen X, Lui AC, Li X. Targeting IL-17A\/glucocorticoid synergy to CSF3 expression in neutrophilic airway diseases. JCI insight. 2020;5(3):e132836.","journal-title":"JCI insight"},{"issue":"1","key":"4423_CR9","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13223-022-00753-4","volume":"19","author":"S Sadrifar","year":"2023","unstructured":"Sadrifar S, Abbasi-Dokht T, Forouzandeh S, Malek F, Yousefi B, Salek Farrokhi A, et al. Immunomodulatory effects of probiotic supplementation in patients with asthma: a randomized, double-blind, placebo-controlled trial. Allergy Asthma Clin Immunol. 2023;19(1):1.","journal-title":"Allergy Asthma Clin Immunol"},{"issue":"3","key":"4423_CR10","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1159\/000526739","volume":"184","author":"T Abbasi-Dokht","year":"2023","unstructured":"Abbasi-Dokht T, Sadrifar S, Forouzandeh S, Malek F, Hemmati M, Kokhaei P, et al. Multistrain probiotics supplement alleviates asthma symptoms via increasing Treg cells population: A randomized, double-blind, placebo-controlled trial. Int Arch Allergy Immunol. 2023;184(3):291\u2013301.","journal-title":"Int Arch Allergy Immunol"},{"issue":"9","key":"4423_CR11","doi-asserted-by":"publisher","first-page":"20841","DOI":"10.3390\/ijms160920841","volume":"16","author":"E Owaga","year":"2015","unstructured":"Owaga E, Hsieh R-H, Mugendi B, Masuku S, Shih C-K, Chang J-S. Th17 cells as potential probiotic therapeutic targets in inflammatory bowel diseases. Int J Mol Sci. 2015;16(9):20841\u201358.","journal-title":"Int J Mol Sci"},{"key":"4423_CR12","doi-asserted-by":"publisher","first-page":"711788","DOI":"10.3389\/fphar.2021.711788","volume":"12","author":"M Ferro","year":"2021","unstructured":"Ferro M, Charneca S, Dourado E, Guerreiro CS, Fonseca JE. Probiotic supplementation for rheumatoid arthritis: A promising adjuvant therapy in the gut microbiome era. Front Pharmacol. 2021;12:711788.","journal-title":"Front Pharmacol"},{"issue":"10","key":"4423_CR13","doi-asserted-by":"publisher","first-page":"e37309","DOI":"10.1097\/MD.0000000000037309","volume":"103","author":"C Chen","year":"2024","unstructured":"Chen C, Wu L, Wang L, Tang X. Probiotics combined with Budesonide and Ipratropium bromide for chronic obstructive pulmonary disease: A retrospective analysis. Medicine. 2024;103(10):e37309.","journal-title":"Medicine"},{"issue":"45","key":"4423_CR14","doi-asserted-by":"publisher","first-page":"e23045","DOI":"10.1097\/MD.0000000000023045","volume":"99","author":"C Pei","year":"2020","unstructured":"Pei C, Wu Y, Wang X, Wang F, Liu L. Effect of probiotics, prebiotics and synbiotics for chronic bronchitis or chronic obstructive pulmonary disease: a protocol for systematic review and meta-analysis. Medicine. 2020;99(45):e23045.","journal-title":"Medicine"},{"key":"4423_CR15","doi-asserted-by":"crossref","unstructured":"Cornelius T. Clinical guideline highlights for the hospitalist: GOLD COPD update 2024. J Hosp Med. 2024.","DOI":"10.1002\/jhm.13416"},{"issue":"5","key":"4423_CR16","doi-asserted-by":"publisher","first-page":"e113","DOI":"10.4187\/respcare.04061","volume":"60","author":"JM Haynes","year":"2015","unstructured":"Haynes JM, Kaminsky DA. The American Thoracic Society\/European Respiratory Society acceptability criteria for spirometry: asking too much or not enough? Respir Care. 2015;60(5):e113\u20134.","journal-title":"Respir Care"},{"issue":"4","key":"4423_CR17","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1183\/09031936.00025214","volume":"44","author":"N Gupta","year":"2014","unstructured":"Gupta N, Pinto LM, Morogan A, Bourbeau J. The COPD assessment test: a systematic review. Eur Respir J. 2014;44(4):873\u201384.","journal-title":"Eur Respir J"},{"key":"4423_CR18","doi-asserted-by":"crossref","unstructured":"Perez T, Burgel PR, Paillasseur J-L, Caillaud D, Desl\u00e9e G, Chanez P et al. Modified Medical Research Council scale vs Baseline Dyspnea Index to evaluate dyspnea in chronic obstructive pulmonary disease. Int J Chronic Obstr Pulm Dis. 2015:1663\u201372.","DOI":"10.2147\/COPD.S82408"},{"key":"4423_CR19","doi-asserted-by":"crossref","unstructured":"Qi Y, Yan Y, Tang D, Han J, Zhu X, Cui M et al. Inflammatory and immune mechanisms in COPD: current status and therapeutic prospects. J Inflamm Res. 2024:6603\u201318.","DOI":"10.2147\/JIR.S478568"},{"issue":"1","key":"4423_CR20","doi-asserted-by":"publisher","first-page":"e00295","DOI":"10.1128\/jb.00295-22","volume":"205","author":"S Lane","year":"2023","unstructured":"Lane S, Hilliam Y, Bomberger JM. Microbial and immune regulation of the gut-lung axis during viral-bacterial coinfection. J Bacteriol. 2023;205(1):e00295\u201322.","journal-title":"J Bacteriol"},{"key":"4423_CR21","doi-asserted-by":"publisher","first-page":"804919","DOI":"10.3389\/fimmu.2021.804919","volume":"12","author":"JD Lourenco","year":"2021","unstructured":"Lourenco JD, Ito JT, Martins MA. Tiberio IdFLC, Lopes FDTQdS. Th17\/Treg imbalance in chronic obstructive pulmonary disease: clinical and experimental evidence. Front Immunol. 2021;12:804919.","journal-title":"Front Immunol"},{"issue":"1","key":"4423_CR22","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1080\/15412555.2017.1416074","volume":"15","author":"K Gorska","year":"2018","unstructured":"Gorska K, Nejman-Gryz P, Paplinska-Goryca M, Korczynski P, Prochorec-Sobieszek M, Krenke R. Comparative study of IL-33 and IL-6 levels in different respiratory samples in mild-to-moderate asthma and COPD. COPD: J Chronic Obstr Pulmonary Disease. 2018;15(1):36\u201345.","journal-title":"COPD: J Chronic Obstr Pulmonary Disease"},{"issue":"10","key":"4423_CR23","doi-asserted-by":"publisher","first-page":"2456","DOI":"10.3390\/microorganisms11102456","volume":"11","author":"R Shahbazi","year":"2023","unstructured":"Shahbazi R, Yasavoli-Sharahi H, Mallet J-F, Sharifzad F, Alsadi N, Cuenin C, et al. Novel probiotic bacterium Rouxiella badensis subsp. acadiensis (Canan SV-53) modulates gut immunity through epigenetic mechanisms. Microorganisms. 2023;11(10):2456.","journal-title":"Microorganisms"},{"issue":"1","key":"4423_CR24","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s12865-022-00484-6","volume":"23","author":"S Aghamohammad","year":"2022","unstructured":"Aghamohammad S, Sepehr A, Miri ST, Najafi S, Rohani M, Pourshafiea MR. The effects of the probiotic cocktail on modulation of the NF-kB and JAK\/STAT signaling pathways involved in the inflammatory response in bowel disease model. BMC Immunol. 2022;23(1):8.","journal-title":"BMC Immunol"},{"issue":"3","key":"4423_CR25","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1007\/s10068-025-01952-6","volume":"35","author":"R Doke","year":"2026","unstructured":"Doke R, Chande K, Dingare S, Vinchurkar K, Singh S. Demystifying the role of postbiotics in inflammation mediated metabolic disorders: an updated review: R. Doke et al. Food Sci Biotechnol. 2026;35(3):463\u201384.","journal-title":"Food Sci Biotechnol"},{"issue":"9","key":"4423_CR26","doi-asserted-by":"publisher","first-page":"4768","DOI":"10.3390\/ijms23094768","volume":"23","author":"S Kotlyarov","year":"2022","unstructured":"Kotlyarov S. Role of short-chain fatty acids produced by gut microbiota in innate lung immunity and pathogenesis of the heterogeneous course of chronic obstructive pulmonary disease. Int J Mol Sci. 2022;23(9):4768.","journal-title":"Int J Mol Sci"},{"key":"4423_CR27","doi-asserted-by":"crossref","unstructured":"Kakavas S, Kotsiou OS, Perlikos F, Mermiri M, Mavrovounis G, Gourgoulianis K et al. Pulmonary function testing in COPD: looking beyond the curtain of FEV1. NPJ primary care respiratory medicine. 2021;31(1):23.","DOI":"10.1038\/s41533-021-00236-w"},{"key":"4423_CR28","doi-asserted-by":"publisher","first-page":"107780","DOI":"10.1016\/j.rmed.2024.107780","volume":"234","author":"JG Jang","year":"2024","unstructured":"Jang JG, Kim Y, Shin SH, Min KH, Jung KS, Kim Y-i, et al. The role of FEV1\/FVC in the prediction of acute exacerbation of COPD. Respir Med. 2024;234:107780.","journal-title":"Respir Med"},{"issue":"1","key":"4423_CR29","doi-asserted-by":"publisher","first-page":"24","DOI":"10.3109\/01480545.2016.1166250","volume":"40","author":"Y Panahi","year":"2017","unstructured":"Panahi Y, Ghanei M, Vahedi E, Mousavi SH, Imani S, Sahebkar A. Efficacy of probiotic supplementation on quality of life and pulmonary symptoms due to sulfur mustard exposure: a randomized double-blind placebo-controlled trial. Drug Chem Toxicol. 2017;40(1):24\u20139.","journal-title":"Drug Chem Toxicol"},{"key":"4423_CR30","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1016\/j.hrtlng.2025.02.002","volume":"71","author":"M Aghamohammadi","year":"2025","unstructured":"Aghamohammadi M, Ghodrati S, Jalili N, Jafari R, Rafiee E, Kamali K, et al. Effects of the oral probiotic Familact on dyspnea management in COPD patients: A randomized controlled trial. Heart Lung. 2025;71:63\u20138.","journal-title":"Heart Lung"},{"issue":"9","key":"4423_CR31","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.4014\/jmb.2301.01033","volume":"33","author":"EY Lim","year":"2023","unstructured":"Lim EY, Song E-J, Shin HS. Gut microbiome as a possible cause of occurrence and therapeutic target in chronic obstructive pulmonary disease. J Microbiol Biotechnol. 2023;33(9):1111.","journal-title":"J Microbiol Biotechnol"},{"key":"4423_CR32","first-page":"CCRPM","volume":"10","author":"F Someya","year":"2016","unstructured":"Someya F, Nakagawa T, Mugii N. The COPD assessment test as a prognostic marker in interstitial lung disease. Clin Med Insights: Circ Respiratory Pulmonary Med. 2016;10:CCRPM.","journal-title":"Clin Med Insights: Circ Respiratory Pulmonary Med"},{"key":"4423_CR33","doi-asserted-by":"crossref","unstructured":"Moya-\u00c1lvarez V, Quevedo-Mar\u00edn JL, Ji Z, Navarro-Jim\u00e9nez C, Jim\u00e9nez-Garc\u00eda R, L\u00f3pez-de-Andr\u00e9s A et al. Variation in assignment of the COPD patients into a GOLD group according to symptoms severity. Int J Chronic Obstr Pulm Dis. 2020:1987\u201395.","DOI":"10.2147\/COPD.S253445"},{"key":"4423_CR34","doi-asserted-by":"publisher","first-page":"101021","DOI":"10.1016\/j.mam.2021.101021","volume":"85","author":"M Morissette","year":"2022","unstructured":"Morissette M, Godbout K, Cote A, Boulet L-P. Asthma COPD overlap: Insights into cellular and molecular mechanisms. Mol Aspects Med. 2022;85:101021.","journal-title":"Mol Aspects Med"},{"key":"4423_CR35","doi-asserted-by":"publisher","first-page":"1410158","DOI":"10.3389\/fimmu.2024.1410158","volume":"15","author":"Y Huang","year":"2024","unstructured":"Huang Y, Niu Y, Wang X, Li X, He Y, Liu X. Identification of novel biomarkers related to neutrophilic inflammation in COPD. Front Immunol. 2024;15:1410158.","journal-title":"Front Immunol"},{"key":"4423_CR36","doi-asserted-by":"publisher","first-page":"570247","DOI":"10.3389\/fped.2020.570247","volume":"8","author":"K Yang","year":"2020","unstructured":"Yang K, Dong W. Perspectives on probiotics and bronchopulmonary dysplasia. Front Pead. 2020;8:570247.","journal-title":"Front Pead"},{"key":"4423_CR37","doi-asserted-by":"crossref","unstructured":"Hua J-l, Hu W-p, Zuo Y-h, Zhang J. Prevention of acute exacerbation in subjects with moderate-to-very severe COPD by modulating lower respiratory microbiome: protocol of a prospective, multicenter, randomized controlled trial. Int J Chronic Obstr Pulm Dis. 2020:2985\u201390.","DOI":"10.2147\/COPD.S274005"}],"container-title":["BMC Pulmonary Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12890-026-04423-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-026-04423-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12890-026-04423-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T01:18:50Z","timestamp":1787102330000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12890-026-04423-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,13]]},"references-count":37,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4423"],"URL":"https:\/\/doi.org\/10.1186\/s12890-026-04423-8","relation":{},"ISSN":["1471-2466"],"issn-type":[{"value":"1471-2466","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,13]]},"assertion":[{"value":"27 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 June 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The study complied with the guidelines for human studies and was conducted in an accordance with the World Medical Association Declaration of Helsinki. The study protocol was approved by the Ethical Board of the Semnan University of Medical Sciences (IR.SEMUMS.REC.1403.202). Written informed consent to participate in the study and publication of their clinical details was obtained from the patient.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"363"}}