{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:52:00Z","timestamp":1790913120201,"version":"4.1.0"},"reference-count":63,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,22]],"date-time":"2023-02-22T00:00:00Z","timestamp":1677024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sichuan Science and Technology Program","award":["20YYJC3358"],"award-info":[{"award-number":["20YYJC3358"]}]},{"name":"Sichuan Science and Technology Program","award":["82001728"],"award-info":[{"award-number":["82001728"]}]},{"name":"Sichuan Science and Technology Program","award":["81973540"],"award-info":[{"award-number":["81973540"]}]},{"name":"Sichuan Science and Technology Program","award":["82271828"],"award-info":[{"award-number":["82271828"]}]},{"name":"Sichuan Science and Technology Program","award":["ZYGD18015"],"award-info":[{"award-number":["ZYGD18015"]}]},{"name":"Sichuan Science and Technology Program","award":["ZYJC18003"],"award-info":[{"award-number":["ZYJC18003"]}]},{"name":"Sichuan Science and Technology Program","award":["2022SCUH0020"],"award-info":[{"award-number":["2022SCUH0020"]}]},{"name":"National Natural Science Foundation of China","award":["20YYJC3358"],"award-info":[{"award-number":["20YYJC3358"]}]},{"name":"National Natural Science Foundation of China","award":["82001728"],"award-info":[{"award-number":["82001728"]}]},{"name":"National Natural Science Foundation of China","award":["81973540"],"award-info":[{"award-number":["81973540"]}]},{"name":"National Natural Science Foundation of China","award":["82271828"],"award-info":[{"award-number":["82271828"]}]},{"name":"National Natural Science Foundation of China","award":["ZYGD18015"],"award-info":[{"award-number":["ZYGD18015"]}]},{"name":"National Natural Science Foundation of China","award":["ZYJC18003"],"award-info":[{"award-number":["ZYJC18003"]}]},{"name":"National Natural Science Foundation of China","award":["2022SCUH0020"],"award-info":[{"award-number":["2022SCUH0020"]}]},{"name":"1\u00b73\u00b75 project for Outstanding interdisciplinary project of West China Hospital, Sichuan University","award":["20YYJC3358"],"award-info":[{"award-number":["20YYJC3358"]}]},{"name":"1\u00b73\u00b75 project for Outstanding interdisciplinary project of West China Hospital, Sichuan University","award":["82001728"],"award-info":[{"award-number":["82001728"]}]},{"name":"1\u00b73\u00b75 project for Outstanding interdisciplinary project of West China Hospital, Sichuan University","award":["81973540"],"award-info":[{"award-number":["81973540"]}]},{"name":"1\u00b73\u00b75 project for Outstanding interdisciplinary project of West China Hospital, Sichuan University","award":["82271828"],"award-info":[{"award-number":["82271828"]}]},{"name":"1\u00b73\u00b75 project for Outstanding interdisciplinary project of West China Hospital, Sichuan University","award":["ZYGD18015"],"award-info":[{"award-number":["ZYGD18015"]}]},{"name":"1\u00b73\u00b75 project for Outstanding interdisciplinary project of West China Hospital, Sichuan University","award":["ZYJC18003"],"award-info":[{"award-number":["ZYJC18003"]}]},{"name":"1\u00b73\u00b75 project for Outstanding interdisciplinary project of West China Hospital, Sichuan University","award":["2022SCUH0020"],"award-info":[{"award-number":["2022SCUH0020"]}]},{"name":"from zero to one Innovative Research Program of Sichuan University","award":["20YYJC3358"],"award-info":[{"award-number":["20YYJC3358"]}]},{"name":"from zero to one Innovative Research Program of Sichuan University","award":["82001728"],"award-info":[{"award-number":["82001728"]}]},{"name":"from zero to one Innovative Research Program of Sichuan University","award":["81973540"],"award-info":[{"award-number":["81973540"]}]},{"name":"from zero to one Innovative Research Program of Sichuan University","award":["82271828"],"award-info":[{"award-number":["82271828"]}]},{"name":"from zero to one Innovative Research Program of Sichuan University","award":["ZYGD18015"],"award-info":[{"award-number":["ZYGD18015"]}]},{"name":"from zero to one Innovative Research Program of Sichuan University","award":["ZYJC18003"],"award-info":[{"award-number":["ZYJC18003"]}]},{"name":"from zero to one Innovative Research Program of Sichuan University","award":["2022SCUH0020"],"award-info":[{"award-number":["2022SCUH0020"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>In this study, the available data from published randomized, controlled trials (RCTs) of the use of intestinal microecological regulators as adjuvant therapies to relieve the disease activity of rheumatoid arthritis (RA) are systematically compared. An English literature search was performed using PubMed, Embase, Scopus, Web of Science and the Cochrane Central Registry of Controlled Trials and supplemented by hand searching reference lists. Three independent reviewers screened and assessed the quality of the studies. Among the 2355 citations identified, 12 RCTs were included. All data were pooled using a mean difference (MD) with a 95% CI. The disease activity score (DAS) showed a significant improvement following microecological regulators treatment (MD (95% CI) of \u22121.01 (\u22121.81, \u22120.2)). A borderline significant reduction in the health assessment questionnaire (HAQ) scores was observed (MD (95% CI) of \u22120.11 (\u22120.21, \u22120.02)). We also confirmed the known effects of probiotics on inflammatory parameters such as the C-reactive protein (CRP) (MD \u22121.78 (95% CI \u22122.90, \u22120.66)) and L-1\u03b2 (MD \u22127.26 (95% CI \u221213.03, \u22121.50)). No significant impact on visual analogue scale (VAS) of pain and erythrocyte sedimentation rate (ESR) reduction was observed. Intestinal microecological regulators supplementation could decrease RA activity with a significant effect on DAS28, HAQ and inflammatory cytokines. Nevertheless, these findings need further confirmation in large clinical studies with greater consideration of the confounding variables of age, disease duration, and individual medication regimens.<\/jats:p>","DOI":"10.3390\/nu15051102","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T01:31:06Z","timestamp":1677115866000},"page":"1102","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Effects of Microecological Regulators on Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of Randomized, Controlled Trials"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7188-2352","authenticated-orcid":false,"given":"Tong","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Rare Diseases Center, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Institute of Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Rare Diseases Center, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Institute of Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0188-8676","authenticated-orcid":false,"given":"Yinlan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Rare Diseases Center, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Institute of Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiuping","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Rare Diseases Center, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Institute of Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Chengdu First People\u2019s Hospital, Chengdu 610021, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehui","family":"Liao","sequence":"additional","affiliation":[{"name":"Meishan People\u2019s Hospital, Meishan 610020, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Rare Diseases Center, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Institute of Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Rare Diseases Center, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Institute of Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yubin","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Rare Diseases Center, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Institute of Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Rheumatology and Immunology, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Rare Diseases Center, West China Hospital, Sichuan University, Chengdu 610041, China"},{"name":"Institute of Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Chengdu 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102735","DOI":"10.1016\/j.autrev.2020.102735","article-title":"Beyond the joints, the extra-articular manifestations in rheumatoid arthritis","volume":"20","author":"Conforti","year":"2021","journal-title":"Autoimmun. 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