The preventive and therapeutic effects of probiotics on mastitis: A systematic review and meta-analysis

Qinghong Yu; Chuchu Xu; Mengqian Wang; Jiayan Zhu; Linghong Yu; Zimei Yang; Shan Liu; Xiufei Gao

doi:10.1371/journal.pone.0274467

Peer Review History

Original SubmissionDecember 7, 2021
11 Jun 2022 Decision Letter - Simone Perna, Editor PONE-D-21-38695The preventive and therapeutic effects of probiotics on mastitis: A Systematic Review and Meta-AnalysisPLOS ONE Dear Dr. Gao, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Jul 26 2022 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Partly ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: No ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: No ******** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: The preventive and therapeutic effects of probiotics on mastitis: A Systematic Review and Meta-Analysis Qinghong Yu · Chuchu Xu · Mengqian Wang · Jiayan Zhu · Linghong Yu · Zimei, Yang, Shan Liu and Xiufei Gao* Yu et al, in this study, meta-analyzed data to identify effects of probiotics on the prevention and treatment of human mastitis. The data of participants of randomized control treatment studies included healthy pregnant and lactating woman taking probiotics systematically by oral route during pregnancy and lactation. Meta-analysis of six data showed that oral doses of prebiotics significantly reduced the incidence of mastitis and tendency of reduction of breast pain rate. Of these, two studies showed highly significant reduction in milk somatic cell count in two studies of healthy woman and five studies of mastitis patients. Increased number of milk somatic cell count is a definite maker of mastitis. It was concluded that, to a certain extent, probiotic intake appears to reduce incidence of mastitis and mastitis-related symptoms in pregnant and lactating woman. Though, this study explored 807 records, only six studies qualified for inclusion in this review. Due to lack of sufficient data, role of probiotics in reducing mastitis and mastitis associated symptoms are speculative. Though, authors have acknowledged the limitations of study and suggest high-quality multicenter trails to support their results. Major issues 1. Line 45: A total of six studies included in the meta-analysis. However, later it is mentioned that two studies of healthy people and five studies of mastitis patients, a total of seven studies are discussed. Please explain this discrepancy or make it the statement clearer. 2. Line 46: “……during pregnancy can reduce the incidence of mastitis (RR: 0.49, 95%CI: 0.35 to 0.69; p<0.0001) and breast pain rate (RR: 0.81, 95 %CI: 0.64 to 1.01; p=0.07)”. This statement explains reduction (P < 0.05) in breast pain rate, which is in fact a tendency of reduction in the pain rate (P = 0.07). Please explain or make the necessary changes. Minor issues • Please be consistent with using word “Figure” or “Fig.” See the guidelines of PlosOne. Reviewer #2: The manuscript has included just 6 studies which are not enough to draw a conclusion under the review The presentation of manuscript is not according to journals instructions/format The abstract is not in proper format The Materials and methods and conclusion parts need to be improved ******** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Ratan K. Choudhary Reviewer #2: No ******** [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: PONE-D-21-38695_reviewers comment.pdf https://doi.org/10.1371/journal.pone.0274467.r001
Revision 1
9 Jul 2022 Author Response Dear editors and reviewers: Thank you for your letter and comments on our manuscript titled “The preventive and therapeutic effects of probiotics on mastitis: A Systematic Review and Meta-Analysis” (PONE-D-21-38695). These comments helped us improve our manuscript, and provided important guidance for future research. We have addressed the editor’s and the reviewers’ comments to the best of our abilities, and revised text to meet the PLOS ONE style requirements. We hope this meets your requirements for a publication. Since our original manuscript has been professionally polished, there may be some differences in wording from my previous manuscripts, but we did not change the original intention. Relevant revisions made in response to reviewer comments, we marked the revised portions in red and highlighted them yellow in manuscript. The main comments and our specific response are detailed below: Reviewer 1: 1. Line 45: A total of six studies included in the meta-analysis. However, later it is mentioned that two studies of healthy people and five studies of mastitis patients, a total of seven studies are discussed. Please explain this discrepancy or make it the statement clearer. Response：I am sorry that this part was not clear in the original manuscript, I should explain that during the review process, we included a total of 6 studies, 2 of which included double data of healthy people and patients with mastitis, and the data discussed at the end were all from these 6 studies. My language did not express clearly, the expression has been removed in the revised manuscript. 2. Line 46: “……during pregnancy can reduce the incidence of mastitis (RR: 0.49, 95%CI: 0.35 to 0.69; p<0.0001) and breast pain rate (RR: 0.81, 95 %CI: 0.64 to 1.01; p=0.07)”. This statement explains reduction (P < 0.05) in breast pain rate, which is in fact a tendency of reduction in the pain rate (P = 0.07). Please explain or make the necessary changes. Response: Thanks for your suggestion, I have revised the abstract accordingly. 3. Please be consistent with using word “Figure” or “Fig.” See the guidelines of PlosOne. Response: Thanks for your suggestion, I have made the corresponding changes according to the guidlines of PLOS ONE. Reviewer 2: 1.The manuscript has included just 6 studies which are not enough to draw a conclusion under the review. Response: Thank you for your suggestion. Due to the widespread abuse of antibiotics and the prudent choice of medication during pregnancy/lactation, our team believes that it is meaningful to evaluate the intervention effect of probiotics at this time. There are really not many relevant studies at present, and we have acknowledged this in the limitation of manuscript. However, since the relevant experiments in the registration have not been published, our research team is also conducting relevant experiments recently. We hope to supplement this evidence when follow-up related research results are available. 2. The presentation of manuscript is not according to journals instructions/format. The abstract is not in proper format. Response: Thanks for your suggestion. I have already revised the format of our manuscript. 3. The Materials and methods and conclusion parts need to be improved. Response: Thanks for your suggestion. Since we did not know the specific modification goals, we consulted Liu S, a statistician, again. And made corresponding changes in the materials and methods and conclusion parts, we hope that this revision will be better than before. Editors: Thanks for your suggestion, we have uploaded and all the figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool and passed the certification. So, we re-uploaded our figure file with no changes to the data. We would be glad to respond to any further questions and comments that you may have. Sincerely yours, Xiufei Gao Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0274467.r002
30 Aug 2022 Decision Letter - Simone Perna, Editor The preventive and therapeutic effects of probiotics on mastitis: A Systematic Review and Meta-Analysis PONE-D-21-38695R1 Dear Dr. Gao, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Simone Perna, Ph.D Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Ratan K Choudhary ******** https://doi.org/10.1371/journal.pone.0274467.r003
Formally Accepted
31 Aug 2022 Acceptance Letter - Simone Perna, Editor PONE-D-21-38695R1 The preventive and therapeutic effects of probiotics on mastitis: A Systematic Review and Meta-Analysis Dear Dr. Gao: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Professor Simone Perna Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0274467.r004

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