Boonma Prapaporn, Shapiro Jordan M, Hollister Emily B, Badu Shyam, Wu Qinglong, Weidler Erica M, Abraham Bincy P, Devaraj Sridevi, Luna Ruth Ann, Versalovic James, Heitkemper Margaret M, Savidge Tor C, Shulman Robert J
Department of Pathology, Texas Children's Microbiome Center, Texas Children's Hospital, Houston, TX, United States.
Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, United States.
Front Pain Res (Lausanne). 2021 Sep 22;2:691689. doi: 10.3389/fpain.2021.691689. eCollection 2021.
Little is known regarding the clinical impact of treatment and treatment duration of probiotic VSL#3 on gut and microbiome function in irritable bowel syndrome (IBS). As part of a safety trial, we assessed the effect of VSL#3 treatment duration on abdominal pain, stooling, gut permeability, microbiome composition and function. Adults with IBS were randomized into an open label trial to receive the probiotic VSL#3 for 4 or 8 weeks. Adverse events, abdominal pain, and stooling patterns were recorded daily. Gut permeability, fecal bile acid levels, and microbiome composition were profiled at baseline and after treatment. Fifteen subjects completed the trial (4-week: = 8; 8-week: = 7). Number of pain episodes decreased in both groups ( = 0.049 and = 0.034; 4- vs. 8-week, respectively). Probiotic organisms contained in VSL#3 were detected in feces by whole shotgun metagenomic sequencing analysis and relative abundances of , and subsp. correlated significantly with improved abdominal pain symptoms and colonic permeability at study completion. Although abdominal pain correlated significantly with the detection of probiotic species at study completion, a composite view of gut microbiome structure showed no changes in community diversity or composition after VSL#3 treatment. Probiotic organisms identified in stool correlated significantly with improvement in colonic permeability and clinical symptoms, prompting future studies to investigate the mechanistic role of VSL#3 and colonic permeability in IBS pathophysiology in a larger randomized controlled trial. www.clinicaltrials.gov, Identifier: NCT00971711.
关于益生菌VSL#3的治疗及治疗时长对肠易激综合征（IBS）患者肠道及微生物群功能的临床影响，目前所知甚少。作为一项安全性试验的一部分，我们评估了VSL#3的治疗时长对腹痛、排便、肠道通透性、微生物群组成及功能的影响。患有IBS的成年人被随机分为一项开放标签试验，接受益生菌VSL#3治疗4周或8周。每天记录不良事件、腹痛及排便模式。在基线及治疗后对肠道通透性、粪便胆汁酸水平及微生物群组成进行分析。15名受试者完成了试验（4周组：n = 8；8周组：n = 7）。两组的疼痛发作次数均减少（分别为P = 0.049和P = 0.034；4周与8周组相比）。通过全基因组鸟枪法宏基因组测序分析在粪便中检测到VSL#3所含的益生菌，并且在研究结束时，双歧杆菌属、嗜酸乳杆菌及德氏乳杆菌保加利亚亚种的相对丰度与腹痛症状改善及结肠通透性显著相关。尽管在研究结束时腹痛与益生菌种类的检测显著相关，但肠道微生物群结构的综合视图显示VSL#3治疗后群落多样性或组成没有变化。粪便中鉴定出的益生菌与结肠通透性改善及临床症状显著相关，这促使未来开展研究，在更大规模的随机对照试验中探究VSL#3及结肠通透性在IBS病理生理学中的机制作用。www.clinicaltrials.gov，标识符：NCT00971711。
