Bednarska Olga, Biskou Olga, Israelsen Hans, Winberg Martin E, Walter Susanna, Keita Åsa V
Department of Gastroenterology, Linköping University Hospital, Linköping, Sweden.
Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
Front Nutr. 2022 Dec 8;9:1004084. doi: 10.3389/fnut.2022.1004084. eCollection 2022.
Impaired intestinal permeability and microbial dysbiosis are important pathophysiological mechanisms underlying irritable bowel syndrome (IBS). ReFerm, also called Profermin, is a postbiotic product of oat gruel fermented with 299v. In this study, we investigated whether ReFerm has a beneficial effect on the intestinal epithelial barrier function in patients with IBS.
Thirty patients with moderate to severe IBS-diarrhoea (IBS-D) or IBS-mixed (IBS-M) were treated with enema containing ReFerm or placebo. The patients underwent sigmoidoscopy with biopsies obtained from the distal colon at baseline and after 14 days of treatment with ReFerm or placebo twice daily. The biopsies were mounted in Ussing chambers, and paracellular and transcellular permeabilities were measured for 120 min. In addition, the effects of ReFerm or placebo on the epithelial barrier were investigated using Caco-2 cells.
ReFerm reduced paracellular permeability ( < 0.05) and increased transepithelial resistance (TER) over time ( < 0.01), whereas the placebo had no significant effect in patients. In ReFerm-treated Caco-2 cells, paracellular and transcellular permeabilities were decreased compared to the control ( < 0.05) and placebo ( < 0.01). TER was increased in Caco-2 ReFerm-treated cells, and normalised TER was increased in ReFerm-treated Caco-2 cells compared to control ( < 0.05) and placebo-treated ( < 0.05) cells.
ReFerm significantly reduced paracellular permeability and improved TER in colonic biopsies collected from patients with IBS and in a Caco-2 cell model. Our results offer new insights into the potential benefits of ReFerm in IBS management. Further studies are needed to identify the molecular mechanisms underlying the barrier-protective properties of ReFerm.
[https://clinicaltrials.gov/], identifier [NCT05475314].
肠道通透性受损和微生物群落失调是肠易激综合征（IBS）重要的病理生理机制。ReFerm，也称为Profermin，是用299v发酵燕麦粥产生的后生元产品。在本研究中，我们调查了ReFerm对IBS患者肠道上皮屏障功能是否具有有益作用。
30例中度至重度腹泻型IBS（IBS-D）或混合型IBS（IBS-M）患者接受含ReFerm或安慰剂的灌肠治疗。患者在基线时以及每天两次使用ReFerm或安慰剂治疗14天后接受乙状结肠镜检查，并从远端结肠获取活检组织。将活检组织置于尤斯灌流小室中，测量120分钟的细胞旁和跨细胞通透性。此外，使用Caco-2细胞研究ReFerm或安慰剂对上皮屏障的影响。
随着时间推移，ReFerm降低了细胞旁通透性（P<0.05）并增加了跨上皮电阻（TER）（P<0.01）；而安慰剂对患者无显著影响。在接受ReFerm治疗的Caco-2细胞中，与对照组（P<0.05）和安慰剂组（P<0.01）相比，细胞旁和跨细胞通透性均降低。接受ReFerm治疗的Caco-2细胞中TER增加，与对照组（P<0.05）和接受安慰剂治疗的细胞（P<0.05）相比，接受ReFerm治疗的Caco-2细胞中TER恢复正常。
ReFerm显著降低了IBS患者结肠活检组织以及Caco-2细胞模型中的细胞旁通透性并改善了TER。我们的结果为ReFerm在IBS管理中的潜在益处提供了新见解。需要进一步研究以确定ReFerm屏障保护特性的分子机制。
[https://clinicaltrials.gov/]，标识符 [NCT05475314]
