Inner Mongolia Key Laboratory of Dairy Biotechnology and Engineering, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China; Key Laboratory of Dairy Products Processing, Ministry of Agriculture and Rural Affairs, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China; Key Laboratory of Dairy Biotechnology and Engineering, Ministry of Education, Inner Mongolia Agricultural University, Hohhot, Inner Mongolia, China.
Jiangzhong Pharmaceutical Co., Ltd., No.1899 Meiling Road, Nanchang 330103, China.
Pharmacol Res. 2023 May;191:106755. doi: 10.1016/j.phrs.2023.106755. Epub 2023 Apr 3.
Chronic constipation (CC) is a common gastrointestinal condition associated with intestinal inflammation, and the condition considerably impairs patients' quality of life. We conducted a large-scale 42-day randomized, double-blind, placebo-controlled trial to investigate the effect of probiotics in alleviating CC. 163 patients diagnosed with CC (following Rome IV criteria) were randomly divided into probiotic (n = 78; received Lactiplantibacillus plantarum P9 [P9]; 1 ×10 CFU/day) and placebo (n = 85; received placebo material) groups. Ingesting P9 significantly improved the weekly mean frequency of complete spontaneous bowel movements (CSBMs) and spontaneous bowel movements (SBMs), while significantly reducing the level of worries and concerns (WO; P < 0.05). Comparing with the placebo group, P9 group was significantly enriched in potentially beneficial bacteria (Lactiplantibacillus plantarum and Ruminococcus_B gnavus), while depriving of several bacterial and phage taxa (Oscillospiraceae sp., Lachnospiraceae sp., and Herelleviridae; P < 0.05). Interesting significant correlations were also observed between some clinical parameters and subjects' gut microbiome, including: negative correlation between Oscillospiraceae sp. and SBMs; positive correlation between WO and Oscillospiraceae sp., Lachnospiraceae sp. Additionally, P9 group had significantly (P < 0.05) more predicted gut microbial bioactive potential involved in the metabolism of amino acids (L-asparagine, L-pipecolinic acid), short-/medium-chain fatty acids (valeric acid and caprylic acid). Furthermore, several metabolites (p-cresol, methylamine, trimethylamine) related to the intestinal barrier and transit decreased significantly after P9 administration (P < 0.05). In short, the constipation relief effect of P9 intervention was accompanied by desirable changes in the fecal metagenome and metabolome. Our findings support the notion of applying probiotics in managing CC.
慢性便秘（CC）是一种常见的胃肠道疾病，与肠道炎症有关，会极大地影响患者的生活质量。我们进行了一项大规模的 42 天随机、双盲、安慰剂对照试验，以研究益生菌在缓解 CC 方面的作用。163 名符合罗马 IV 标准的 CC 患者被随机分为益生菌（n=78；接受植物乳杆菌 P9[P9]；1×10 CFU/天）和安慰剂（n=85；接受安慰剂材料）组。摄入 P9 显著改善了每周平均完全自发性排便（CSBMs）和自发性排便（SBMs）的频率，同时显著降低了担忧程度（WO；P<0.05）。与安慰剂组相比，P9 组中潜在有益细菌（植物乳杆菌和 Ruminococcus_B gnavus）明显富集，而几种细菌和噬菌体分类群（Oscillospiraceae sp.、Lachnospiraceae sp. 和 Herelleviridae；P<0.05）则减少。还观察到一些临床参数和受试者肠道微生物组之间存在有趣的显著相关性，包括：Oscillospiraceae sp.与 SBMs 呈负相关；WO 与 Oscillospiraceae sp.、Lachnospiraceae sp. 呈正相关。此外，P9 组中参与氨基酸（L-天冬酰胺、L-哌啶酸）代谢的预测肠道微生物生物活性潜力显著增加（P<0.05）。此外，几种与肠道屏障和转运相关的代谢物（对甲酚、甲胺、三甲胺）在 P9 给药后显著降低（P<0.05）。简而言之，P9 干预的便秘缓解效果伴随着粪便宏基因组和代谢组的理想变化。我们的研究结果支持应用益生菌来管理 CC 的观点。
