Division of Food Microbiology and Bioprocesses, Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, Milan, Italy.
Dipartimento di Scienze Mediche e Chirurgiche, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Gut Microbes. 2024 Jan-Dec;16(1):2298246. doi: 10.1080/19490976.2023.2298246. Epub 2024 Jan 4.
Probiotics are exploited for adjuvant treatment in IBS, but reliable guidance for selecting the appropriate probiotic to adopt for different forms of IBS is lacking. We aimed to identify markers for recognizing non-constipated (NC) IBS patients that may show significant clinical improvements upon treatment with the probiotic strain DG (LDG). To this purpose, we performed a post-hoc analysis of samples collected during a multicenter, double-blind, parallel-group, placebo-controlled trial in which NC-IBS patients were randomized to receive at least 24 billion CFU LDG or placebo capsules . for 12 weeks. The primary clinical endpoint was the composite response based on improved abdominal pain and fecal type. The fecal microbiome and serum markers of intestinal (PV1 and zonulin), liver, and kidney functions were investigated. We found that responders (R) in the probiotic arm (25%) differed from non-responders (NR) based on the abundance of 18 bacterial taxa, including the families , spp. and , which were overrepresented in R patients. These taxa also distinguished R (but not NR) patients from healthy controls. Probiotic intervention significantly reduced the abundance of these bacteria in R, but not in NR. Analogous results emerged for from the analysis of data from a previous trial on IBS with the same probiotic. Finally, was positively correlated with the plasmalemmal vesicle associated protein-1 (PV-1) and the markers of liver function. In conclusion, LDG is effective on NC-IBS patients with NC-IBS with a greater abundance of potential pathobionts. Among these, has emerged as a potential predictor of probiotic efficacy.
益生菌被用于 IBS 的辅助治疗,但缺乏针对不同类型 IBS 选择合适益生菌的可靠指导。我们旨在确定识别非便秘型(NC)IBS 患者的标志物,这些患者在接受益生菌菌株 DG(LDG)治疗后可能会有显著的临床改善。为此,我们对一项多中心、双盲、平行组、安慰剂对照试验中收集的样本进行了事后分析,该试验中,NC-IBS 患者被随机分配接受至少 240 亿 CFU LDG 或安慰剂胶囊治疗 12 周。主要临床终点是基于腹痛和粪便类型改善的综合反应。我们调查了粪便微生物组和肠道(PV1 和 zonulin)、肝脏和肾脏功能的血清标志物。我们发现,益生菌组的应答者(R)(25%)与非应答者(NR)在 18 种细菌分类群的丰度上存在差异,包括科、属和属,这些分类群在 R 患者中更为丰富。这些分类群还将 R 患者(但不是 NR 患者)与健康对照区分开来。益生菌干预显著降低了 R 患者中这些细菌的丰度,但对 NR 患者没有影响。对来自使用相同益生菌的 IBS 先前试验的数据的分析也得出了类似的结果。最后,与质膜小泡相关蛋白-1(PV-1)和肝功能标志物呈正相关。总之,LDG 对 NC-IBS 患者有效,这些患者的潜在病原菌丰度更高。其中,已成为益生菌疗效的潜在预测因子。
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