Roos Stefan, Dahlgren Atti-La, Mao Yu-Kang, Pallin Anton, Stanisz Andrew M, Forsythe Paul, Kunze Wolfgang, Hellström Per M
Department of Molecular Sciences, Uppsala BioCenter, Swedish University of Agricultural Sciences, Uppsala, Sweden.
BioGaia AB, Stockholm, Sweden.
Neurogastroenterol Motil. 2025 May;37(5):e70012. doi: 10.1111/nmo.70012. Epub 2025 Mar 3.
Chronic constipation is a prevalent, burdensome gastrointestinal disorder whose etiology and pathophysiology remain poorly understood. Differences in the composition of the intestinal microbiota have been shown between constipated patients and healthy people. Data indicate that these microbial differences contribute to the disorder.
Preclinical studies in mice examined the effects of Lactobacillus gasseri on intestinal motility ex vivo, the reversal of motility inhibition by μ-opioid receptor agonists ex vivo and in vivo in mice, and the effects on capsaicin-stimulated transient receptor potential vanilloid 1 (TRPV1) in Jurkat cells. Thereafter, a clinical study of 40 women with functional constipation was conducted to investigate the effects of Lactobacillus gasseri with a randomized parallel design. After 14 days of baseline recording, treatment with Lactobacillus gasseri or placebo was given over 28 days, with 14 days of follow-up. Outcomes with complete spontaneous bowel movements (CSBM), spontaneous bowel movements, emptying frequency, abdominal pain, time spent for defecation, Bristol stool form scale, use of rescue laxatives, and impact on sex life were investigated.
In preclinical studies, Lactobacillus gasseri increased intestinal motility in an ex vivo model, reversed the motility inhibition caused by μ-opioid receptor agonist ex vivo and in vivo in mice, and counteracted capsaicin-stimulated activity of TRPV1 in Jurkat cells. In the clinical trial, Lactobacillus gasseri showed a significant reduction in abdominal pain, along with a correlation and tendency for an increased number of CSBM. Few adverse events were encountered.
Treatment with Lactobacillus gasseri can alleviate pain sensations in functional constipation, possibly with an improved bowel-emptying function.
慢性便秘是一种常见且负担沉重的胃肠道疾病，其病因和病理生理学仍知之甚少。便秘患者与健康人群的肠道微生物群组成存在差异。数据表明，这些微生物差异与该疾病有关。
在小鼠身上进行的临床前研究，检测了加氏乳杆菌对离体肠道运动的影响、μ-阿片受体激动剂在离体和体内对小鼠运动抑制的逆转作用，以及对Jurkat细胞中辣椒素刺激的瞬时受体电位香草酸亚型1（TRPV1）的影响。此后，采用随机平行设计对40名功能性便秘女性进行了一项临床研究，以调查加氏乳杆菌的效果。在进行14天的基线记录后，给予加氏乳杆菌或安慰剂治疗28天，并进行14天的随访。研究了完全自主排便（CSBM）、自主排便、排空频率、腹痛、排便时间、布里斯托大便分类法、急救泻药的使用情况以及对性生活的影响等结果。
在临床前研究中，加氏乳杆菌在离体模型中增加了肠道运动，在离体和体内逆转了μ-阿片受体激动剂对小鼠造成的运动抑制，并抵消了Jurkat细胞中辣椒素刺激的TRPV1活性。在临床试验中，加氏乳杆菌显著减轻了腹痛，同时CSBM数量有增加的相关性和趋势。不良事件很少。
加氏乳杆菌治疗可缓解功能性便秘中的疼痛感，可能还能改善排便功能。
