Li Erfeng, Wang Jie, Guo Bin, Zhang Wenbin
Department: Endoscopy Center, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, Shanxi Province, China.
Front Cell Infect Microbiol. 2025 Jun 12;15:1616066. doi: 10.3389/fcimb.2025.1616066. eCollection 2025.
IBS often appears as bloating, altered bowel patterns, and abdominal pain (AP).Probiotics and SCFA may be useful in mucosal repair and symptom relief, according to earlier research, however there is currently a lack of systematic evidence supporting their therapeutic effectiveness across a variety of IBS subtypes.
To investigate the impacts of probiotics on signs and intestinal barrier function (IBF) in individuals with multiple IBS subtypes, and evaluate the role of SCFA in this process.
A double-blind randomized controlled trial (DBRCT) design was adopted. Using the Rome IV criteria, a total of 120 individuals with IBS were randomised to either the probiotic group (PG) or placebo group (PLG). The intervention lasted for 12 weeks with an additional 4-week follow-up. In addition to fecal SCFA (FSCFA) levels, intestinal permeability (L/M ratio), tight junction proteins (TJP), serum/fecal inflammatory markers, and adverse event occurrence, the primary endpoint (PEP) evaluated was IBS Symptom Severity Scale (IBS-SSS) scores. Subgroup analysis was performed in selected cases.
In terms of symptom scores, there was a major correlation among group and time (F=9.314, P<0.001), and repeated-measures ANOVA showed that the PG's scores were considerably < than those of the control group (CG) beginning in week 8 (all P<0.01). Levels of acetate, propionate, and butyrate considerably increased after 12 weeks of intervention (all P<0.01). Intestinal permeability and Occludin significantly improved at weeks 8 and 12 (all P<0.0167), while important differences in Claudin-1 and Zonulin appeared only at week 12 (all P<0.0167). Inflammatory markers considerably decreased at week 12 (all P<0.0167). There were no statistically significant differences in adherence or adverse events (P>0.05). Reductions in symptom scores were positively connected with an increase in SCFAs (r=0.43, P=0.002). Subgroup analysis across multiple IBS subtypes indicated significant symptom relief at week 12 for all subtypes (all P<0.05).
Probiotics significantly improved clinical symptoms in IBS patients of different subtypes by increasing short-chain fatty acid levels, repairing the intestinal barrier, and reducing inflammation.
肠易激综合征（IBS）常表现为腹胀、排便习惯改变和腹痛（AP）。根据早期研究，益生菌和短链脂肪酸（SCFA）可能有助于黏膜修复和缓解症状，然而目前缺乏系统证据支持它们对各种IBS亚型的治疗效果。
研究益生菌对多种IBS亚型患者体征和肠道屏障功能（IBF）的影响，并评估SCFA在此过程中的作用。
采用双盲随机对照试验（DBRCT）设计。根据罗马IV标准，共120例IBS患者被随机分为益生菌组（PG）或安慰剂组（PLG）。干预持续12周，并额外进行4周随访。除了粪便SCFA（FSCFA）水平、肠道通透性（L/M比值）、紧密连接蛋白（TJP）、血清/粪便炎症标志物以及不良事件发生情况外，评估的主要终点（PEP）是IBS症状严重程度量表（IBS-SSS）评分。对选定病例进行亚组分析。
在症状评分方面，组间和时间存在显著相关性（F = 9.314，P < 0.001），重复测量方差分析显示，从第8周开始，PG组的评分显著低于对照组（CG）（所有P < 0.01）。干预12周后，乙酸盐、丙酸盐和丁酸盐水平显著升高（所有P < 0.01）。在第8周和第12周时，肠道通透性和闭合蛋白显著改善（所有P < 0.0167），而紧密连接蛋白-1和闭合小环蛋白的重要差异仅在第12周出现（所有P < 0.0167）。炎症标志物在第12周时显著降低（所有P < 0.0167）。依从性或不良事件方面无统计学显著差异（P > 0.05）。症状评分的降低与SCFAs的增加呈正相关（r = 0.43，P = 0.002）。对多种IBS亚型的亚组分析表明，所有亚型在第12周时症状均有显著缓解（所有P < 0.05）。
益生菌通过提高短链脂肪酸水平、修复肠道屏障和减轻炎症，显著改善了不同亚型IBS患者的临床症状。
