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Effect of Lactobacillus paracasei CNCM I-1572 on symptoms, gut microbiota, short chain fatty acids, and immune activation in patients with irritable bowel syndrome: A pilot randomized clinical trial

  • 2018-05
  • United European Gastroenterology Journal 6(4)
    • C. Cremon
    • S. Guglielmetti
    • G. Gargari
    • Valentina Taverniti
    • A. Castellazzi
    • C. Valsecchi
    • C. Tagliacarne
    • W. Fiore
    • M. Bellini
    • L. Bertani
    • D. Gambaccini
    • M. Cicala
    • B. Germanà
    • M. Vecchi
    • I. Pagano
    • M. Barbaro
    • L. Bellacosa
    • V. Stanghellini
    • G. Barbara

Abstract

Background: Evidence suggests a role of intestinal microbiota-host interactions in the pathophysiology and symptoms of irritable bowel syndrome (IBS).

Objective: The objective of this article is to assess the effects of Lactobacillus paracasei CNCM I-1572 on clinical and gut microbiota-related factors in IBS.

Methods: We conducted a multicenter, randomized, double-blind, cross-over, 18-week, placebo-controlled, pilot trial assessing the effect of Lactobacillus paracasei CNCM I-1572 on symptoms, gut microbiota composition, fecal short chain fatty acid (SCFA), immunoglobulin A, and cytokines in IBS. The intestinal microbial ecosystem was characterized by 16S rRNA gene profiling.

Results: Forty IBS patients were enrolled from five Italian centers. Lactobacillus paracasei CNCM I-1572 did not significantly improve IBS symptoms, including primary efficacy variables worst abdominal pain/discomfort and IBS degree of relief. Interestingly, Lactobacillus paracasei CNCM I-1572 induced a significant reduction in genus Ruminococcus, dominated by taxa related to Ruminococcus bromii and Ruminococcus callidus, a significant increase in the SCFAs acetate and butyrate, and a significant reduction in the pro-inflammatory cytokine interleukin-15.

Conclusions: This pilot study shows that Lactobacillus paracasei CNCM I-1572 is able to modulate gut microbiota structure/function and reduce immune activation in IBS. As no statistically significant effect on IBS-symptoms was found, further studies are necessary to determine the role of this probiotic in IBS. The study was registered at ClinicalTrials.gov registry under identifier NCT02371499.

Keywords: Irritable bowel syndrome; dietary compounds; microbiota; probiotics.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lactobacillus paracaseiIncreased SCFA Butyrate LevelsBeneficial
Moderate
Lactobacillus paracaseiIncreased Short-Chain Fatty Acids (Acetate)Beneficial
Moderate
Lactobacillus paracaseiNo Improvement in IBS SymptomsNeutral
Small
Lactobacillus paracaseiReduced Pro-Inflammatory Cytokine Interleukin-15 LevelsBeneficial
Moderate
Lactobacillus paracaseiReduced Ruminococcus Genus LevelsBeneficial
Moderate
Lactobacillus paracasei 431Increased Short Chain Fatty Acids (SCFAs) LevelsBeneficial
Moderate
Lactobacillus paracasei 431Reduced Pro-Inflammatory Cytokine Interleukin-15 LevelsBeneficial
Moderate
Lactobacillus paracasei 431Reduced Ruminococcus AbundanceBeneficial
Moderate
Lactobacillus paracasei DSM 13434Increased SCFA Butyrate LevelsBeneficial
Moderate
Lactobacillus paracasei DSM 13434Increased Short-Chain Fatty Acids (Acetate)Beneficial
Moderate
Lactobacillus paracasei DSM 13434Reduced Pro-Inflammatory Cytokine Interleukin-15 LevelsBeneficial
Moderate
Lactobacillus paracasei DSM 13434Reduced Ruminococcus Genus LevelsBeneficial
Moderate
Lactobacillus paracasei HA-196Increased Short Chain Fatty AcidsBeneficial
Moderate
Lactobacillus paracasei HA-196No Improvement in IBS SymptomsNeutral
Small
Lactobacillus paracasei HA-196Reduced Pro-Inflammatory Cytokine Interleukin-15 LevelsBeneficial
Moderate
Lactobacillus paracasei HA-196Reduced Ruminococcus Genus LevelsBeneficial
Moderate
Lactobacillus paracasei IMC 502Reduced Pro-Inflammatory Cytokine Interleukin-15 LevelsBeneficial
Moderate
Lactobacillus paracasei IMC 502Reduced Ruminococcus Genus LevelsBeneficial
Moderate
Lactobacillus paracasei LPC09Reduced Pro-inflammatory Cytokine Levels (Interleukin-15)Beneficial
Moderate
Lactobacillus paracasei LPC09Reduced Ruminococcus Genus LevelsBeneficial
Moderate
Lactobacillus paracasei MCC1849Reduced Pro-Inflammatory Cytokine Interleukin-15 LevelsBeneficial
Moderate
Lactobacillus paracasei MCC1849Reduced Ruminococcus Genus LevelsBeneficial
Moderate
Lactobacillus paracasei UALpc-04No Improvement in IBS SymptomsNeutral
Small
Lactobacillus paracasei UALpc-04Reduced Pro-Inflammatory Cytokine Interleukin-15 LevelsBeneficial
Moderate
Lactobacillus paracasei UALpc-04Reduced Ruminococcus Genus LevelsBeneficial
Moderate
Lactobacillus paracasei VPro 224No Improvement in IBS SymptomsNeutral
Small
Lactobacillus paracasei VPro 224Reduced Interleukin-15 LevelsBeneficial
Moderate
Lactobacillus paracasei VPro 224Reduced Ruminococcus AbundanceBeneficial
Moderate
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