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
- PubMed: 29881616
- DOI: 10.1177/2050640617736478
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
| Supplement | Health Outcome | Effect Type | Effect Size |
|---|---|---|---|
| Lactobacillus paracasei | Increased SCFA Butyrate Levels | Beneficial | Moderate |
| Lactobacillus paracasei | Increased Short-Chain Fatty Acids (Acetate) | Beneficial | Moderate |
| Lactobacillus paracasei | No Improvement in IBS Symptoms | Neutral | Small |
| Lactobacillus paracasei | Reduced Pro-Inflammatory Cytokine Interleukin-15 Levels | Beneficial | Moderate |
| Lactobacillus paracasei | Reduced Ruminococcus Genus Levels | Beneficial | Moderate |
| Lactobacillus paracasei 431 | Increased Short Chain Fatty Acids (SCFAs) Levels | Beneficial | Moderate |
| Lactobacillus paracasei 431 | Reduced Pro-Inflammatory Cytokine Interleukin-15 Levels | Beneficial | Moderate |
| Lactobacillus paracasei 431 | Reduced Ruminococcus Abundance | Beneficial | Moderate |
| Lactobacillus paracasei DSM 13434 | Increased SCFA Butyrate Levels | Beneficial | Moderate |
| Lactobacillus paracasei DSM 13434 | Increased Short-Chain Fatty Acids (Acetate) | Beneficial | Moderate |
| Lactobacillus paracasei DSM 13434 | Reduced Pro-Inflammatory Cytokine Interleukin-15 Levels | Beneficial | Moderate |
| Lactobacillus paracasei DSM 13434 | Reduced Ruminococcus Genus Levels | Beneficial | Moderate |
| Lactobacillus paracasei HA-196 | Increased Short Chain Fatty Acids | Beneficial | Moderate |
| Lactobacillus paracasei HA-196 | No Improvement in IBS Symptoms | Neutral | Small |
| Lactobacillus paracasei HA-196 | Reduced Pro-Inflammatory Cytokine Interleukin-15 Levels | Beneficial | Moderate |
| Lactobacillus paracasei HA-196 | Reduced Ruminococcus Genus Levels | Beneficial | Moderate |
| Lactobacillus paracasei IMC 502 | Reduced Pro-Inflammatory Cytokine Interleukin-15 Levels | Beneficial | Moderate |
| Lactobacillus paracasei IMC 502 | Reduced Ruminococcus Genus Levels | Beneficial | Moderate |
| Lactobacillus paracasei LPC09 | Reduced Pro-inflammatory Cytokine Levels (Interleukin-15) | Beneficial | Moderate |
| Lactobacillus paracasei LPC09 | Reduced Ruminococcus Genus Levels | Beneficial | Moderate |
| Lactobacillus paracasei MCC1849 | Reduced Pro-Inflammatory Cytokine Interleukin-15 Levels | Beneficial | Moderate |
| Lactobacillus paracasei MCC1849 | Reduced Ruminococcus Genus Levels | Beneficial | Moderate |
| Lactobacillus paracasei UALpc-04 | No Improvement in IBS Symptoms | Neutral | Small |
| Lactobacillus paracasei UALpc-04 | Reduced Pro-Inflammatory Cytokine Interleukin-15 Levels | Beneficial | Moderate |
| Lactobacillus paracasei UALpc-04 | Reduced Ruminococcus Genus Levels | Beneficial | Moderate |
| Lactobacillus paracasei VPro 224 | No Improvement in IBS Symptoms | Neutral | Small |
| Lactobacillus paracasei VPro 224 | Reduced Interleukin-15 Levels | Beneficial | Moderate |
| Lactobacillus paracasei VPro 224 | Reduced Ruminococcus Abundance | Beneficial | Moderate |