Oral administration of Lactobacillus casei DG® after ileostomy closure in restorative proctocolectomy: a randomized placebo-controlled trial (microbiota and immune microenvironment in pouchitis -MEP1).
- 2024-11
- Gut microbes 16(1)
- Imerio Angriman
- Melania Scarpa
- Edoardo Savarino
- Ilaria Patuzzi
- Alessandra Rigo
- Andromachi Kotsafti
- Astghik Stepanyan
- Elisa Sciuto
- Francesco Celotto
- Silvia Negro
- Silvia Negro
- Antonino Caruso
- Cesare Ruffolo
- Romeo Bardini
- Salvatore Pucciarelli
- Brigida Barberio
- Gaya Spolverato
- Fabiana Zingone
- Renata D'Incà
- Ignazio Castagliuolo
- Marco Scarpa
- PubMed: 39485259
- DOI: 10.1080/19490976.2024.2423037
Study Design
- Type
- Randomized Controlled Trial (RCT)
- Population
- 52 patients undergoing restorative proctocolectomy
- Methods
- single-center, randomized, double-blinded, placebo-controlled trial; daily oral supplementation of L. casei DG® or placebo for 8 weeks from ileostomy closure
- Blinding
- Double-blind
- Duration
- 8 weeks
Pouchitis is an idiopathic inflammatory disease that may occur in ileal pouches, and it can lead to ileal pouch failure. This was a single-center, randomized, double-blinded, placebo-controlled trial that assessed the effect of Lactobacillus casei (L. casei) DG®, a probiotic strain, on the ileal pouch mucosa to determine the crosstalk between microbiota and mucosal immune system. Fifty-two patients undergoing restorative proctocolectomy were recruited and randomly assigned to receive a daily oral supplementation of L. casei DG® (n = 26) or placebo (n = 26) for 8 weeks from the ileostomy closure (T0) to a pouch endoscopy after 8 weeks (T1) and 1 year (T2). Ileal pouch mucosa samples were collected at T0, T1, and T2. At T1, the L. casei DG®-supplemented group showed a significant reduction of inflammatory cytokines levels compared to T0 baseline levels in the pouch mucosa, whereas in the placebo group cytokines levels resulted stable. In conclusion, probiotic manipulation of mucosal microbiota by L. casei DG®-supplementation after stoma closure in patients who underwent restorative proctocolectomy has a beneficial impact on the ileal pouch microenvironment. Registration number: NCT03136419 (http://www.clinicaltrials.gov).