AUTHOR=Boonma Prapaporn , Shapiro Jordan M. , Hollister Emily B. , Badu Shyam , Wu Qinglong , Weidler Erica M. , Abraham Bincy P. , Devaraj Sridevi , Luna Ruth Ann , Versalovic James , Heitkemper Margaret M. , Savidge Tor C. , Shulman Robert J. 

TITLE=Probiotic VSL#3 Treatment Reduces Colonic Permeability and Abdominal Pain Symptoms in Patients With Irritable Bowel Syndrome

JOURNAL=Frontiers in Pain Research

VOLUME=2

YEAR=2021

URL=https://www.frontiersin.org/journals/pain-research/articles/10.3389/fpain.2021.691689

DOI=10.3389/fpain.2021.691689

ISSN=2673-561X

ABSTRACT=<p><bold>Background:</bold> Little is known regarding the clinical impact of treatment and treatment duration of probiotic VSL#3 on gut and microbiome function in irritable bowel syndrome (IBS). As part of a safety trial, we assessed the effect of VSL#3 treatment duration on abdominal pain, stooling, gut permeability, microbiome composition and function.</p><p><bold>Methods:</bold> Adults with IBS were randomized into an open label trial to receive the probiotic VSL#3 for 4 or 8 weeks. Adverse events, abdominal pain, and stooling patterns were recorded daily. Gut permeability, fecal bile acid levels, and microbiome composition were profiled at baseline and after treatment.</p><p><bold>Results:</bold> Fifteen subjects completed the trial (4-week: <italic>n</italic> = 8; 8-week: <italic>n</italic> = 7). Number of pain episodes decreased in both groups (<italic>P</italic> = 0.049 and <italic>P</italic> = 0.034; 4- vs. 8-week, respectively). Probiotic organisms contained in VSL#3 were detected in feces by whole shotgun metagenomic sequencing analysis and relative abundances of <italic>Streptococcus thermophilus, Bifidobacterium animalis, Lactobacillus plantarum</italic>, and <italic>Lactobacillus casei</italic> subsp. <italic>paraccasei</italic> correlated significantly with improved abdominal pain symptoms and colonic permeability at study completion. Although abdominal pain correlated significantly with the detection of probiotic species at study completion, a composite view of gut microbiome structure showed no changes in community diversity or composition after VSL#3 treatment.</p><p><bold>Conclusions:</bold> Probiotic organisms identified in stool correlated significantly with improvement in colonic permeability and clinical symptoms, prompting future studies to investigate the mechanistic role of VSL#3 and colonic permeability in IBS pathophysiology in a larger randomized controlled trial.</p><p><bold>Clinical Trial Registration:</bold><ext-link ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov" xmlns:xlink="http://www.w3.org/1999/xlink">www.clinicaltrials.gov</ext-link>, Identifier: NCT00971711.</p>