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

Authors

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

Publication Date

1-1-2021

Journal

Frontiers in Pain Research

DOI

10.3389/fpain.2021.691689

PMID

35295488

PMCID

PMC8915646

PubMedCentral® Posted Date

9-22-2022

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

irritable bowel syndrome, VSL#3, probiotic, permeability, microbiome, bile acids

Abstract

Background: 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.

Methods: 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.

Results: Fifteen subjects completed the trial (4-week: n = 8; 8-week: n = 7). Number of pain episodes decreased in both groups (P = 0.049 and P = 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 Streptococcus thermophilus, Bifidobacterium animalis, Lactobacillus plantarum, and Lactobacillus casei subsp. paraccasei 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.

Conclusions: 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.

Clinical Trial Registration: www.clinicaltrials.gov, Identifier: NCT00971711.