Probiotic treatment induced change of inflammation related metabolites in IBS-D patients/double-blind, randomized, placebo-controlled trial

Abstract

There have been many studies suggesting that probiotics are effective in patients with diarrhea-predominant irritable bowel syndrome (IBS-D). However, its mechanism of action as well as prediction of response is still to be elucidated. In the present study, to find out metabolomic characteristics of probiotic effect in IBS-D, we compared IBS symptom changes and metabolomic characteristics in the subjects' urine samples between multi-strain probiotics (one strain of Lactobacillus sp. and four strains of Bifidobacterium sp.) group (n = 32) and placebo group (n = 31). After 8 weeks' administration (3 times/day), dissatisfaction in bowel habits and stool frequencies were significantly improved. Also, probiotics group had significantly changed seven metabolites including palmitic acid methyl ester (PAME) and 4,6-dihydroxyquinoline, 4-(2-aminophenyl)-2,4-dioxobutanoic acid (DOBA). According to IBS-SSS and IBS-QoL questionnaires, IBS-SSS responders showed higher PAME levels and IBS-QoL responders showed lower DOBA levels. This suggests potential role of these metabolites as a biomarker to predict probiotics effect in IBS-D patients.

Keywords: Irritable bowel syndrome; Metabolomics; Probiotics.

Conflict of interest statement

Conflict of interestThe authors have no financial conflicts of interest to declare.

© The Korean Society of Food Science and Technology 2019.

Figures

Fig. 1

A flow diagram illustrating the study design

Fig. 2

Comparison of (A) IBS-SSS and (B) IBS-QoL scores between placebo and probiotics groups

Fig. 3

Correlation analysis of metabolites and IBS-SSS or IBS-QoL in the probiotics treatment group. Palmitic acid methyl ester and IBS-SSS in responders (A) and in non-responders (B). 4-(2-Aminophenyl)-2,4-dioxobutanoic acid and IBS-QoL in responders (C) and in non-responders (D) excluding outliers. Black line: linear trend; blue line: 95% confidence band; red line: 95% prediction band