Clinical Response and Changes of Cytokines and Zonulin Levels in Patients with Diarrhoea-Predominant Irritable Bowel Syndrome Treated with Bifidobacterium Longum ES1 for 8 or 12 Weeks: A Preliminary Report

Abstract

Bifidobacterium longum (B. longum) ES1 is a probiotic strain capable of modulating microbiome composition, anti-inflammatory activity and intestinal barrier function. We investigated the use of B. Longum ES1 in the treatment of patients with diarrhoea-predominant irritable bowel syndrome (IBS-D). Sixteen patients were treated for 8 or 12 weeks with B. Longum ES1 (1 × 109 CFU/day). Serum zonulin and cytokines were measured at baseline (T0) and at the end of therapy (T1). Clinical response to therapy was assessed by IBS Severity Scoring System. Interleukin (IL)-6, IL-8, IL-12p70 and tumor necrosis factor (TNF) α levels decreased from T0 to T1, irrespective of treatment duration (p < 0.05), while zonulin levels diminished only in patients treated for 12 weeks (p = 0.036). Clinical response was observed in 5/16 patients (31%): 4/8 (50%) treated for 12 weeks and 1/8 (13%) treated for 8 weeks. Abdominal pain improved only in patients treated for 12 weeks (5/8 vs. 0/8, p = 0.025), while stool consistency improved regardless of therapy duration (p < 0.001). In conclusion, the results of this pilot study showed, in IBS-D patients treated for 12 weeks with B. longum ES1, a reduction in the levels of pro-inflammatory cytokines, and intestinal permeability as well as an improvement in gastrointestinal symptoms, but further studies including a placebo-control group are necessary to prove a causal link.

Probiotics, Prebiotics, and Synbiotics in the Irritable Bowel Syndrome Treatment: A Review

“…Similarly, Zhou et al (2020) noted the improvement of intestinal permeability, along with positive changes in GIT microbiota in the rat WAS (water avoidance stress) model after B. langum treatment [ 94 ]. However, contrary to Caviglia et al (2020), the research team did not establish any impact of B. langum on serum cytokines levels in rats [ 93 , 94 ]. Lewis et al (2020) conducted a trial involving two separate probiotics.…”

“…acidophilus DDS ® -1 contributed to the reduction of stress levels of IBS individuals [ 92 ]. Caviglia et al (2020) and Zhou et al (2020) used Bifidobacterium langum as a probiotic in studies conducted on humans and rats, respectively [ 93 , 94 ]. Caviglia et al (2020), who analyzed strain B. langum ES1, observed improvement in overall IBS symptoms and enhanced intestinal barrier integrity, as well as immune-inflammatory state of IBS-D patients [ 93 ].…”

“…Caviglia et al (2020) and Zhou et al (2020) used Bifidobacterium langum as a probiotic in studies conducted on humans and rats, respectively [ 93 , 94 ]. Caviglia et al (2020), who analyzed strain B. langum ES1, observed improvement in overall IBS symptoms and enhanced intestinal barrier integrity, as well as immune-inflammatory state of IBS-D patients [ 93 ]. Similarly, Zhou et al (2020) noted the improvement of intestinal permeability, along with positive changes in GIT microbiota in the rat WAS (water avoidance stress) model after B. langum treatment [ 94 ].…”

“…Most of the cited research was carried out in double-blind mode; however, there are still some trial designs conducted without placebo, or control group [ 93 , 112 , 113 , 114 , 125 ], as well as research conducted in full awareness of investigators, and/or participants of the administrated product (treatment/control) [ 81 , 93 , 112 , 113 , 114 , 125 ]. Moreover, the number of studies including the dose-related effect of probiotics on IBS subjects is very limited [ 86 , 89 , 96 ].…”

Bifidobacterium Longum: Protection against Inflammatory Bowel Disease

“…8 weeks after treatment, disease activity and clinical scores are greatly reduced [102]. 12 weeks after treatment with Bifidobacterium longum in patients with IBS-D, proinflammatory cytokines (IL-6, IL-8, and tumor necrosis factor TNF-α) were decreased, and intestinal permeability and gastrointestinal symptoms were improved [103]. Besides, Bifidobacterium longum is also used together with other ingredients to achieve better results.…”