Efficacy and safety of spore-forming probiotics in the treatment of functional dyspepsia: a pilot randomised, double-blind, placebo-controlled trial

Wauters, Lucas; Slaets, Helena; Paepe, Kim De; Ceulemans, Michael; Wetzels, Suzan; Geboers, Karlien; Tóth, Joran; Thys, Wannes; Dybajlo, Raf; Walgraeve, Daan; Biessen, Erik A. L.; Verbeke, Kristin; Tack, Jan; Wiele, Tom Van de; Hellings, Niels; Vanuytsel, Tim

doi:10.1016/s2468-1253(21)00226-0

Cited by 67 publications

(75 citation statements)

References 29 publications

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“…In humans, Bacillus spores have been shown to be beneficial in gastro-intestinal disorders. A recent study utilized B. subtilis and B. coagulans spores to treat adults with functional dyspepsia [ 177 ]. Patients given spore probiotics, as compared to placebo, more often reached clinical endpoint [ 177 ].…”

Section: Potential Of Sporobiota As Treatmentmentioning

confidence: 99%

“…A recent study utilized B. subtilis and B. coagulans spores to treat adults with functional dyspepsia [ 177 ]. Patients given spore probiotics, as compared to placebo, more often reached clinical endpoint [ 177 ]. Administration of B. subtilis spores has also been shown to be as beneficial in Irritable Bowel Syndrome patients as a low FODMAP diet or antibiotics [ 178 ].…”

Section: Potential Of Sporobiota As Treatmentmentioning

confidence: 99%

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Mechanisms and Applications of Bacterial Sporulation and Germination in the Intestine

Koopman

Remijas

Seppen

et al. 2022

IJMS

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Recent studies have suggested a major role for endospore forming bacteria within the gut microbiota, not only as pathogens but also as commensal and beneficial members contributing to gut homeostasis. In this review the sporulation processes, spore properties, and germination processes will be explained within the scope of the human gut. Within the gut, spore-forming bacteria are known to interact with the host’s immune system, both in vegetative cell and spore form. Together with the resistant nature of the spore, these characteristics offer potential for spores’ use as delivery vehicles for therapeutics. In the last part of the review, the therapeutic potential of spores as probiotics, vaccine vehicles, and drug delivery systems will be discussed.

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Section: Potential Of Sporobiota As Treatmentmentioning

confidence: 99%

Section: Potential Of Sporobiota As Treatmentmentioning

confidence: 99%

Mechanisms and Applications of Bacterial Sporulation and Germination in the Intestine

Koopman

Remijas

Seppen

et al. 2022

IJMS

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“…While no effects were found of a Lactobacillus gasseri strain (LG21) on urinary sucrose excretion in dyspeptic patients ( Nakae et al, 2016 ), the probiotic L. casei LC01 regulated epithelial permeability through reduced miR-144 and increased OCLN and ZO1 expression ( Hou et al, 2020 ). Interestingly, beneficial in vitro effects of gastric acid-resistant endospores on permeability and inflammation may also contribute to the immunological and microbial benefits of Bacillus coagulans and subtilis strains in FD ( Marzorati et al, 2020 ; Wauters et al, 2021d ). Similar to our previous study, no effects on LBP were found with these spore-forming probiotics ( Wauters et al, 2021d ), even in combination with other pro- and prebiotics in long-term PPI-users ( Horvath et al, 2020 ).…”

Section: Effect Of Existing and Novel Treatmentsmentioning

confidence: 99%

“…Interestingly, beneficial in vitro effects of gastric acid-resistant endospores on permeability and inflammation may also contribute to the immunological and microbial benefits of Bacillus coagulans and subtilis strains in FD ( Marzorati et al, 2020 ; Wauters et al, 2021d ). Similar to our previous study, no effects on LBP were found with these spore-forming probiotics ( Wauters et al, 2021d ), even in combination with other pro- and prebiotics in long-term PPI-users ( Horvath et al, 2020 ). Indeed, alterations in FD patients on long-term PPI would justify the search for alternative treatments, including pre- or probiotics.…”

Section: Effect Of Existing and Novel Treatmentsmentioning

confidence: 99%

The Role of Leaky Gut in Functional Dyspepsia

et al. 2022

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Patients with functional dyspepsia (FD) complain of epigastric symptoms with no identifiable cause. Increased intestinal permeability has been described in these patients, especially in the proximal small bowel or duodenum, and was associated with mucosal immune activation and symptoms. In this review, we discuss duodenal barrier function, including techniques currently applied in FD research. We summarize the available data on duodenal permeability in FD and factors associated to increased permeability, including mucosal eosinophils, mast cells, luminal and systemic factors. While the increased influx of antigens into the duodenal mucosa could result in local immune activation, clinical evidence for a causal role of permeability is lacking in the absence of specific barrier-protective treatments. As both existing and novel treatments, including proton pump inhibitors (PPI) and pre- or probiotics may impact duodenal barrier function, it is important to recognize and study these alterations to improve the knowledge and management of FD.

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“…Interestingly, while this study did not find a pronounced change in microbiome composition, it did show that an increase in Faecalibacterium could be associated with probiotic efficacy. In addition, a reduction in SIBO was shown in the intervention group, which can be inferred from the reduced proportion of positive glycolic acid breath tests in patients with FD taking PPIs ( Wauters et al, 2021 ). Although studies are still scarce, the findings described above showing that probiotics have a positive effect on the severity of FD symptoms could imply a link between dysbiosis as a cause and FD symptoms as a consequence.…”

Section: The Microbiome and Its Role In The Pathophysiology Of Functi...mentioning

confidence: 99%

Bi-Directionality of the Microbiota-Gut-Brain Axis in Patients With Functional Dyspepsia: Relevance of Psychotherapy and Probiotics

Rupp¹,

Stengel

2022

Front. Neurosci.

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Functional dyspepsia is one of the most commonly diagnosed disorders of the gut-brain interaction worldwide. The precise pathogenesis of functional dyspepsia is complex and remains incompletely understood. Therefore, advances in the understanding of functional dyspepsia could change clinical practice. The aim of this review is to highlight the relevance of psychotherapy and probiotics in the context of the microbiota-gut-brain axis in the pathophysiology and especially in the treatment of functional dyspepsia. Therefore, studies which have been conducted to investigate the role of psychotherapy and probiotics in FD and the microbiota-gut-brain axis in the pathophysiology of functional dyspepsia were examined, and the outcomes of this research summarized. There might be a link between changes in the microbiome and functional dyspepsia. Even though, specific alterations in the microbiome that may be pathognomonic in functional dyspepsia remain unclear, the use of probiotics became a viable treatment option for patients with functional dyspepsia. Since mental illness also plays an important role in the pathophysiology of functional dyspepsia, psychotherapy is a useful treatment method, with additional study results indicating that psychotherapy may also shift the microbiome in a favorable direction. Moreover, other findings suggest that probiotics can be used not only to alleviate gastrointestinal symptoms in functional dyspepsia, but also to treat or even prevent mental disorders in these patients. In summary, in this review we highlight the bi-directionality of the microbiota-gut-brain axis in the pathophysiology of functional dyspepsia. Although there are multiple treatment approaches, the burden of disease in patients with functional dyspepsia is still enormous and a definitive therapy to cure this disease does not (yet) exist. Lastly, there is a lack of studies on the impact of dysbiosis, mental health and probiotics on pathophysiology and symptomatology in functional dyspepsia which should be investigated in future studies.

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Efficacy and safety of spore-forming probiotics in the treatment of functional dyspepsia: a pilot randomised, double-blind, placebo-controlled trial

Cited by 67 publications

References 29 publications

Mechanisms and Applications of Bacterial Sporulation and Germination in the Intestine

Mechanisms and Applications of Bacterial Sporulation and Germination in the Intestine

The Role of Leaky Gut in Functional Dyspepsia

Bi-Directionality of the Microbiota-Gut-Brain Axis in Patients With Functional Dyspepsia: Relevance of Psychotherapy and Probiotics

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