The effect and improvement of probiotic Probio-Fit on intestinal bacteriobis in patients with irritable bowel syndrome (IBS).

。Irritable bowel syndrome (IBS) is a disease of gastrointestinal structure and bio-chemical dysfunction, clinically manifested as a group of persistent or intermittent episodes of abdominal pain, bloating, while the frequency of detocation and stool shape changes. It is common in the middle-aged and youth groups (20-50 years of age). According to the Bristol stool classification, IBS can be divided into four clinical types: diarrhea type (IBS-D), constipation type (IBS-C), mixed type (diarrhea constipation alternating) and indeter form. Generally caused by changes in intestinal dynamics, high sensitivity of the internal organs, imbalance of the intestinal bacteria, psychological and other factors. The main treatments are diet regulation, psychotherapy and medication (laxatives, urinals) etc.Probiotic Probio-Fit
®
contains three excellent probiotics, including:
L. casei
Zhang, 3×10
9
CFU/g), and Bacillus plant P-8 (
L. Plantarum
P-8,3×10
9
CFU/g) and LDF V9 (
B. lactis
V9,4×10
9
CFU/g), which have begun to bear fruit in improving metabolic diseases and regulating the intestinal tracts of related patients× Therefore, this trial looked at the effects of probiotic probio-fit
®
on symptom improvement in IBS patients and on gut bacterios.。 The trial method test details 1. Subjects randomized, double-blind and controlled trials were conducted, and 45 IBS patients were randomly divided into control groups and probiotic groups (IBS patients met the Roman standard IBS level III diagnostic criteria of at least 3 days/month for chronic abdominal pain or discomfort), of which 24 in the probiotic group and 21 patients in the control group (3 patients were excluded from the trial).。 2. The trial process the control group was given general basic treatment (including lactose oral solution and montite dispersion, abdominal pain discomfort patients taking Malay acid mebutin, anxious insomniacs taking Flupentixol, etc.), probiotic group in the basic treatment at the same time daily
Probio-Fit
®
powder 2g (10 billion CFU), treatment for 28 days.。 3. Testing methodstwo groups of patient feces samples were collected in 0, 7 and 28 days to detect changes in the patient's intestinal virlota. Take blood samples at 0 and 28 days to detect changes in blood indicators and assess clinical improvement (Figure 1).。 Figure 1: Trial Design DetailsResults 01. Blood Indicators and IBS Symptom ScoreAfter 28 days of treatment, blood cell lebinin 8 (IL-8) (
P
<0.0001), tumor necrotologist α The concentrations of indicators such as TNF-α (
P
<0.0001) and lipid polysaccharides (LPS) (
P
<0.0001) were significantly reduced, while the probiotic group decreased even more significantly. Cell lebines (IL-6) (
P
<0.01) and D-lactic acid decreased significantly in probiotic-only groups (
P
<0.0001), with no significant changes in the control group (Figure 2). After 28 days of intervention, IL-6 and TNF-α significantly lower levels in the probiotic group than in the control group. The quality of life score and IBS symptom score were improved in both the probiotic group and the control group, and the IBS symptom score in the probiotic group was significantly lower than that of the control group (
P
<0.01) on the 28th day.。 This showed that after probiotic intervention, the blood index of IBS patients improved significantly, the quality of life score increased, the IBS symptom score decreased significantly, and the IBS symptoms improved significantly when conventional drugs were used in combination with probiotics.。 Figure 2: Changes in cytokine content and IBS symptom score; A is IL-8, B is IL-6, C is TNF-α, D is D-lactic acid, E is lipid polysaccharides, F is IBS quality of life score, GIBS symptom score 02. Intestinal microbiobiotamic analysisusing Shannon Index and Super 1 index to assess the microbiobiota of the intestinal bacterium. The Shannon Index assessment found that although there was no significant difference in intestinal microbiobiotics in the probiotic group and the control group at the end of treatment, there was a significant decrease in the diversity of the control group (
P
<0.05) from 0 to 7 days, and significantly on the 7th day. Lower than the probiotic group (
P
-0.06) (Figure 3A), indicating that drug treatment alone reduces bacteriobial diversity at the beginning of treatment, while the addition of probiotic-assisted therapy can increase microbial diversity to some extent. The hyper-1 index assessed changes in intestinal bacterigroup richness in IBS patients and found that probiotic groups increased more, but were not statistically significant (Figure 3B).。 Figure 3 (AB): A for the Shannon index analysis, B for the super 1 index analysis UniFrac weighted average distance of the main coordinate analysis found that the probiotic group and the control group intestinal bacterios group on the 7th day of treatment there is a significant difference (
P
x 0.004), this difference decreased to the 28th day, but still exists (
P
s 0.079). This suggests that probiotics affect changes in the patient's gut bacteria (Figure 2C-E).。 Figure 3 (CDE): UniFrac weighted average distance main coordinate analysis, C is day 0, D is day 7, E is day 28 03. Intestinal bacterial analysis Analysis of differences in gastrointestinal microorganisms We mainly monitored the trend of changes in their dominant genus Platts (Platts genus, Mycobacterium genus and Mycobacterium genus) and found that the change patterns of plastobacteria genus were quite opposite, with greater fluctuations in the relative content of Bacillus and Bacillus acuity in the control group (Figure 4).。 Individual medications can cause more changes in the patient's intestinal virlota on the 7th day, with a significant increase in the genus
Bacteroides
,
P
<0.001), and Bifibacterium (
Bifidobacterium
,
P
<0.05), butybutyric bacteria (
But) There were significant decreases in

P
<0.05), Dorsey genus
Dorea
,
P
<0.05) and Mycobacterium genus
Euterbacium
,
P
<0.05). It has been reported that the proportion of mycobacteria is higher in patients with severe IBS. This suggests that medication has led to a decline in some beneficial bacteria, which may not be conducive to the mitigation of IBS, although there is some recovery later in treatment. Probiotic-assisted treatment significantly reduces harmful bacteria such as citric acid genus
Citrobacter
,
P
<0.05) and E. coli genus
Escherichia
,
P
<0.05). This suggests that the probiotic mechanism may be to prevent disturbances that were harmful to the host bacteriovirus by the initial drug, keeping the gut bacteriota healthy during treatment.。 Figure 4: Details of changes in the intestinal bacteriocype, A is the relative abundance change of the dominant genus, B is the relative abundance change of the rich genus of the two groups of important differences identified, C is the analysis of serum parameters and related genus abundance 04.enterotype changes At the end of the treatment, the patient became a 2 enterotypes dominated by the genus Bacillus and Platts, where the probiotic group belongs to two enterotypes, the plaster genus-based enterotypes are all samples of the probiotic group, some studies have found that the increase of Platts helps to alleviate IBS. This suggests that probiotics contribute to the treatment of IBS, but there are differences in the response of the intestinal bacteriota in the probiotic group.。 Further monitoring of the differences in the intestinal bacteriota of the probiotic group during the treatment, it was found that the sample initially attributed to the two enterobacteria there are more different strains, although the number of different strains decreased after treatment, but the fecal Platts, tender Thyrobacteria, lively pneumococcus and other advantageous strains still exist differences (Figure 5).。 Figure 5: Analysis of changes in bowel type and microbial compositionTrial ConclusionsProbiotics
Probio-Fit
®
Combined drugs are more effective in improving IBS and can significantly reduce the content of pathogenic cytokines; At the same time, it can be very good to regulate the intestinal bacterios, improve the diversity of intestinal viruls, effectively alleviate the decline of beneficial bacteria caused by drug treatment, prevent the disturbance of harmful bacteria, so that the intestinal viruls remain healthy.article was published in: European Journal of Nutrition (2020) DOI:10.1007/s00394-020-02437-4