A postbiotic fermented oat gruel may have a beneficial effect on the colonic mucosal barrier in patients with irritable bowel syndrome

Abstract

BackgroundImpaired intestinal permeability and microbial dysbiosis are important pathophysiological mechanisms underlying irritable bowel syndrome (IBS). ReFerm®, also called Profermin®, is a postbiotic product of oat gruel fermented with Lactobacillus plantarum 299v. In this study, we investigated whether ReFerm® has a beneficial effect on the intestinal epithelial barrier function in patients with IBS.Materials and methodsThirty patients with moderate to severe IBS-diarrhoea (IBS-D) or IBS-mixed (IBS-M) were treated with enema containing ReFerm® or placebo. The patients underwent sigmoidoscopy with biopsies obtained from the distal colon at baseline and after 14 days of treatment with ReFerm® or placebo twice daily. The biopsies were mounted in Ussing chambers, and paracellular and transcellular permeabilities were measured for 120 min. In addition, the effects of ReFerm® or placebo on the epithelial barrier were investigated in vitro using Caco-2 cells.ResultsReFerm® reduced paracellular permeability (p < 0.05) and increased transepithelial resistance (TER) over time (p < 0.01), whereas the placebo had no significant effect in patients. In ReFerm®-treated Caco-2 cells, paracellular and transcellular permeabilities were decreased compared to the control (p < 0.05) and placebo (p < 0.01). TER was increased in Caco-2 ReFerm®-treated cells, and normalised TER was increased in ReFerm®-treated Caco-2 cells compared to control (p < 0.05) and placebo-treated (p < 0.05) cells.ConclusionReFerm® significantly reduced paracellular permeability and improved TER in colonic biopsies collected from patients with IBS and in a Caco-2 cell model. Our results offer new insights into the potential benefits of ReFerm® in IBS management. Further studies are needed to identify the molecular mechanisms underlying the barrier-protective properties of ReFerm®.Clinical trial registration[https://clinicaltrials.gov/], identifier [NCT05475314].

Efficacy of probiotics, prebiotics and synbiotics in irritable bowel syndrome: a systematic review and meta-analysis of randomized, double-blind, placebo-controlled trials

“…Full-text screening was conducted in the remaining 150 articles. We identified 46 studies of probiotic therapy in IBS [16–59], three studies of prebiotics [60–62] and three studies of synbiotics [63–65]. Finally, 50 articles reporting 52 studies were included in this meta-analysis.…”

“…Although the synbiotics did not significantly increase the response rate in IBS patients ( P >0.05), it could reduce flatulence to some extent ( P =0.038). Bednarska et al using synbiotics (a postbiotic fermented oat gruel with probiotics) found there was no significant difference of response rate between intervention group (5/18) and control group (4/12) [65].…”

Lidocaine ameliorates intestinal barrier dysfunction in irritable bowel syndrome by modulating corticotropin‐releasing hormone receptor 2

“…Male rats aged 8–12 weeks were included in the study. It has been reported that patients with IBS exhibit increased intestinal permeability 33 . In this study, an IBS model was created by subjecting rats to WAS 34 .…”

“…It has been reported that patients with IBS exhibit increased intestinal permeability. 33 In this study, an IBS model was created by subjecting rats to WAS. 34 The rats were randomly divided into three groups: the control group, the model group, and the lidocaine group, with seven rats in each group.…”

Nutrition, Physical Activity and Supplementation in Irritable Bowel Syndrome

“…The authors, therefore, concluded that supplementation with Lactobacillus plantarum 299v did not show significant efficacy in the treatment of IBS [ 64 ]. In contrast, a randomized experimental study also conducted in 2022 by Bednarska et al noted that Lactobacillus plantarum 299v had a more beneficial effect on the course of IBS compared to placebo [ 65 ]. In this analysis, 30 people diagnosed with moderate IBS were assigned to one of two groups.…”