The effect of a multispecies probiotic on microbiota composition in a clinical trial of patients with diarrhea‐predominant irritable bowel syndrome

Abstract

Identifying patients with a more amenable microbiome at treatment initiation may result in better treatment response.

Probiotics in irritable bowel syndrome: Where are we?

“…Non‐responders exhibited a greater number of more abundant bacteria than responders including Streptococcus , Dorea , and Rumicococcus gnavus (a species suggested to be a potential biomarker of IBS). The results of this study are in line with the data presented by Hod et al, indicating that fecal bacterial patterns at baseline may be predictive of response to intervention influencing gut microbiota. All together these data suggest that patient responsiveness to interventions targeting dysbiosis may be linked to intestinal microbial ecosystem, suggesting a need for tailored therapies.…”

“…Indeed, a functional rather than structural effect of probiotics is in line with evidence from a systematic review of seven studies showing that probiotics did not modify the main components of endogenous microbiota . These results are also in keeping with the data reported by Hod et al in this issue of Neurogastroenterology and Motility, indicating that the impact of probiotics in the modulation of intestinal microbial ecosystem is limited. The putative functional mechanisms underlying probiotic improvement of gut dysbiosis, and the metabolic pathways leading to IBS symptom improvement is at this time only speculative and requires further investigation in ad hoc studies.…”

“…In addition, it is questionable that the same probiotic strategy can be equally effective in all patients with IBS, as demonstrated by a recent study reporting dissimilar results in patients with IBS‐C (symptoms worsened) as compared to patients with IBS‐D or IBS‐M (improved) . Female gender may be more likely to respond to probiotic treatment, as suggested by trials performed only in women with IBS as the study of Hod et al, but this will require further studies.…”

“…IBS is still largely characterized by the lack of reliable biological markers . In this context, the identification of microbial signatures that may act as biomarkers and predict clinical response to specific probiotic interventions is welcome …”

“…In this issue of Neurogastroenterology and Motility, Hod et al assessed the impact of a multispecies probiotic (BIO‐25) on gut microbiota composition in women with irritable bowel syndrome with diarrhea (IBS‐D) as well as biological and clinical predictors of therapeutic response. The authors analyzed biological samples obtained in a previously published double‐blind, placebo‐controlled study performed on 107 women with IBS‐D.…”