Collinsella aerofaciens as a predictive marker of response to probiotic treatment in non-constipated irritable bowel syndrome

ABSTRACT

Probiotics are exploited for adjuvant treatment in IBS, but reliable guidance for selecting the appropriate probiotic to adopt for different forms of IBS is lacking. We aimed to identify markers for recognizing non-constipated (NC) IBS patients that may show significant clinical improvements upon treatment with the probiotic strain Lacticaseibacillus paracasei DG (LDG). To this purpose, we performed a post-hoc analysis of samples collected during a multicenter, double-blind, parallel-group, placebo-controlled trial in which NC-IBS patients were randomized to receive at least 24 billion CFU LDG or placebo capsules b.i.d. for 12 weeks. The primary clinical endpoint was the composite response based on improved abdominal pain and fecal type. The fecal microbiome and serum markers of intestinal (PV1 and zonulin), liver, and kidney functions were investigated. We found that responders (R) in the probiotic arm (25%) differed from non-responders (NR) based on the abundance of 18 bacterial taxa, including the families Coriobacteriaceae, Dorea spp. and Collinsella aerofaciens, which were overrepresented in R patients. These taxa also distinguished R (but not NR) patients from healthy controls. Probiotic intervention significantly reduced the abundance of these bacteria in R, but not in NR. Analogous results emerged for C. aerofaciens from the analysis of data from a previous trial on IBS with the same probiotic. Finally, C. aerofaciens was positively correlated with the plasmalemmal vesicle associated protein-1 (PV-1) and the markers of liver function. In conclusion, LDG is effective on NC-IBS patients with NC-IBS with a greater abundance of potential pathobionts. Among these, C. aerofaciens has emerged as a potential predictor of probiotic efficacy.

GRAPHICAL ABSTRACT

KEYWORDS:

• Dorea
• Coriobacteriaceae
• 16S rRNA gene profiling
• PV-1
• diarrhea-predominant IBS
• mixed-type IBS
• dysbiotic-type IBS
• gut-liver axis

Collaborators

Bruno Annibale, Roma; Guido Basilisco, Milano; Leonilde Bonfrate, Bari; Michele Cicala, Roma; Rocco Cosintino, Roma; Antonio Di Sabatino, Pavia; Raffaella Ferraro, Vercelli; Francesca Galeazzi, Padova; Bastianello Germanà, Belluno; Giovanni Maconi, Milano; Santino Marchi, Pisa; Gerardo Nardone, Napoli; Matteo Neri, Chieti; Fabio Pace, Seriate; Piero Portincasa, Bari; Franco Radaelli, Como; Marcello Rodi, Vercelli; Giovanni Sarnelli, Napoli; Paolo Usai, Cagliari.

Competing interests

SG received research/educational grants and/or speaker/consultation fees from several food and pharmaceutical companies, including Sofar S.p.A. WF, an employee of Sofar S.p.A., which financially supported the study. The probiotic product used in this study was commercialized by a company that financially supported the study.

Data availability statement

Metataxonomic raw sequencing data are available as FASTQ files in the European Nucleotide Archive (ENA) of the European Bioinformatics Institute under the accession code PRJEB56302. Metataxonomic raw sequencing data related to PROBE-IBS/1²⁰ are under accession code PRJEB18753. Processed data are included in the article or uploaded as supplementary materials. All the other data are available upon request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/19490976.2023.2298246

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by Sofar S.p.A.