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Metabolic syndrome is associated with disturbances in gut microbiota composition. We aimed to investigate the effect of  Lactobacillus casei  Shirota ( Lc S) on gut microbiota composition, gut barrier integrity, intestinal inflammation and serum bile acid profile in metabolic syndrome. In a single-centre, prospective, randomised controlled pilot study, 28 subjects with metabolic syndrome received either  Lc S for 12 weeks (n = 13) or no  Lc S (n = 15). Data were compared to healthy controls (n = 16). Gut microbiota composition was characterised from stool using 454 pyrosequencing of 16S rRNA genes. Serum bile acids were quantified by tandem mass spectrometry. Zonulin and calprotectin were measured in serum and stool by ELISA.  Bacteroidetes/Firmicutes  ratio was significantly higher in healthy controls compared to metabolic syndrome but was not influenced by  Lc S.  Lc S supplementation led to enrichment of  Parabacteroides . Zonulin and calprotectin were increased in metabolic syndrome stool samples but not influenced by  Lc S supplementation. Serum bile acids were similar to controls and not influenced by  Lc S supplementation. Metabolic syndrome is associated with a higher  Bacteroidetes/Firmicutes  ratio and gut barrier dysfunction but  Lc S was not able to change this.  Lc S administration was associated with subtle microbiota changes at genus level.   Trial Registration  ClinicalTrials.gov  NCT01182844

plos one

Lactobacillus casei Shirota Supplementation Does Not Restore Gut Microbiota Composition and Gut Barrier in Metabolic Syndrome: A Randomized Pilot Study