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Lactobacillus acidophilus NCFM affects colonic mucosal opioid receptor expression in patients with functional abdominal pain ‐ a randomised clinical study
Author(s) -
RingelKulka T.,
Goldsmith J. R.,
Carroll I. M.,
Barros S. P.,
Palsson O.,
Jobin C.,
Ringel Y.
Publication year - 2014
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.12800
Subject(s) - medicine , lactobacillus acidophilus , abdominal pain , bloating , gastroenterology , probiotic , irritable bowel syndrome , genetics , bacteria , biology
Summary Background In a recent double‐blinded clinical trial, the probiotic combination of Lactobacillus acidophilus NCFM (L‐ NCFM ) and B‐ LB i07 reduced bloating symptoms in patients with functional bowel disorders; an effect more evident in those who reported abdominal pain. In mice, L‐ NCFM but not B‐ LB i07 induced colonic mu‐opioid receptor ( MOR ) and cannabinoid receptor 2 ( CB 2) expression, and reduced visceral sensitivity. Aims To determine if L‐ NCFM was the active component in the clinical trial and to investigate the mechanism of action in humans with mild to moderate abdominal pain. Methods Caucasian women ( n = 20) 18–70 years with mild to moderate abdominal pain were enrolled in a double‐blind, two‐armed, single‐centre study. Patients were given either L‐NCFM alone or in combination with B‐LBi07 for 21 days at a total dose of 2×10 10 CFU b.d. Colonic biopsies were collected during unsedated, unprepped flexible sigmoidoscopy before and at the end of probiotic consumption. mRNA and immunostaining were then performed on these biopsies. Patients kept symptom diaries for the 7 days prior to starting probiotic therapy and for the last 7 days of therapy. Results L‐NCFM alone, but not with B‐LBi07, induced colonic MOR mRNA and protein expression, as well as downstream signalling, as measured by enterocyte STAT3‐phosphorylation. In contrast, CB2 expression was decreased. Both treatment groups trended towards improvement in symptoms, but the study was insufficiently powered to draw meaningful conclusions. Conclusions Lactobacillus acidophilus NCFM modulates mu‐opioid receptor expression and activity, while the combination of L‐ NCFM and B‐ LB i07 does not. This study provides a possible mechanism for action by which probiotics modulates pain sensation in humans (Clinical Trial Number: NCT 01064661).