Sa2051 Safety and Tolerability of a 2-Month Course of Lactobacillus Reuteri and Effect on Circulating and Fecal Biomarkers in Healthy Adults

Abstract

Introduction: Obesity and metabolic disorders are linked to inflammation via gut flora and/ or gut permeability. Gut derived endotoxin triggers inflammation leading to metabolic syndrome (MetS) and contributing to oxidative stress. Aim: To investigate the effect of Lactobacillus casei Shirota on gut permeability, presence of endotoxin and neutrophil function in MetS. Patients and Methods: Patients with MetS were randomized to receive 3 x 6.5x109 CFU Lactobacillus casei Shirota (probiotic group) or not for 3 months. Gut permeability was assessed by a differential sugar absorption method, endotoxin by an adapted limulus amoebocyte lysate assay, neutrophil function and toll-like receptor (TLR) expression by flow cytometry and ELISA was used to detect lipopolysaccharide binding protein (LBP) and sCD14 levels. Results: Twenty-eight patients and 10 healthy controls were included. Gut permeability was significantly increased in MetS compared to controls but did not differ between patient groups. None of the patients were positive for endotoxin. LBP and sCD14 levels were not significantly different from healthy controls. C-reactive protein and LBP levels slightly but significantly increased after 3 months within the probiotics group. Neutrophil function and TLR expression did not differ from healthy controls or within the patient groups. Discussion: Gut permeability of MetS patients was increased before markers of low grade inflammation were measurable, most likely because only a minority of patients had morbid obesity normally leading to inflammation. Lactobacillus casei Shirota did not have any influence on any parameter tested possibly due to too short study duration or underdosing of Lactobacillus casei Shirota.