Effects of Lacticaseibacillus paracasei 207-27 on intestinal function and its regulatory mechanism in patients with chronic constipation

Background & Aims: Constipation is a disorder affecting the quality of life of patients, and symptoms following current treatments still need to be improved. Although probiotics treat constipation, the efficacy and safety of this therapy remain controversial. This a randomized, double-blind, placebo-dense controlled trialaimed to investigate the clinical impact of the probiotic bacterium Lacticaseibacillus paracasei 207-27 on chronic constipation. Methods : We recruited 80 patients aged 18–65 with chronic constipation and divided them into probiotic ( Lacticaseibacillus paracasei 207-27) and placebo (maltodextrin) groups. The participants were treated twice daily for 4 weeks, and stool samples and questionnaires were collected before and after treatment. The 16S rRNA sequencing and untargeted metabolomics data were analyzed. Results : Bowel movements, total short-chain fatty acid, and propionic acid were significantly improved in the probiotic group compared with in the placebo (control) group ( p <0.05) following the 4-week intervention. After the intervention, the placebo group had higher Phylum Firmicutes number ( p <0.0001) and abundance of Escherichia-Shigella genus ( p= 0.0257) and Roseburia genus ( p =0.0202) but lower abundances of Actinobacteria phylum ( p =0.0177), Bifidobacterium genus ( p <0.0001), and Roseburia genus ( p =0.0001) than the probiotic group. Probiotic intervention reduced the abundance of the Bacteroides genus ( p =0.0001) and Blautia genus ( p =0.0213) compared with that before intervention (week 0). The analysis of non-target metabolites revealed a significant increase in 3-sulfinoalanine associated with taurine and hypotaurine metabolism in 3-methylxanthine associated with caffeine metabolism and a significant downregulation of 3-methylindolepyruvate associated with tryptophan metabolism after probiotic intervention. Conclusion : Lacticaseibacillusparacasei 207-27 improved constipation symptoms and altered the intestinal microbiota, which could improve patients’ quality of life. Trial registration : chictr.org.cn ChiCTR2200056274, 03/02/2022.