A postbiotic fermented oat gruel may have a beneficial effect on the colonic mucosal barrier in patients with irritable bowel syndrome

Olga Bednarska; Olga Biskou; Hans Israelsen; Martin E Winberg; Susanna Walter; Åsa V Keita

doi:10.3389/fnut.2022.1004084

A postbiotic fermented oat gruel may have a beneficial effect on the colonic mucosal barrier in patients with irritable bowel syndrome

Front Nutr. 2022 Dec 8:9:1004084. doi: 10.3389/fnut.2022.1004084. eCollection 2022.

Authors

Olga Bednarska¹, Olga Biskou², Hans Israelsen³, Martin E Winberg², Susanna Walter^{1

4}, Åsa V Keita²

Affiliations

¹ Department of Gastroenterology, Linköping University Hospital, Linköping, Sweden.
² Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
³ Nordic Rebalance A/S, Hillerød, Denmark.
⁴ Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.

Abstract

Background: Impaired intestinal permeability and microbial dysbiosis are important pathophysiological mechanisms underlying irritable bowel syndrome (IBS). ReFerm^®, also called Profermin^®, is a postbiotic product of oat gruel fermented with Lactobacillus plantarum 299v. In this study, we investigated whether ReFerm^® has a beneficial effect on the intestinal epithelial barrier function in patients with IBS.

Materials and methods: Thirty patients with moderate to severe IBS-diarrhoea (IBS-D) or IBS-mixed (IBS-M) were treated with enema containing ReFerm^® or placebo. The patients underwent sigmoidoscopy with biopsies obtained from the distal colon at baseline and after 14 days of treatment with ReFerm^® or placebo twice daily. The biopsies were mounted in Ussing chambers, and paracellular and transcellular permeabilities were measured for 120 min. In addition, the effects of ReFerm^® or placebo on the epithelial barrier were investigated in vitro using Caco-2 cells.

Results: ReFerm^® reduced paracellular permeability (p < 0.05) and increased transepithelial resistance (TER) over time (p < 0.01), whereas the placebo had no significant effect in patients. In ReFerm^®-treated Caco-2 cells, paracellular and transcellular permeabilities were decreased compared to the control (p < 0.05) and placebo (p < 0.01). TER was increased in Caco-2 ReFerm^®-treated cells, and normalised TER was increased in ReFerm^®-treated Caco-2 cells compared to control (p < 0.05) and placebo-treated (p < 0.05) cells.

Conclusion: ReFerm^® significantly reduced paracellular permeability and improved TER in colonic biopsies collected from patients with IBS and in a Caco-2 cell model. Our results offer new insights into the potential benefits of ReFerm^® in IBS management. Further studies are needed to identify the molecular mechanisms underlying the barrier-protective properties of ReFerm^®.

Clinical trial registration: [https://clinicaltrials.gov/], identifier [NCT05475314].

Keywords: IBS–irritable bowel syndrome; fermented oats; gut permeability; intestinal barrier; postbiotics.

Associated data

ClinicalTrials.gov/NCT05475314