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| Name | Class |
|---|---|
| UCSI University | OTHER |
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Irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder characterized by recurrent abdominal pain and altered bowel habits, often associated with impaired intestinal barrier function, low-grade inflammation, and dysregulation of the gut-brain axis. Postbiotics have emerged as a promising therapeutic approach due to their immunomodulatory, anti-inflammatory, and gut barrier-protective properties.
This completed single-arm, open-label clinical study evaluated the efficacy of PosBion® postbiotic supplementation in adults with IBS over a 12-week intervention period. The study assessed changes in IBS symptom severity, quality of life, gastrointestinal health, inflammatory biomarkers, intestinal barrier integrity, mucosal immunity, oxidative stress, and gut-brain axis biomarkers using validated questionnaires and salivary biomarker analyses.
Irritable bowel syndrome (IBS) is one of the most prevalent disorders of gut-brain interaction, affecting millions of individuals worldwide and substantially impairing quality of life. Increasing evidence suggests that IBS is associated with intestinal dysbiosis, impaired intestinal barrier function, microbial translocation, low-grade inflammation, oxidative stress, altered mucosal immunity, and dysregulation of the gut-brain axis. These interconnected mechanisms represent important therapeutic targets for nutritional interventions.
Postbiotics, consisting of inactivated microorganisms and their bioactive components, have attracted increasing attention due to their safety, stability, and potential health benefits. Experimental and clinical studies suggest that postbiotics may improve intestinal homeostasis by strengthening epithelial barrier integrity, modulating immune responses, suppressing intestinal inflammation, and regulating host-microbiota interactions.
This completed prospective, single-arm, open-label clinical study investigated the efficacy of PosBion® postbiotic supplementation in adults with IBS. Fifty-five subjects were enrolled, of whom fifty completed the 12-week intervention. Subjects consumed two sachets of PosBion® daily throughout the study period.
Clinical efficacy was evaluated using the Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS), Irritable Bowel Syndrome Quality of Life (IBS-QOL) questionnaire, and a gastrointestinal health visual analogue scale (GI Health VAS). To investigate the potential mechanisms underlying the intervention, serial saliva samples were collected at baseline and during follow-up visits for biomarker analyses.
Inflammatory responses were assessed by measuring salivary calprotectin, interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-8 (IL-8), lactoferrin, and myeloperoxidase (MPO). Intestinal barrier integrity and intestinal permeability were evaluated using salivary zonulin, lipopolysaccharide (LPS), and lipopolysaccharide-binding protein (LBP). Mucosal immune function was assessed using secretory immunoglobulin A (sIgA), while oxidative stress was evaluated by measuring salivary malondialdehyde (MDA). Gut-brain axis responses were assessed using salivary cortisol and serotonin.
The study aimed to determine whether PosBion® supplementation could improve clinical outcomes in IBS while modulating biomarkers associated with intestinal inflammation, barrier integrity, mucosal immunity, oxidative stress, and gut-brain axis function, thereby providing mechanistic evidence supporting the therapeutic potential of postbiotics in IBS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PosBion® Postbiotic Supplementation | Experimental | Subjects received PosBion® postbiotic supplementation for 12 weeks. Each sachet contained Lactobacillus plantarum RS5 (2,500 mg) and Lactobacillus plantarum RI11 (2,500 mg). Subjects were instructed to consume two sachets daily throughout the intervention period. Clinical assessments and saliva samples were collected at baseline and at Weeks 4, 8, and 12 to evaluate changes in IBS symptoms, quality of life, gastrointestinal health, inflammatory biomarkers, intestinal barrier function, mucosal immunity, oxidative stress, and gut-brain axis biomarkers. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Postbiotic supplementation | Dietary Supplement | PosBion® is a dietary postbiotic supplement containing inactivated Lactobacillus plantarum RS5 (2,500 mg) and Lactobacillus plantarum RI11 (2,500 mg) per sachet. Subjects consumed two sachets orally once daily for 12 weeks. The intervention was evaluated for its effects on IBS symptoms, quality of life, gastrointestinal health, intestinal inflammation, intestinal barrier integrity, mucosal immunity, oxidative stress, and gut-brain axis biomarkers. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Irritable Bowel Syndrome Quality of Life (IBS-QOL) Score | IBS-related quality of life was assessed using the 34-item Irritable Bowel Syndrome Quality of Life questionnaire. Raw item scores were transformed to a total score ranging from 0 to 100. Higher scores indicate better IBS-related quality of life and a better outcome. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Irritable Bowel Syndrome Symptom Severity Scale (IBS-SSS) Score | Irritable bowel syndrome symptom severity was assessed using the 5-item Irritable Bowel Syndrome Symptom Severity Scale. The scale evaluates abdominal pain severity, abdominal pain frequency, abdominal distension, dissatisfaction with bowel habits, and interference with daily life. The total score ranges from 0 to 500, with higher scores indicating more severe IBS symptoms and a worse outcome. | Baseline, Week 4, Week 8, and Week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Gastrointestinal Health Visual Analogue Scale (GI Health VAS) | To evaluate changes in subjects' self-perceived gastrointestinal health using a visual analogue scale, ranging from 0 to 10. Zero is equivalent to the worst possible GI health and 10 indicates the best possible GI health. | Baseline, Week 4, Week 8, and Week 12 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chung Keat Tan, PhD | UCSI University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UCSI University | Cheras | Kuala Lumpur | 56000 | Malaysia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35014601 | Background | Singh P, Alm EJ, Kelley JM, Cheng V, Smith M, Kassam Z, Nee J, Iturrino J, Lembo A. Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D. Gut Microbes. 2022 Jan-Dec;14(1):2020067. doi: 10.1080/19490976.2021.2020067. | |
| 39275354 | Background | Roth B, Nseir M, Jeppsson H, D'Amato M, Sundquist K, Ohlsson B. A Starch- and Sucrose-Reduced Diet Has Similar Efficiency as Low FODMAP in IBS-A Randomized Non-Inferiority Study. Nutrients. 2024 Sep 9;16(17):3039. doi: 10.3390/nu16173039. |
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De-identified individual participant data underlying the results reported in the published articles, including demographic characteristics, clinical outcome measures, questionnaire scores, and biomarker data, will be made available to qualified researchers upon reasonable request. Requests must be accompanied by a scientifically sound research proposal and will be subject to approval by the principal investigator and study sponsor to ensure participant confidentiality and compliance with applicable ethical and institutional requirements. Data will become available beginning 6 months after publication of the primary study results and will remain available for 5 years.
Six months after publication of the primary study results and will remain available for 5 years.
Qualified researchers with a scientifically sound research proposal will be eligible. Access requests will be reviewed and approved by the principal investigator and study sponsor.
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| ID | Term |
|---|---|
| D043183 | Irritable Bowel Syndrome |
| D015212 | Inflammatory Bowel Diseases |
| D005767 | Gastrointestinal Diseases |
| ID | Term |
|---|---|
| D003109 | Colonic Diseases, Functional |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D004066 | Digestive System Diseases |
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This was a single-arm, prospective, open-label interventional study in which all enrolled subjects received PosBion® postbiotic supplementation for 12 weeks. Clinical assessments and salivary biomarker measurements were performed at baseline and at Weeks 4, 8, and 12 to evaluate changes over time within the same cohort.
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| Change in Salivary Calprotectin Concentration |
Salivary calprotectin concentration was measured using enzyme-linked immunosorbent assay (ELISA) as a marker of intestinal inflammation and neutrophil activation. |
| Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Interleukin-1β (IL-1β) Concentration | Salivary IL-1β concentration was measured using ELISA as a marker of pro-inflammatory cytokine activity. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Interleukin-6 (IL-6) Concentration | Salivary IL-6 concentration was measured using ELISA as a marker of inflammatory responses. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Interleukin-8 (IL-8) Concentration | Salivary IL-8 concentration was measured using ELISA as a marker of neutrophil recruitment and intestinal inflammatory responses. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Lactoferrin Concentration | Salivary lactoferrin concentration was measured using ELISA as a marker of neutrophil activation and intestinal inflammation. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Myeloperoxidase (MPO) Concentration | Salivary myeloperoxidase concentration was measured using ELISA as a marker of neutrophil-derived oxidative inflammatory activity. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Zonulin Concentration | Salivary zonulin concentration was measured using ELISA as a marker of intestinal barrier integrity and intestinal permeability. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Lipopolysaccharide (LPS) Concentration | Salivary lipopolysaccharide concentration was measured using ELISA to evaluate microbial endotoxin exposure associated with intestinal permeability. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Lipopolysaccharide-Binding Protein (LBP) Concentration | Salivary lipopolysaccharide-binding protein concentration was measured using ELISA as an indicator of host response to bacterial endotoxin and microbial translocation. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Secretory Immunoglobulin A (sIgA) Concentration | Salivary secretory immunoglobulin A concentration was measured using ELISA to assess mucosal immune function. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Malondialdehyde (MDA) Concentration | Salivary malondialdehyde concentration was measured using ELISA as a marker of lipid peroxidation and oxidative stress. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Cortisol Concentration | Salivary cortisol concentration was measured using ELISA to assess physiological stress responses associated with the gut-brain axis. | Baseline, Week 4, Week 8, and Week 12 |
| Change in Salivary Serotonin Concentration | Salivary serotonin concentration was measured using ELISA as a biomarker of gut-brain axis function and neurotransmitter regulation. | Baseline, Week 4, Week 8, and Week 12 |
| D005759 | Gastroenteritis |