Objective: To evaluate the effect of Lactobacillus casei strain Shirota (LcS) supplementation on symptoms, gut microbiota and faecal metabolites in patients with Parkinson’s disease (PD).

Background: Studies have found that probiotics improve the symptoms associated with constipation in PD patients. However, comprehensive analyses of the impact of probiotic supplementation on clinical symptoms and the underlying mechanism are still lacking.

Method: We performed a randomized, double-blind, placebo-controlled trial in patients with PD. Patients (n=122) were randomly assigned to either fermented milk containing 10 billion LcS  produced by Yakult (n=63) or placebo (n=59), once daily for 12 weeks. All participants were examined and recorded the basic clinical features by questionnaires. Fecal samples were collected at baseline and after 12 weeks. Gut microbiota and faecal metabolites were investigated by 16S rRNA sequencing and liquid chromatography-mass spectrometry (LC-MS) simultaneously. Trial registration number:ChiCTR1800016795.

Results: After 12 weeks of intervention, the constipation-related symptoms were noticeably improved compare with the baseline in the LcS group based on Wexner and PAC-QOL scores. LcS supplementation could improve the non-motor symptoms including NMS-Quest, HAMD, HAMA and PDQ-39 scores compare with the base line. Additionally, probiotic supplementationt resulted in a statistically significant reduction in NMS-Quest (-6.33 ± 5.93 vs -1.22 ± 5.17, P<0.001), HAMA (-2.08 ± 2.78 vs -0.54 ± 1.52, P<0.001), HAMD (-1.44 ± 2.14 vs 0.08 ± 1.25, P<0.001) and PDQ-39 (-1.83 ± 3.71 vs 0.35 ± 3.18, P=0.001) scores than placebo. There was no significant shift in α-diversity or β-diversity between baseline and follow-up for probiotic and placebo groups. While, there were significant differences in the abundance of different taxa ranging from phyla to genus level between groups by LEfSe analysis. The levels of several amino acids (tyrosine, methionine and tryptophan) and fatty acids were changed dramatically in the probiotic group compared with the placebo group.

Conclusion: Our study evidenced that supplementation with LcS may be a useful approach in managing non-motor symptoms of PD. The effects could derive from mechanisms associated with a modulation of gut microbiota and faecal metabolomic profiles.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/effect-of-lactobacillus-casei-supplementation-on-clinical-response-gut-microbiota-and-faecal-metabolites-in-patients-with-parkinsons-disease-a-randomized-double-blind-placebo-controlled-trial/