Lab4 and Cholesterol Study
This double-blind, placebo-controlled study examines the role of probiotic administration in the prevention of C. difficile-associated diarrhoea (CDAD) in elderly patients receiving antibiotic therapy.
Results showed that Lab4 probiotics reduced the incidence of Clostridium difficile diarrhoea in these patients.
46% of patients supplemented with Lab4 probiotics were positive for Clostridium difficile toxin compared to 78% of patients in the placebo group
• Cholesterol lowering ability and bile salts hydrolase (BSH) activity in Lab4 probiotics was assessed using in vitro models
• The effect of Lab4 probiotics on cholesterol transport was assessed in an in vitro Caco-2 cells intestinal model
• Cholesterol levels in bacterial culture media were lowered in the presence of Lab4 probiotic mixture (#P=0.076)
Bile salt hydrolase activity
• A white precipitate was observed when Lab4 probiotic mixture was grown in the presence of bile salts, which is indicative of BSH activity.
• Lab4 probiotic mixture significantly reduced the expression of cholesterol transporter NPC1L1, which is critical for the uptake of cholesterol (**P<0.001)
• Lab4 probiotic mixture significantly reduced the efflux of intracellular cholesterol from intestinal epithelial cells into the basolateral (tissue) compartment (*P=0.004)
Summary Proposed Mechanism of Action
1. CHOLESTEROL REMOVAL [cholesterol is bound or metabolised by Lab4 and subsequently excreted in faeces]
2. BILE SALT HYDROLASE ACTIVITY [deconjugation (modifying) of bile acids leads to their reduced re-absorption and places an increased demand on the liver to synthesize more bile acids from circulating cholesterol in blood to replenish intestinal bile acids lost in faeces]
3. REDUCTION OF CHOLESTEROL TRANSPORT ACROSS THE INTESTINAL EPITHELIUM [3a – reduced expression of the NCP1L1 cholesterol transporter; 3b- reduction in the efflux of intracellular cholesterol to the basolateral compartment (tissue) and reduced expression of the ABCA-1 cholesterol transporter; 3c – no change on the intracellular cholesterol efflux back into the apical (intestinal lumen) compartment]
Lab4 probiotics showed promising cholesterol lowering potential.