Gut-lung axis: AB-Biotics’s COVID-19 trial shows “significant” results for probiotics

24 Mar 2021 --- COVID-19 patients who consumed AB-Biotics’ probiotics once a day for a month saw “significant” impacts on remission rate, duration of symptoms and viral load. The placebo-controlled, double-blinded clinical trial sheds light on the gut-lung axis and has now been submitted for peer review.

“The product that commercialized this specific combination of strains is under discussion with 65 pharmaceutical and food supplement companies,” Jordi Riera, AB-Biotics’ business development director, tells NutritionInsight.

He expects it will be marketed in the UK by the beginning of May. Germany, Italy and Spain will follow in June. The approval process in the US is still unclear, but the company is hopeful for a May launch. 

“The preliminary results of this clinical trial are encouraging, and we are extremely excited to be part of such timely research,” says lead investigator Dr. Pedro Gutierrez-Castrellon. He works at the Hospital General Manuel Gea González in Mexico City, which collaborated on the study. 

Addressing the gut-lung axis
The study’s hypothesis revolves around the cross-talk between intestinal and pulmonary tissues – commonly referred to as the gut-lung axis.

Mediated by the microbiome and immune cells, the axis has demonstrated its importance in certain respiratory diseases. 

With 75 percent of the immune system being associated with gut cells, the gut microbiota has been shown to be significantly involved in regulating the development and function of the immune system, notes AB-Biotics.

Notably, one in three patients afflicted with COVID-19 has dysbiosis. AB-Biotics adds that patients with gastrointestinal symptoms also had increased severity of the disease, thus making the microbiota a potential therapeutic target to study for COVID-19 management and transmission.One in three patients afflicted with COVID-19 has dysbiosis.

Four strains
The study included 300 non-hospitalized adult participants with PCR-confirmed COVID-19 and mild symptoms. 

Riera explains that ambulatory outpatients represent a naturalistic sample of COVID patients as most patients will only develop mild symptoms.

“We had a significant interest in avoiding hospitalizations, therefore starting from patients with mild or moderate symptoms was the obvious choice. Statistically, we would have expected a portion of those to develop severe symptoms and be hospitalized over the course of the study, but none did,” he says. 

For 30 days, half the group received a placebo capsule, while the others were given a once-a-day probiotic, supplied by Kaneka Corporation’s subsidiary, AB-Biotics. 

The four probiotic strains in the capsule were L. plantarum KABP-033, L. plantarum KABP-022, L. plantarum KABP-023 and P. acidilactici KABP-021.

Riera details that three of these strains had given excellent results in other trials, mainly both in diarrhea and gut inflammation. “The fourth strain is totally new, and it was included since it overproduces a protein of interest in immune enhancement.”

In addition to impacting remission rate, duration of symptoms and viral load (as measured by RT-PCR), no intensive care unit admissions were observed during the study period. 

Additionally, there was no adverse event noted associated with the probiotics strain blend.

Planning the next steps
Once the study is peer-reviewed, the researchers will share detailed efficacy and safety results, including: 

• Remission rate, as measured by both the absence of COVID-19 symptoms and a negative RT-PCR test.
• Reduction in the number of symptomatic patients with COVID-19.
• Reduction in the duration of specific symptoms.
• Reduced viral load in nasopharyngeal swabs.
• Increased specific IgG and IgM levels against SARS-CoV-2.

Gutierrez-Castrellon also stresses that further research is needed to corroborate and explore additional benefits.

“However, it’s important to note that probiotics are well known for their health benefits on the host when administered in adequate amounts,” he urges. 

As stated by the World Health Organization, probiotics require well-designed clinical trials to identify their benefits, which are strictly strain-specific

“Therefore positive evidence in a clinical trial for a particular health condition cannot be extrapolated or extended to other strains without clinical evidence,” Gutierrez-Castrellon concludes. 

Gut-immunity link heats up
Experts are increasingly pointing to the connection between the gut and immunity, especially in light of COVID-19. 

In December, an analysis of 300,000 UK users of the ZOE COVID Symptom Study App found that supplementation of probiotics – among other nutrients – was associated with a lower risk of self-reported SARS-CoV-2 infection. 

Meanwhile, DSM, ADM and Biosearch Life have all also investigated the role that their respective probiotic strains can play in fighting the pandemic.

Other ingredients entering the immunity ring include prebiotics, whey protein, vitamins D and C, astaxanthin and omega 3 fatty acids. 

By Katherine Durrell