{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T03:06:01Z","timestamp":1791515161166,"version":"4.3.4"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T00:00:00Z","timestamp":1720051200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003945","name":"Link\u00f6pings Universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003945","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder that affects ~4% of the global population. ReFerm<jats:sup>\u00ae<\/jats:sup> is a postbiotic product derived from oat gruel fermented with <jats:italic>Lactobacillus plantarum 299v<\/jats:italic>, and it has been shown to have beneficial effects on intestinal permeability in patients with IBS. In this study, we investigated the effects of ReFerm<jats:sup>\u00ae<\/jats:sup> on regulators of intestinal permeability, namely mast cells and enteric glial cells.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>A total of 30 patients with moderate to severe IBS were treated with an enema containing ReFerm<jats:sup>\u00ae<\/jats:sup> or a placebo twice daily. The patients underwent sigmoidoscopy with biopsies obtained from the distal colon at baseline and after 14 days of treatment. These biopsies were processed in two ways: some were fixed, embedded in paraffin, sectioned, and stained for mast cells and enteric glial cells; others were cryopreserved, lysed, and subjected to Western blotting to analyze the same markers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Treatment with ReFerm<jats:sup>\u00ae<\/jats:sup>, but not the placebo, significantly reduced mast cell tryptase protein levels in the biopsy lysates. Although the number of mast cells remained unchanged in colonic biopsies, ReFerm<jats:sup>\u00ae<\/jats:sup> treatment significantly reduced mast cell degranulation, a result not observed in the placebo group. Neither ReFerm<jats:sup>\u00ae<\/jats:sup> or placebo treatment had an impact on total protein levels or the number of enteric glial cells in the biopsies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ReFerm<jats:sup>\u00ae<\/jats:sup> treatment significantly reduced both total mast cell tryptase levels and the degranulation of mast cells in colonic biopsies from patients with IBS, suggesting a decrease in mast cell activity as a potential mechanism underlying the beneficial effects of ReFerm<jats:sup>\u00ae<\/jats:sup>. However, further research is required to assess the molecular mechanisms through which ReFerm<jats:sup>\u00ae<\/jats:sup> operates in the colons of patients with IBS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:ext-link>https:\/\/clinicaltrials.gov<\/jats:ext-link>, identifier: NCT05475314.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2024.1408623","type":"journal-article","created":{"date-parts":[[2024,7,4]],"date-time":"2024-07-04T11:47:10Z","timestamp":1720093630000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["ReFerm\u00ae: a postbiotic fermented oat gruel composition is reducing mast cell degranulation in the colon of patients with irritable bowel 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