{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:50:04Z","timestamp":1790351404928,"version":"4.1.0"},"reference-count":70,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Impaired intestinal permeability and microbial dysbiosis are important pathophysiological mechanisms underlying irritable bowel syndrome (IBS). ReFerm<jats:sup>\u00ae<\/jats:sup>, also called Profermin<jats:sup>\u00ae<\/jats:sup>, is a postbiotic product of oat gruel fermented with <jats:italic>Lactobacillus plantarum<\/jats:italic> 299v. In this study, we investigated whether ReFerm<jats:sup>\u00ae<\/jats:sup> has a beneficial effect on the intestinal epithelial barrier function in patients with IBS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>Thirty patients with moderate to severe IBS-diarrhoea (IBS-D) or IBS-mixed (IBS-M) were treated with enema containing ReFerm<jats:sup>\u00ae<\/jats:sup> or placebo. The patients underwent sigmoidoscopy with biopsies obtained from the distal colon at baseline and after 14 days of treatment with ReFerm<jats:sup>\u00ae<\/jats:sup> or placebo twice daily. The biopsies were mounted in Ussing chambers, and paracellular and transcellular permeabilities were measured for 120 min. In addition, the effects of ReFerm<jats:sup>\u00ae<\/jats:sup> or placebo on the epithelial barrier were investigated <jats:italic>in vitro<\/jats:italic> using Caco-2 cells.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>ReFerm<jats:sup>\u00ae<\/jats:sup> reduced paracellular permeability (<jats:italic>p<\/jats:italic> &amp;lt; 0.05) and increased transepithelial resistance (TER) over time (<jats:italic>p<\/jats:italic> &amp;lt; 0.01), whereas the placebo had no significant effect in patients. In ReFerm<jats:sup>\u00ae<\/jats:sup>-treated Caco-2 cells, paracellular and transcellular permeabilities were decreased compared to the control (<jats:italic>p<\/jats:italic> &amp;lt; 0.05) and placebo (<jats:italic>p<\/jats:italic> &amp;lt; 0.01). TER was increased in Caco-2 ReFerm<jats:sup>\u00ae<\/jats:sup>-treated cells, and normalised TER was increased in ReFerm<jats:sup>\u00ae<\/jats:sup>-treated Caco-2 cells compared to control (<jats:italic>p<\/jats:italic> &amp;lt; 0.05) and placebo-treated (<jats:italic>p<\/jats:italic> &amp;lt; 0.05) cells.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>ReFerm<jats:sup>\u00ae<\/jats:sup> significantly reduced paracellular permeability and improved TER in colonic biopsies collected from patients with IBS and in a Caco-2 cell model. Our results offer new insights into the potential benefits of ReFerm<jats:sup>\u00ae<\/jats:sup> in IBS management. Further studies are needed to identify the molecular mechanisms underlying the barrier-protective properties of ReFerm<jats:sup>\u00ae<\/jats:sup>.<\/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\/fnut.2022.1004084","type":"journal-article","created":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T12:11:13Z","timestamp":1670501473000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":22,"title":["A postbiotic fermented oat gruel may have a beneficial effect on the colonic mucosal barrier in patients with irritable bowel 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