Researchers in China and Malaysia analyzed how the probiotic affected gene expression and suggested that “inflammatory, immune, neuroendocrine, and motility-related host-response pathways may be involved”. They noted, however, that further research is required to validate the causal mechanisms.
Functional constipation is the most common gut-brain disorder affecting around 12% globally. Dysregulation of the gut-brain axis and low-grade mucosal inflammation may impair neuromuscular coordination, thereby affecting intestinal motility and stool passage.
Conventional treatments such as laxatives and prokinetics may only provide temporary symptom relief and can have adverse effects such as electrolyte imbalance. Therefore, microbiome-modulating approaches are of increasing interest.
L. plantarum is a species found in fermented foods and the human gut. The strain L. plantarum Probio87 is isolated from breast milk and has shown gastrointestinal resilience and immune-modulatory effects in previous studies.
“From a nutritional perspective, Probio87 supplementation may be viewed as a microbiota-targeted dietary strategy that complements standard constipation management, including dietary fiber intake, hydration, and physical activity,” the current researchers noted.
“This is particularly relevant for functional constipation, where long-term pharmacological treatment may be undesirable and patient-centered nutritional strategies are often preferred.”
Study details
The double-blind randomized controlled trial involved 104 adult participants with functional constipation. They consumed Lactiplantibacillus plantarum Probio87 or placebo for 8 weeks, followed by a 4-week post-intervention follow-up.
All participants received standardized lifestyle recommendations throughout the study to minimize confounding from diet and lifestyle.
The participants recorded their bowel movement patterns and symptoms in a diary, and the researchers evaluated constipation using the ROME-IV criteria at the beginning of the study, at week 8, and at week 12. They also assessed quality of life and depression symptoms using appropriate scales. Gene expression responses to the probiotics were analyzed using blood samples.
The findings revealed that more participants in the probiotic group experienced increased weekly spontaneous bowel movements compared to the placebo group. The researchers also observed improvements in scores relating to ROME-IV criteria, constipation-related quality of life, sleep, and anxiety, “with benefits persisting during the post-intervention follow-up period.” Laboratory results also demonstrated the safety of the probiotics.
The gene expression analysis revealed differences between the two groups, suggesting “modulation of pathways related to inflammation, immune regulation, neuroendocrine signaling, and gut motility,” the researchers wrote.
However, they noted that because gene expression was measured in whole blood rather than intestinal tissue, the findings should be interpreted as exploratory host-response signals rather than direct evidence of gut mechanisms.
Acknowledging the study limitations, the researchers recommended larger multicenter studies to confirm the clinical and molecular findings.
Source: Front. Nutr., https://doi.org/10.3389/fnut.2026.1876944 “Lactiplantibacillus plantarum Probio87 supplementation improves functional constipation and is associated with peripheral gene-expression responses related to inflammation and the gut–brain axis: a randomized, double-blind, placebo-controlled trial.” Authors: F. Zheng et al.
