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Identifying the factors influencing outcome in probiotic studies in overweight and obese patients: host or microbiome?
  1. Benjamin H Mullish1,
  2. Daryn R Michael2,
  3. Julie AK McDonald1,3,
  4. Giulia Masetti2,4,
  5. Sue F Plummer2,
  6. Julian R Marchesi1,5
  1. 1 Division of Digestive Diseases, Imperial College London, Faculty of Medicine, London, UK
  2. 2 Research, Cultech Ltd, Port Talbot, UK
  3. 3 MRC Centre for Molecular Bacteriology and Infection, Imperial College London, London, UK
  4. 4 Department of Cellular Computational and Integrative Biology, University of Trento, Povo, Italy
  5. 5 Cardiff University, School of Biosciences, Cardiff, UK
  1. Correspondence to Professor Julian R Marchesi, Division of Digestive Diseases, Imperial College London Faculty of Medicine, London W2 1NY, UK; j.marchesi{at}

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We read with interest Rodriguez and colleagues’ study, using microbiota transfer from obese stool donors into inulin-treated hum-ob mice, to define a gut microbiome signature predicting response to prebiotic.1 However, the impact of other microbiome-based interventions (and particularly probiotics) on weight loss in humans is highly-variable between individuals.2 We were interested as to whether baseline gut microbiota, or aspects of host physiology, may predict weight loss during probiotic studies.

In our recent double-blind study (ISRCTN12562026), overweight/obese adults were randomised to either 6 months of Lab4P probiotic (containing lactobacilli and bifidobacteria) or placebo.3 A higher proportion of participants receiving probiotic lost weight compared with those receiving placebo, and the extent of weight loss in the probiotic arm was greater than the placebo group.3 We subsequently performed metataxonome and metabonome analysis on stool samples from study participants (using 16S rRNA gene sequencing and liquid chromatography-mass spectrometry bile acid profiling, respectively, applying established protocols4 5).

We observed no difference in stool microbiota alpha-diversity at baseline between participants losing weight during the study versus those who did not (figure 1A); furthermore, no differences were observed in microbiota composition between groups at any taxonomic level. Conversely, on stool bile acid profiling, …

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  • Contributors DRM and SFP coordinated the clinical trial and sample collection. BHM, DRM, JAKM and GM undertook the experimental work. All authors were involved in analysis of data and writing the manuscript. All authors approved the final manuscript.

  • Funding Metabonomics studies were performed at the MRC-NIHR National Phenome Centre at Imperial College London; this centre receives financial support from the Medical Research Council (MRC) and National Institute of Health Research (NIHR) (grant number MC_PC_12025). BHM is the recipient of an NIHR Academic Clinical Lectureship. The Division of Digestive Diseases and MRC-NIHR National Phenome Centre at Imperial College London receive financial and infrastructure support from the NIHR Imperial Biomedical Research Centre (BRC) based at Imperial College Healthcare NHS Trust and Imperial College London.

  • Competing interests DRM, GM and SFP are/were employees of Cultech Ltd.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.