This research study aims to determine if a probiotic called Limosilactobacillus fermentum CRL 1446 can improve the health of people at risk for cardiovascular disease. The study will be conducted with volunteers who will randomly consume either the probiotic or a placebo (a capsule without the probiotic), without knowing which one they are taking. The researchers will analyze how the probiotic affects blood sugar control, body composition, inflammation, and oxidative stress. The goal is to determine if this beneficial bacterium, by influencing the gut microbiota, could be a new strategy to prevent or mitigate chronic heart diseases.
The clinical study protocol, titled "Biological Effects of Consuming Limosilactobacillus fermentum CRL 1446 CONICET in Volunteers with Cardiovascular Risk Factors" was issued in October 2025 in Version 3. Rationale and Theoretical Background The protocol is underpinned by the acknowledgment of the \*\*key influence of the gut microbiota\*\* on human health, especially concerning cardiovascular risk factors. Data from Argentina's Fourth National Risk Factor Survey indicates a rise in overweight and obesity from 49% in 2005 to 61.6% in 2018. Overweight and obesity, along with dyslipidemia, hypertension, insulin resistance, and chronic inflammation, are closely correlated with imbalances in the gut microbiota, known as dysbiosis, which elevates the risk of cardiovascular diseases. Dysbiosis is characterized by a reduction in bacterial diversity, an increase in pro-inflammatory bacteria, and a decrease in beneficial bacteria that produce short-chain fatty acids. Nutritional intervention utilizing probiotics presents a promising alternative for modulating the gut microbiota's composition and function, thereby improving major cardiovascular risk factors. A probiotic is defined by FAO/WHO as "live microorganisms that, when administered in adequate amounts, confer a health benefit on the host". The specific strain under investigation, \*\*Limosilactobacillus fermentum CRL 1446\*\*, demonstrates a singular combination of functional mechanisms that support its potential efficacy in individuals with cardiovascular risk factors. Preclinical assays have shown that administration of the feruloyl esterase-producing strain L. fermentum CRL1446 improves metabolic and oxidative parameters. It is capable of modulating the gut microbiota through the production of beneficial metabolites, enhancing the integrity of the intestinal barrier and reducing bacterial translocation. Furthermore, this strain positively affects lipid metabolism by regulating key enzymes involved in lipid synthesis and degradation. It also exhibits an immunomodulatory action observed in preclinical trials, promoting an anti-inflammatory profile by stimulating regulatory cytokines and decreasing pro-inflammatory mediators. The strain's dual anti-inflammatory and antioxidant effect is linked to an increase in endogenous antioxidant enzymes like superoxide dismutase and glutathione peroxidase, suggesting a capacity to counteract cellular oxidative damage and potentially preserve endothelial function. Research Question and Hypothesis The primary research question is whether the consumption of L. fermentum CRL1446 can induce improvements in the metabolic health of adult volunteers with cardiovascular risk factors, potentially preventing or mitigating non-communicable chronic diseases. The working hypothesis is that volunteers who consume L. fermentum CRL 1446 will exhibit significant improvements in their metabolic health compared to those who do not. Objectives The \*\*general objective\*\* is to assess the efficacy of the L. fermentum CRL1446 strain in preventing postprandial glucose peaks, modulating intracellular and plasma inflammatory and redox status, and altering body composition, in volunteers receiving both acute (up to 30 days) and chronic (from 90 days) nutritional interventions. \*\*Specific objectives\*\* include: 1. Evaluating gastrointestinal symptomatology using the GSRS scale in 80 volunteers during the acute and chronic intervention phases. 2. Evaluating postprandial glucose absorption levels and body composition changes in 30 volunteers before and after of consuming 1 capsule/day and 2 capsules/day of L. fermentum CRL1446, compared to placebo. Acute intervention phase. 3. Evaluating postprandial glucose absorption levels and body composition changes in 50 volunteers before and after of consuming 1 capsule/day and 2 capsules/day of L. fermentum CRL1446, compared to placebo. Chronic intervention phase. 4. Evaluating the modification of biomarkers for oxidative stress, antioxidant defenses, DNA damage, and chronic inflammation in 50 volunteers before and after of consumption (1 capsule/day and 2 capsules/day), compared to placebo. Chronic intervention phase.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
QUADRUPLE
Enrollment
80
Acute phase: After randomization of the groups, patients will be instructed to take one capsule daily of Limosilactobacillus fermentum 1446 CRL CONICET 2.20E + 9 CFU (colony-forming units) with their main meal for 30 days. After a 15-day medication-free period, the groups will be crossed over and undergo another 30-day intervention. Following this phase, the acute intervention will be repeated with two capsules daily. Chronic phase: After randomization of the groups, patients will be instructed to take one capsule daily of Limosilactobacillus fermentum 1446 CRL CONICET 2.20E + 9 CFU with their main meal for 90 days. After a 15-day drug washout period, the groups will be crossed over, and patients who received a placebo will undergo a 90-day intervention with one daily capsule of Limosilactobacillus fermentum 1446 CRL CONICET 2.20E + 9 CFU with their main meal. Following this phase, the chronic intervention will be repeated with two capsules daily.
Acute phase: After the initial randomization, patients will be instructed to take one placebo capsule (inert excipient) daily with their main meal for 30 days. After a 15-day break, the intervention will be repeated with the arms crossed. Once the initial intervention is completed, the acute intervention will be repeated with two capsules daily. Chronic phase: After the initial randomization, patients will be instructed to take one placebo capsule (inert excipient) daily with their main meal for 90 days. After a 15-day break, the intervention will be repeated with the arms crossed. Once the initial intervention is completed, the chronic intervention will be repeated with two capsules daily.
Raul Francisco Pastor
Buenos Aires, Buenos Aires City, Argentina
TIEMPO MEDICO Health Research Center
Buenos Aires, Argentina
Evaluation of the effects on gastrointestinal well-being and molecular biology by the consumption of Limosilactobacillus fermentum CRL 1446 CONICET 2.20E+9 CFU in volunteers with cardiovascular risk factors.
The researchers propose to thoroughly evaluate the effects on gastrointestinal well-being, glucose metabolism and redox metabolism (oxidative stress, endogenous antioxidant defenses and chronic inflammation) in participants with cardiovascular risk factors, with the aim of determining the impact of the Limosilactobacillus fermentum CRL 1446 CONICET strain on the prevention of cardiovascular diseases.
Time frame: 150 days (acute) 390 days (chronic)
Weekly survey on gastrointestinal well-being, tolerance, side effects and/or adverse effects in participants with cardiovascular risk factors, from the acute and chronic consumption of Limosilactobacillus Fermentum CRL 1446 CASASCO CONICET
Gastrointestinal symptoms; 1. Health effects 2. Tolerance 3. Side effects 4. Adverse effects. Method: Using the Gastrointestinal Symptom Rating Scale (GSRS). Units: Score on a scale of 1 to 7 described below on 15 different items 1. No discomfort at all 2. Minor discomfort 3. Mild discomfort 4. Moderate discomfort 5. Moderately severe discomfort 6. Severe discomfort 7. Very severe discomfort
Time frame: 150 days (acute) 390 days (chronic)
Continuous glucose monitoring by transdermal sensor.
Monitoring biomarkers: 1. Glucosa in mg/dL 2. Glucose Control Index (GCI) in percentage %. The Glucose Control Index (GCI) is an estimate of HbA1c based on the average glucose level over the past 10 to 14 days, obtained through continuous glucose monitoring (CGM/Flash). Unlike laboratory-derived HbA1c, the GCI provides short-term information to assess current control and adjust treatment. Calculation: It is derived directly from the daily average glucose recorded by a sensor, which generally requires at least 5-7 days of data. Formula: The formula used is: GCI in % = 3.31 + 0.02392 x glucose in mg/dL.
Time frame: 150 days (acute) and 390 days (chronic)
Measure of the body composition by impedance analysis
Biomarkers: 1. Muscle mass in kg 2. Fat mass in kg
Time frame: 150 days (acute) and 390 days (chronic)
Measure of the oxidative stress
Biomarkers: 1. Lipid peroxidation in nmol/mg of protein. 2. Carbonylated proteins in nmol/mg of protein. 3. 8(OH)dG in ng/mL.
Time frame: 390 days
Measure of the antioxidant defenses
Biomarkers: 1. Total Antioxidant Status in mEqTROLOX/mL 2. Glutathione in nmol/mg of protein
Time frame: 390 days.
Measure of the chronic inflammation
Biomarkers: 1. Ferritin in ng/mL 2. Haptoglobin in mg/mL 3. High-sensitivity PCR in mg/dL
Time frame: 390 days
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