Zmora · Cell 2018 · placebo-controlled trial with animal model · n=?

Personalized Gut Mucosal Colonization Resistance to Empiric Probiotics Is Associated with Unique Host and Microbiome Features.

Cited 1690 times in the scientific literature.

Level 2 - randomized trial

Controlled clinical trial in humans with sequential invasive sampling, combined with animal experiments.

PubMed 30193112 · doi:10.1016/j.cell.2018.08.041 · record verified 2026-08-30

What was done

Researchers evaluated gastrointestinal mucosal colonization by administering an 11-strain probiotic combination or placebo to both mice (conventionally colonized vs. germ-free) and human participants. Metagenomic and multi-omics profiling was performed on stool and sequentially sampled mucosal-associated gastrointestinal tissue at baseline and during intervention.

What was found

The abstract reports no numerical values or effect sizes. Probiotics remained viable through gastrointestinal transit. Conventionally colonized mice exhibited strong mucosal colonization resistance compared to germ-free mice. In humans, mucosal colonization was person-, region-, and strain-specific, driven by baseline host and microbiome characteristics, and could not be detected from stool composition. Probiotic supplementation caused only transient, individualized alterations in mucosal community structure and gut gene expression.

Why it matters

Standard stool analysis fails to reflect mucosal probiotic colonization, showing that universal empiric probiotic supplementation is limited by personalized mucosal resistance mechanisms.

Limits

The abstract does not state human or animal sample sizes, participant baseline health characteristics, duration of follow-up, or quantitative statistical metrics.

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