Role of Lactobacillus Johnsonii in Gastroesophageal Reflux Disease in Obese Mice Following Sleeve Gastrectomy.

Abstract

BACKGROUND: Sleeve gastrectomy (SG) is an effective weight-loss intervention but often exacerbates the onset and progression of gastroesophageal reflux disease (GERD). This study aimed to explore the possibility of alleviating GERD symptoms by supplementing with Lactobacillus johnsonii to regulate and restore the gut microbiota structure after SG. METHODS: Obese C57BL/6J mice were divided into a sham surgery group (Sham group), an SG group (Ope group), an SG&#x2009;+&#x2009;L. johnsonii group (Ope_P group), and a blank control group (Con group). The Ope_P group received 0.2 mL of L. johnsonii (1&#x2009;&#xd7;&#x2009;10^9 CFU/mL) daily for 8 weeks. The results showed that SG-induced GERD was pathologically manifested as thickened esophageal epithelium, basal cell hyperplasia, and elevated iNOS expression levels. After treatment with L. johnsonii, these pathological changes were significantly improved (P&#x2009;<&#x2009;0.05), accompanied by the restoration of gut microbiota structure, notably by increasing the Firmicutes-to-Bacteroidetes ratio and decreasing Proteobacteria. CONCLUSIONS: These findings suggest that L. johnsonii may improve GERD by modulating post-SG gut dysbiosis, providing a theoretical basis for probiotic treatment of GERD following SG.