Clostridium butyricum Strain MIYAIRI 588 (CBM588) as a Precision Probiotic Therapy in the Ketogenic Diet: A Possible Application?

The ketogenic diet has proven to be effective in many recent studies not only as a weight-losing strategy but also as a valuable add-on therapy in medical conditions such as diabetes and epilepsy. Additionally, frequent conditions such as autism spectrum disorders and Alzheimer disease could have a benefit derived from ketogenic diet metabolic changes. Many of these benefits could be driven by an intestinal microbiota change. While the effects of a ketogenic diet on microbiota should still be thoroughly clarified, as most studies observe an increase in bacterial strains considered neuroprotective such as Akkermansia muciniphila, with a concomitant reduction in some pathogenic strains such as Salmonella spp. it is important to highlight how many studies show a reduction in butyrate-producing strains, leading to a colonic proinflammatory state with increased intestinal permeability and an increase in pathogenic bacterial strains. The Clostridium butyricum strain MIYAIRI 588 (CBM588) is a butyrate-producing strain that was recently approved for human use in Europe due to its safety and effectiveness. The beneficial effect of CBM588 on the human colon could derive from a mucosal layer thickness increase and mucosal immune cell regulation, leading to a reduction in diarrhea and mucosal damage. Additionally, CBM588 could improve systemic insulin sensitivity and reduce the splanchnic organ inflammatory state. Therefore, CBM588 is a bacterial strain that should be considered an add-on when following a ketogenic diet, leading to a reduction in some of the potential gastrointestinal side effects and improving weight management through increased insulin sensitivity and the optimization of the lipid metabolism.