Lactobacillus casei

Lactobacillus casei (Lacticaseibacillus casei): A Comprehensive Reference

1. Identity, Nomenclature, and Classification

Current and Historical Names

Lacticaseibacillus casei is an organism that belongs to the largest genus in the family Lactobacillaceae, a lactic acid bacterium (LAB), previously classified as Lactobacillus casei. The species is still widely referenced in the literature under its former name Lactobacillus casei, and the two names are used interchangeably in commercial, regulatory, and scientific contexts. Its full taxonomic classification is: Domain: Bacteria; Phylum: Bacillota (Firmicutes); Class: Bacilli; Order: Lactobacillales; Family: Lactobacillaceae; Genus: Lacticaseibacillus; Species: L. casei.

Its species epithet derives from the Latin word casei, meaning "of cheese," a nod to its frequent appearance in fermented milk products. Individual strains are denoted by strain codes (e.g., Shirota, DN-114 001, ATCC 334) and must be considered separately for efficacy and safety. Alternative names include Lactobacillus casei (legacy name), Lacticaseibacillus casei, and commercial designations such as L. casei Shirota or L. casei DN-114 001.

Microbiological Characteristics

Lactobacilli are Gram-positive, rod-shaped, facultatively anaerobic or microaerophilic, non-spore-forming, acid-tolerant, and catalase-negative bacteria with DNA G+C content that is usually less than 50 mol%. Members of the L. casei group are facultatively heterofermentative, have 45–47 mol% DNA G+C content, and have identical peptidoglycan types (L-Lys-D-Asp). The species is a non-sporing, rod-shaped, Gram-positive microorganism that can be found within the reproductive and digestive tract of the human body.

Taxonomic Complexity

The Lactobacillus casei group (LCG), composed of the closely related Lactobacillus casei, Lactobacillus paracasei, and Lactobacillus rhamnosus, are some of the most widely researched and applied probiotic species of lactobacilli. The three species have been extensively studied, classified, and reclassified due to their health-promoting properties. Historically, appeals were put forward to the International Committee on Systematic Bacteriology (ICSB) to modify the L. casei group; the status of the nomenclature in this group has been somewhat contested since 1989, with classification wavering between L. casei and L. paracasei. Although this group comprises many commercially valuable strains, its taxonomic status has long been contentious, because methods with inadequate taxonomic resolution have been used, leading to species being mislabeled in products, publications, and some publicly available DNA sequences.

Natural Sources and Ecological Niches

Because of its aciduric nature, L. casei is found in many fermented foods of both plant (e.g., fermented vegetables, sourdough, wine) and animal (e.g., dairy products, cured meat, and fermented sausages) origin. Lactobacillus spp. are part of the microbiota of humans and animals, where they colonize the gastrointestinal tract (GIT) and the urogenital tract. They are also found in a variety of food products from fruits and vegetables to a range of naturally fermented products. These strains, which are frequently used in the fermentation of foods like cheese and yogurts, have been grown and studied. L. casei is found in cheddar cheese, with L. casei and L. rhamnosus recognized as the predominant species in cheddar manufactured in Australia and New Zealand.

2. Traditional and Historical Use

The use of fermented foods reflects an intimate relationship between humans and microorganisms, and lactobacilli in particular, stretching back over 8,000 years. People around the world have developed a huge variety of fermented foods from the milk of cows, goats, camels, buffalos, and other animals, or from equivalent plant material such as soybean and maize. Differences in fermentation technologies and microbial environments led to different tastes, forms, and textures. Fermented foods are often intimately bound up with civilization, customs, culture, social relationships, and in some cases beliefs or religion.

The LCG have long been used in fermentations whether as adjunct or starter cultures. Fermentation was originally based on conversion of carbohydrate into organic acids, mostly lactic acid, intended to preserve nutrient in milk, but then it developed into other capabilities associated with health benefit. Lactobacillus strains, which are well-known for enhancing gut flora, are abundant as probiotics in fermented foods including kimchi, sauerkraut, koumiss, yogurt, kurut, cheese, kefir, and kombucha.

Lactobacillus casei has a story that begins in the world of traditional dairy. Scientists first discovered it in cheese in the early 1900s, and in 1971 Hansen and Lessel officially recognized it as a species. The genus Lactobacillus was first formally described by Beijerinck in 1901. In 1919, Orla-Jensen divided it into three subgenera — Thermobacterium, Streptobacterium, and Betabacterium — according to their optimal growth temperature and hexose fermentation pathway.

The traditional applications of L. casei-bearing fermented foods were empirical in character. Fermented dairy and vegetable foods containing L. casei-like organisms have been consumed for centuries for their preservative and sensory properties and traditional association with digestive health (fermented milks, cheeses, pickles). Traditional claims were empirical: improved digestion, preserved foods, and general well-being. A landmark development in the deliberate use of a defined L. casei strain was the commercialization of the Shirota strain by Japanese scientist Minoru Shirota beginning in the 1930s, leading to the Yakult product. The long history of use of Lactobacillus spp. in fermented products has led to their recognition as GRAS (generally recognized as safe) by the US Food and Drug Authority (FDA), and earned them a place on the QPS (qualified presumption of safety) list assembled by the European Food Safety Authority (EFSA).

3. Key Constituents and Active Components

Unlike a botanical herb with isolable phytochemical constituents, L. casei as a living microorganism exerts its effects through an array of structural and secreted components, metabolites, and the consequences of its colonization and metabolic activity within the host gut. The principal bioactive entities are described below.

Cell Wall Components

It is well documented that bacterial cell surface components and structures are critical factors for host-microbe interaction, immune modulation, and symbiosis. Toll-like receptors (TLRs) expressed on mammalian epithelial and immune cells act as pattern recognition receptors, which are individually responsible for a variety of different bacterial components, such as peptidoglycan (PG), lipoteichoic acid (LTA), and wall teichoic acid (WTA) from Gram-positive bacteria, as well as flagella, lipoproteins, and nucleic acids.

Among the principal bioactive entities identified are Microbe-Associated Molecular Patterns (MAMPs), such as lipoteichoic acid (LTA), peptidoglycan (PGN), exopolysaccharide (EPS), and surface proteins. These molecules are recognized by pattern recognition receptors (PRRs) expressed on epithelial immune cells, including Toll-like receptors (TLRs) and NOD-like receptors (e.g., NOD2). Signal transduction predominantly occurs via the MyD88-dependent pathway, activating NF-κB and MAPKs such as ERK, JNK, and p38, concurrently contributing to the regulation of cytokine production, dendritic cell (DC) activation, and the balance of Th1, Th2, Th17, and Treg lymphocytes.

When fractionated subcellular fractions of Lactobacillus casei were tested for NF-κB activation and TNF-α production in macrophage cell lines, the activity was found to be as follows: protoplast > cell wall ≫ polysaccharide-peptidoglycan complex. Both crude extracts and purified lipoteichoic acids (LTAs) from L. casei significantly induced TNF-α secretion from macrophage cells and splenocytes in a TLR2-dependent manner.

Exopolysaccharides (EPS)

MAMPs such as peptidoglycan (PGN), lipoteichoic acid (LTA), and exopolysaccharides (EPSs) interact with pattern recognition receptors like Toll-like receptors, initiating immune-signaling cascades that regulate cytokine production and inflammation. Lactobacilli-derived MAMPs exhibit dual immunomodulatory effects: they can enhance pro-inflammatory responses (e.g., IL-1β, IL-6, and TNF-α) under inflammatory contexts, while enhancing regulatory pathways via IL-10 and regulatory T-cell (Treg) induction in anti-inflammatory settings.

Surface Proteins: P40 and P75

Protective effects on the intestinal epithelium have been ascribed to P40 and P75, two well-characterized cell wall muramidases present in the culture supernatant of strains belonging to the taxon Lactobacillus casei/paracasei/rhamnosus. Lactobacillus casei BL23 extracellular vesicles (EVs) contain lipoteichoic acid (LTA), and all detected P40 and most of P75 were associated to EVs and possibly located at their external surface.

Lactic Acid and Short-Chain Fatty Acids

By producing lactic acid and other metabolites, L. casei can alter luminal pH, which affects enzyme activity and nutrient absorption. Fermentation of dietary fiber and other substrates by L. casei and its interactions with the gut microbiota also contribute to shifts in short-chain fatty acid (SCFA) profiles, which are relevant to gut motility, epithelial energy metabolism, and systemic immune tone.

4. Mechanisms of Action

Intestinal Barrier Function

Some L. casei strains upregulate tight junction proteins in epithelial cells, which can support barrier integrity and reduce translocation of microbial products. Some Lactobacillus strains present probiotic properties through maintaining the micro-ecological balance via different mechanisms, such as mucosal barrier function and barrier immunity. Notably, not only living cells but also Lactobacillus derivatives (postbiotics: soluble secreted products; and para-probiotics: cell structural components) may exert antipathogenic effects and beneficial functions for the gut mucosal barrier.

Immunomodulation

At the mucosal surface, L. casei can interact with dendritic cells, epithelial pattern-recognition receptors, and secretory immune components. These interactions can lead to modulation of cytokine production, enhancement of secretory IgA, and changes in local T-cell responses. Some Lactobacillus strains present probiotic properties through maintaining the micro-ecological balance via mechanisms that include mucosal barrier function and barrier immunity, and even address some neurological issues by microbiota–gut–brain/liver/lung axis communication.

A recent study found that the immune response in the small intestine induced by L. casei could extend to the systemic immune system. At the same time, the activating of macrophages and stimulating of the production of pro-inflammatory cytokines interferon-γ and TNF occurred. An underlying immunoregulatory mechanism of lactobacilli is that toll-like receptors (TLRs) binding to Lactobacilli activate NF-κB to induce specific gene expressions.

NK Cell Activity and Innate Immunity

L. casei Shirota (LcS) is able to promote innate immunity by increasing NK cell activity, and it improves inflammatory status by increasing the IL-10/IL-12 ratio. Furthermore, LcS has been described to enhance the activity of cytotoxic T lymphocytes (CD8+ T cells) via induction of pro-inflammatory cytokines. In vitro studies with human peripheral blood mononuclear cells suggest that LcS stimulates monocytes/macrophages to produce IL-12 and augments NK cell activity.

Competitive Exclusion and Colonization Resistance

Probiotics may exclude or inhibit the growth of certain pathogens; they may improve gut barrier function; and they can modulate mucosal and/or systemic immune response or metabolic functions. The LCG must be capable of surviving a number of stress conditions if they are to be used in industry, including oxidative stress, osmotic stress, cold stress, acid stress, and long-term storage. In addition to their need to tolerate these conditions in food processing, live strains must be able to survive passage through the GIT if intended for health-promoting purposes.

5. Scientific Evidence by Area of Use

5.1 Gastrointestinal Health and Diarrhea

Antibiotic-Associated Diarrhea (AAD)

LcS has been reported to exhibit various beneficial effects on gastrointestinal function and disorders, including prevention of diarrhea, improved bowel movements, and alleviating colitis symptoms, as well as immunomodulatory properties.

A number of randomized controlled trials have examined L. casei for the prevention or treatment of antibiotic-associated diarrhea. In one randomized double-blind clinical trial, a group of hospitalized patients who contracted diarrhea during or after 7 days of antibiotic suspension were randomized to receive probiotics (Lactobacillus casei and Bifidobacterium breve) or placebo three times a day. Seventy patients were studied. The average duration of diarrhea among those who were healed was 4.87 ± 2.13 days in the probiotic group and 4.52 ± 2.55 days in the control (p = 0.36). Four (11.4%) patients in the probiotic group and ten (28.6%) in the placebo group were not cured (p = 0.13). While a trend was observed, the difference did not reach statistical significance in this study, highlighting the heterogeneity of outcomes in this area. In a meta-analysis involving 707 patients from 0 to 18 years of age in six studies, doses between 5.5 and 40 × 10⁹ CFU/day of probiotics from different species or strains were studied.

Constipation

Two weeks of consecutive ingestion of 65 mL/day of beverages containing 6.5 × 10⁹ CFU/mL Lactobacillus casei strain Shirota (LcS) led to a significant decline in the occurrence of hard and lumpy stool in constipated adults.

In a study investigating the effects of LcS on constipated patients, 16 constipated patients and 22 non-constipated participants were recruited. The subjects consumed 100 mL of an LcS beverage (10⁸ CFU/mL) per day for 28 days. Fecal non-volatile metabolites were determined by GC/MS. In constipated patients, LcS intervention significantly improved defecation frequency (from 4.81 to 7.81 times per week, p < 0.05), stool consistency (from 2.52 to 3.68, p < 0.05), and constipation-related symptoms. A total of 14 non-volatile fecal metabolites were obtained as potential constipation-related metabolites regulated by LcS.

A separate randomized, double-blind, placebo-controlled trial examined LcS in constipated patients with depression. Subjects consumed 100 mL of a LcS beverage (10⁸ CFU/mL) or placebo every day for 9 weeks. After ingesting beverages for this period, no significant differences in total patient constipation-symptom scores were observed in the LcS group compared with the placebo group overall. However, symptoms related to rectal tearing and the stool symptom subscale were more alleviated in the LcS group than in the placebo group. The daily consumption of LcS for 9 weeks appeared to relieve constipation and improve potentially depressive symptoms in patients with depression, and significantly decrease IL-6 levels. The evidence for LcS in constipation is encouraging but mixed across trials, with the most consistent finding being improvement in stool consistency rather than complete symptom resolution.

Irritable Bowel Syndrome (IBS)

Meta-analyses point to a modest but significant effect of probiotics on symptoms in irritable bowel syndrome (IBS). A randomized, double-blind, placebo-controlled intervention study was conducted to assess the effect of the probiotic Lactobacillus casei Shirota (LcS) on symptoms and quality of life in IBS patients. IBS patients (Rome II criteria) between 18 and 65 years of age were included. The study consisted of an 8-week intervention period in which participants received probiotic (LcS) or placebo twice daily, followed by an 8-week follow-up period. The primary outcome was a decrease of at least 30% in a composite mean symptom score (MSS) at week 8. After probiotic treatment with LcS, no improvement of 30% in MSS was observed after 8 weeks. This negative result is consistent with a broader finding: in the field of IBS, an RCT with L. casei Shirota also failed to show significant improvement in IBS. Overall, more consistent evidence is needed regarding the efficacy and safety of probiotics for the treatment of patients with IBS. Evidence for LcS in IBS must currently be characterized as weak and inconsistent.

Stress-Related Gastrointestinal Dysfunction

A study found that the scores for "abdominal discomfort and pain" as well as for "indigestion" and "diarrhea" increased at 1–2 weeks before examination in the placebo group, and that the daily consumption of L. casei strain Shirota resulted in a tendency toward improvement in "abdominal discomfort and pain" and a significant improvement of "indigestion" in medical students exposed to academic stress. This finding, from a clinical study of healthy medical students, is preliminary but suggests a plausible role for LcS in stress-modulated gut symptoms.

5.2 Immune Function and Upper Respiratory Tract Infections

A prospective randomized controlled study examined the impact of daily LcS fermented milk (LcS-FM) on upper respiratory tract infections (URTIs) in healthy middle-aged office workers. The incidence of URTIs during the intervention period was significantly lower in the LcS-FM group than in the control milk group (22.4 vs. 53.2%, P = 0.002). The time-to-event analysis showed a significantly higher URTI-free rate in the LcS-FM group. The cumulative number of URTI episodes and cumulative days with URTI symptoms per person was lower in the LcS-FM group, and the duration per episode was shorter. Inhibition of both reductions in NK cell activity and increases in salivary cortisol levels was observed in the LcS-FM group. The results suggest that daily intake of fermented milk with LcS may reduce the risk of URTIs in healthy middle-aged office workers, probably through modulation of the immune system.

A separate human study investigated immune responses in healthy adults consuming a probiotic drink containing LcS. Daily ingestion of a probiotic drink containing LcS (1.3 × 10¹⁰ live cells) by healthy adults was investigated over a period including 4 weeks of LcS intake, 6 weeks of discontinuation, and a final 4 weeks of LcS. There was a significant increase in expression of the T cell activation marker CD3+CD69+ and a significant increase in the NK cell marker CD3+CD16/56+. Expression of the NK cell activation marker CD16/56+CD69+ in ex vivo unstimulated blood cells was 62% higher at week 10 and 74% higher at week 14. This study also found that LcS-FM inhibited increases in the levels of the stress hormone cortisol, which has the ability to decrease NK cell activity. While these human immunological data are encouraging, the mechanistic link between NK cell changes and actual infection outcomes requires further investigation. The URTI reduction findings are promising but based on a limited number of trials.

5.3 Inflammatory Bowel Disease (IBD)

In clinical trials, several strains of Lactobacillus and Bifidobacterium have shown therapeutic effects on IBD. Lactobacillus casei, one of the most widely used probiotics, has been reported to alleviate multiple diseases. However, the effects of this species on intestinal diseases are strain-specific. The physiological characteristics of 29 L. casei strains were determined, including gastrointestinal transit tolerance, oligosaccharide fermentation, HT-29 cell adhesion, generation time, exopolysaccharide production, acetic acid production, and conjugated linoleic acid synthesis. The effects of five candidate strains on mice with induced colitis were evaluated. The results showed that only Lactobacillus casei M2S01 effectively relieved colitis; this strain recovered body weight, restored disease activity index score, and promoted anti-inflammatory cytokine expression. Much of the evidence in IBD for L. casei specifically remains in animal models; robust human clinical trials demonstrating efficacy in Crohn's disease or ulcerative colitis are limited.

Lysate of probiotic bacterium L. casei DN-114 001 was investigated for its ability to decrease the severity of intestinal inflammation in a murine model of IBD. The preventive effect of oral administration of Lc significantly reduced the severity of acute dextran sulfate sodium (DSS) colitis in BALB/c mice. This is preclinical evidence and cannot be directly extrapolated to human clinical outcomes.

5.4 Acute Gastroenteritis

A prospective clinical study in hospitalized patients examined the effect of twice-daily LcS administration during acute gastroenteritis. L. casei Shirota administration twice a day had positive effects on the reduction of bowel movements, improvement of kidney function, and inflammation compared to the control group. The authors suggested that additional LcS administration might be considered in patients with acute gastroenteritis who present with high inflammation markers and/or acute impaired kidney function. Treatment with LcS resulted in a significant decrease of CRP on days five, six, and seven. Leukocyte counts decreased in all groups, with the effect significantly higher in the LcS group receiving antibiotics on day three. This evidence is from a single prospective study and requires replication.

6. Body Systems and Health Areas

• Gastrointestinal System: The most extensively studied area. Evidence supports roles in stool consistency, bowel movement frequency, prevention of antibiotic-associated diarrhea, and, to a limited extent, constipation management. Evidence in IBS is currently inconsistent.
• Immune System: Some Lactobacillus strains present probiotic properties through maintaining the micro-ecological balance via mechanisms such as mucosal barrier function and barrier immunity, and they may even address some neurological issues by microbiota–gut–brain/liver/lung axis communication. NK cell modulation and secretory IgA enhancement are the best-documented immune effects of specific LcS strains.
• Upper Respiratory Tract: Limited but positive RCT data for LcS in reducing URTI incidence and duration in healthy adults, likely mediated via immunomodulation.
• Gut Microbiota Composition: Introduction of probiotics to the intestines can modulate gut microbiota composition and in turn regulate the host immune system and modify the inflammatory response. Probiotics can also improve intestinal barrier function and exhibit a positive impact on host physiological and pathological conditions via gut microbiota-derived metabolites.
• Mental Health / Gut–Brain Axis: Emerging research has investigated LcS's influence on gut microbiota in the context of depression and stress. Evidence remains preliminary; study results are mixed, and conclusions are limited.

7. Dosage Forms and Doses Reported in Studies

Lacticaseibacillus casei (formerly Lactobacillus casei) is a Gram-positive, non-spore-forming lactic acid bacterium commonly used as a food-grade probiotic; typical daily doses in clinical studies range from 1 × 10⁸ to 1 × 10¹⁰ CFU.

The following doses have been reported in published human studies:

• In a study on constipation, subjects consumed 100 mL of an LcS beverage (10⁸ CFU/mL) per day for 28 days.
• In another constipation study, 65 mL/day of beverages containing 6.5 × 10⁹ CFU/mL LcS was administered for 2 weeks.
• In a trial of constipation in depressed patients, subjects consumed 100 mL of a LcS beverage (10⁸ CFU/mL) or placebo every day for 9 weeks.
• In an immune study, daily ingestion of a probiotic drink containing LcS at 1.3 × 10¹⁰ live cells per day was used over multiple weeks.
• In the IBS randomized trial, participants received LcS or placebo twice daily for an 8-week intervention period, followed by an 8-week follow-up period.

Commercially, L. casei is used in fermenting dairy products and in its application as a probiotic. Dosage forms encountered in research include fermented milk beverages, capsules, and food-incorporated preparations. Well-known probiotic strains such as L. casei ATCC 393 have been successfully used as starter or adjunct cultures in the production of dairy products and dry-fermented sausages, especially in cheese production. Supplement capsule products standardized to defined CFU counts are also widely used but dose ranges in capsule-based human studies vary considerably across the literature.

8. Safety Considerations and Interactions

General Population Safety

In immunocompetent adults, L. casei is generally safe; common adverse events are mild GI symptoms — bloating (~5–20%) and transient flatulence. The long history of use in fermented products has led to their recognition as GRAS by the US FDA, and they hold a place on the QPS list assembled by EFSA.

Risk in Immunocompromised and High-Risk Populations

A few recent cases of bacteremia and/or sepsis associated with lactobacilli have been reported in patients with different underlying diseases such as ulcerative colitis, suggesting that extensive damage of the colonic mucous membrane increases the risk of bacteremia. Other cases of bacteremia involve HIV-infected populations or other immunocompromised patients. Three cases of L. casei sepsis were described in a pediatric intensive care unit — two with congenital heart disease and the third with a cervical spinal cord injury.

At least eight cases of bacteremia associated with lactobacilli have been reported, including Lactobacillus acidophilus, Lactobacillus casei, and Lactobacillus GG. In general, Lactobacillus endocarditis is a rare condition that affects individuals with underlying heart conditions, such as a heart valve abnormality or artificial heart valve. These individuals have an increased risk of developing bacterial infections in the heart, including Lactobacillus endocarditis.

A published case report documents a rare case of Lactobacillus casei endocarditis in a 71-year-old female, immunocompromised due to chronic steroid intake, who presented with a productive cough and low-grade fever. Blood cultures grew L. casei resistant to vancomycin and meropenem. Transesophageal echocardiography showed mitral and aortic vegetations; valve replacement was done after successfully removing vegetations.

The FDA suggested immunosuppression, structural heart disease, inpatient status, pregnancy, and potential for translocation of probiotic across the bowel wall as conditions potentially associated with at-risk adverse events in probiotic clinical trials. Increasing reports on Lactobacillus bacteremia-associated morbidity and mortality in immunocompromised patients have raised safety concerns about its use in this group.

Antibiotic Interactions

Antibiotics can inactivate bacterial probiotics; separation of doses by 2–3 hours is recommended to improve co-administration effectiveness. This is particularly relevant since L. casei is frequently studied in the context of antibiotic-associated diarrhea, where probiotic and antibiotic are co-administered.

Intrinsic Antibiotic Resistance and Gene Transfer Concerns

The scientific information available supports the hypothesis of the existence of a gut resistance gene pool and the possible transferability of antibiotic resistance genes. Reports on possible in vivo transfer are very scarce, although they are needed. Some empirical concerns regarding the safety of probiotics are the occurrence of disease, adverse metabolic effects on the gastrointestinal tract, and gene transfer events. Safety issues include the antimicrobial resistance of the lactobacilli, the convenience of making proper identification of these bacteria, and recent risk reports on probiotic lactobacilli in certain risk groups, mainly immunocompromised patients and patients with short gut syndrome or undergoing cardiac surgery.

Product Mislabeling

Although the L. casei group comprises many commercially valuable strains, its taxonomic status has long been contentious, and methods with inadequate taxonomic resolution have been used, leading to species being mislabeled in products, publications, and some publicly available DNA sequences. This means that products labeled as containing L. casei may not always contain the strain implied, underscoring the importance of strain-level verification in evaluating both commercial products and clinical evidence.

References

• Wikipedia: Lacticaseibacillus casei
• The Lactobacillus casei Group: History and Health Related Applications — PMC (Frontiers in Microbiology, 2018)
• Identification and Classification for the Lactobacillus casei Group — PMC
• Lactobacillus casei — ScienceDirect Topics (Immunology and Microbiology)
• Lactobacillus casei — ScienceDirect Topics (Agricultural and Biological Sciences)
• The Lactobacillus casei Group: History and Health Related Applications — Frontiers in Microbiology
• Beneficial lactobacilli in food and feed: long-term use, biodiversity and proposals for specific and realistic safety assessments — FEMS Microbiology Reviews
• Health-Promoting Properties of Lactobacilli in Fermented Dairy Products — Frontiers in Microbiology
• Contribution of Lactobacilli on Intestinal Mucosal Barrier and Diseases: Perspectives and Challenges of Lactobacillus casei — PMC (Life, 2022)
• Lysate of Probiotic Lactobacillus casei DN-114 001 Ameliorates Colitis by Strengthening the Gut Barrier Function and Changing the Gut Microenvironment — PMC
• Lactobacillus casei Strain Shirota Ameliorates Dextran Sulfate Sodium-Induced Colitis in Mice — PMC (Frontiers in Immunology, 2022)
• Efficacy of Lactobacillus casei Shirota for patients with irritable bowel syndrome — PubMed
• Fermented Milk Containing Lactobacillus casei Strain Shirota Preserves the Diversity of the Gut Microbiota and Relieves Abdominal Dysfunction in Healthy Medical Students Exposed to Academic Stress — Applied and Environmental Microbiology
• The effect of Lactobacillus casei and Bifidobacterium breve on antibiotic-associated diarrhea treatment: randomized double-blind clinical trial — SciELO Brazil
• A Lactobacillus casei Shirota probiotic drink reduces antibiotic-associated diarrhoea in patients with spinal cord injuries: a randomised controlled trial — British Journal of Nutrition
• Risk and Safety of Probiotics — PMC (Clinical Infectious Diseases, 2015)
• Probiotic Lactobacilli Precautions — Frontiers in Microbiology
• Probiotic Lactobacilli Precautions — PMC
• A Case of Lactobacillus casei Endocarditis Associated With Probiotic Intake in an Immunocompromised Patient — Cureus
• Diagnostic difficulties of Lactobacillus casei bacteraemia in immunocompetent patients: A case report — PMC
• Immune Response of Healthy Adults to the Ingested Probiotic Lactobacillus casei Shirota — Scandinavian Journal of Immunology
• Daily intake of fermented milk with Lactobacillus casei strain Shirota reduces the incidence and duration of upper respiratory tract infections in healthy middle-aged office workers — PMC (European Journal of Nutrition)
• Selective effects of Lactobacillus casei Shirota on T cell activation, natural killer cell activity and cytokine production — PMC
• Lectin Microarray Reveals Binding Profiles of Lactobacillus casei Strains — PMC
• Lactobacilli-Derived Microbe-Associated Molecular Patterns (MAMPs) in Host Immune Modulation — MDPI Biomolecules
• Lipoteichoic Acids from Lactobacillus Strains Elicit Strong Tumor Necrosis Factor Alpha-Inducing Activities in Macrophages through Toll-Like Receptor 2 — PMC
• Lactobacillus casei extracellular vesicles stimulate EGFR pathway likely due to the presence of proteins P40 and P75 — Scientific Reports
• Lactobacillus casei Strain Shirota Alleviates Constipation in Adults by Increasing the Pipecolinic Acid Level in the Gut — PMC (Frontiers in Microbiology)
• Effects of Fermented Milk Containing Lacticaseibacillus paracasei Strain Shirota on Constipation in Patients with Depression — PMC
• Physiological Characteristics of Lactobacillus casei Strains and Their Alleviation Effects against Inflammatory Bowel Disease — PMC
• Probiotic significance of Lactobacillus strains: a comprehensive review on health impacts, research gaps, and future prospects — PMC
• Probiotic Lactobacillus casei Shirota improves kidney function, inflammation and bowel movements in hospitalized patients with acute gastroenteritis — ScienceDirect