Kou GJ, Shen J, Li LX, Zuo XL, Li YQ. Lactobacillus acidophilus attenuates polyethylene glycol-induced susceptibility to Citrobacter rodentium infection via microbiota modulation. World J Gastroenterol 2026; 32(11): 114335 [DOI: 10.3748/wjg.v32.i11.114335]
Corresponding Author of This Article
Yan-Qing Li, Department of Gastroenterology, Qilu Hospital of Shandong University, No. 107 Wenhua West Road, Jinan 250012, Shandong Province, China. liyanqing@sdu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Guan-Jun Kou, Xiu-Li Zuo, Yan-Qing Li, Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Jing Shen, Advanced Medical Research Institute, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
Li-Xiang Li, Department of Gastroenterology, Laboratory of Translational Gastroenterology, Qilu Hospital of Shandong University, Jinan 250012, Shandong Province, China
Author contributions: Kou GJ contributed to statistical analysis, study concept and design and manuscript drafting; Shen J contributed to data analysis and interpretation; Li LX contributed to critical revision of the manuscript for important intellectual content; Zuo XL and Li YQ contributed to study supervision. All authors have read and approved the manuscript.
Supported by the National Natural Science Foundation of China, No. 82470571.
Institutional animal care and use committee statement: This animal use was approved by the Institutional Animal Care and Use Committee of Qilu Hospital, Shandong University (Approval No. DWLL-2021-058). All procedures and methods adhered to the relevant guidelines and regulations.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
ARRIVE guidelines statement: The authors have read the ARRIVE guidelines, and the manuscript was prepared and revised according to the ARRIVE guidelines.
Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon request.
Corresponding author: Yan-Qing Li, Department of Gastroenterology, Qilu Hospital of Shandong University, No. 107 Wenhua West Road, Jinan 250012, Shandong Province, China. liyanqing@sdu.edu.cn
Received: September 17, 2025 Revised: October 17, 2025 Accepted: January 4, 2026 Published online: March 21, 2026 Processing time: 180 Days and 23.5 Hours
Abstract
BACKGROUND
Polyethylene glycol (PEG), a globally prevalent laxative, is extensively applied for bowel preparation prior to colonoscopy or abdominal surgery due to its exceptional safety profile. Nevertheless, emerging evidence suggests that PEG administration might induce significant alterations in colonic microbiota composition, with dysbiotic effects persisting for over two weeks. The potential implications of such microbiotic perturbations concerning opportunistic pathogen colonization and invasion remain elusive.
AIM
To investigate whether PEG increases the risk of intestinal infection, and whether Lactobacillus acidophilus (LAC) can mitigate the adverse effects and thereby reduce the risk of subsequent enteric infections.
METHODS
To investigate this, we employed a murine model infected with Citrobacter rodentium (CR), a surrogate for enteropathogenic Escherichia coli and enterohemorrhagic Escherichia coli, following PEG-induced bowel preparation.
RESULTS
The severity of infectious enteritis was assessed, and the prophylactic efficacy of LAC supplementation was evaluated. Our findings indicate that PEG administration significantly elevated CR load, enhanced virulence gene expression, and exacerbated intestinal inflammation post-infection, with the infection window extending approximately 14 days. Through fecal metagenomic analysis and co-housing experiments, we demonstrated that PEG-associated enteritis is critically mediated by gut microbiota dysbiosis. Furthermore, supplementation with LAC was shown to mitigate susceptibility to CR infection.
CONCLUSION
Our results suggest that PEG administration microbiota-dependently increases intestinal infection susceptibility, highlighting the therapeutic potential of LAC in restoring microbial homeostasis.
Core Tip: Although polyethylene glycol is a relevant compound for clinical applications, recent studies suggest that it could potentially alter the colonic microbiota composition, thereby opening ways for opportunistic pathogen colonization and invasion. Therefore, we aimed to shed light to these questions by infecting a murine model with Citrobacter rodentium, a surrogate for enteropathogenic Escherichia coli and enterohemorrhagic Escherichia coli. Furthermore, we investigated whether Lactobacillus acidophilus administration could potentially protect the colon microbiota against such possible alteration and pathogen invasion.
