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Lacticaseibacillus paracasei is a probiotic bacterium and live biotherapeutic product (LBP) being investigated for the treatment of Type 1 diabetes (T1D). It functions by modulating the gut microbiota to increase systemic levels of L-lactate. This gut-derived lactate promotes the lactylation of the transcription factor CREB1 at the Lys136 residue within regulatory T cells (Tregs). This post-translational modification reprograms a Bcl6-centered transcriptional program that sustains Treg stability and suppressive function, thereby restoring immune tolerance and restraining autoimmune destruction of pancreatic beta cells. Clinical trial data indicates that oral supplementation with L. paracasei is associated with improved C-peptide secretion and better glycemic control in patients with T1D.
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