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Lactobacillus johnsonii is a species of lactic acid bacteria utilized as a probiotic and live biotherapeutic product. It is currently being evaluated in clinical trials, primarily by the Sir Run Run Shaw Hospital and Zhejiang University, for the treatment of mild active ulcerative colitis in elderly patients and for improving ovarian function in perimenopausal women. The therapeutic effects of L. johnsonii are largely mediated through its modulation of the gut microbiota and the production of bioactive metabolites. In preclinical studies, it has demonstrated anti-atherosclerotic properties by increasing butyrate levels, which activate G-protein coupled receptors (GPR41, GPR43, and GPR109A) to inhibit macrophage pyroptosis. Additionally, it exhibits bile salt hydrolase activity, converting conjugated bile acids into chenodeoxycholic acid (CDCA), which promotes apoptosis in colorectal cancer cells by inducing mitochondrial dysfunction and oxidative stress.
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