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Lactobacillus reuteri ATG-F4 (LT-002) is an investigational live biotherapeutic product (LBP) consisting of a specific probiotic bacterial strain originally isolated from the human gut. Developed by AtoGEN Co., Ltd., it is currently in Phase 2 clinical development for the treatment of chemotherapy-induced cachexia in patients with advanced colorectal or pancreatic cancer receiving oxaliplatin-based chemotherapy. The strain's mechanism of action involves the gut-muscle and gut-brain axes; it promotes muscle protein synthesis by activating the mTOR signaling pathway and inhibits muscle degradation by downregulating the muscle atrophy factor MuRF1 (TRIM63). Furthermore, ATG-F4 modulates the gut microbiota composition, increasing the production of short-chain fatty acids (SCFAs) such as butyrate and acetate, and has demonstrated the ability to modulate dopamine and serotonin levels, suggesting potential applications in mental health disorders like depression and anxiety.
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