Reviewer ’s report  
 
Title: Lactobacillus casei DG and its postbiotic reduce the inflammatory mucosal response: an 
ex-vivo organ culture model of post -infectious i rritable bowel syndrome  
 
Version: 0 Date: 29 Jan 2017  
 
Reviewer: Massimo Bellini  
 
Reviewer's report:  
 
It is a well written paper dealing with an interesting matter, the role of Lactobacillus casei DG  
and its postbiotic in modulating the inflammatory/immune -response in post -infectious IBS.  
The aim of the study is sufficiently defined  and the methods are very clearly described  
The data are easily understandable and the discussion and conclusions are well balanced and 
adequately supported by the data.  
 
Introduction  
It should be appreciable if the authors used to define IBS, instead of the Rome III criteria, the 
Rome IV. So, n. 3 Shih DQ…… should change into "Lacy BE, Mearin F,….. Bowel Disorders; 
Gastroenterology 2016…"  
 
Patients and Methods  
- Were the patients consecutively enrolled?  
 
- What are the "normal findings…. at histological exam inations"?:  as in their discussion the 
authors state that a "chronic low grade inflammation of the intestinal mucosa" is "typically 
observed in IBS patients" .  
 
Results  
- pag.9 "IL -6 mRNA levels were higher in colonic than in ileal mucosa while IL -8 mRNA 
levels were higher in ileal than in colonic mucosa"  
 
- pag.10 "Interestingly, the protective effect was more evident in ileal than in colonic mucosa"  
Are the authors able to provide an explanation for these findings? If they have one they  should 
briefly d iscuss these points, otherwise they should underline they could be very interesting issues 
for possible further investigations.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls ? 
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in r elation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer revie w policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as  confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Reviewer ’s report  
 
Title: Lactobacillus casei DG and its postbiotic reduce the inflammatory mucosal response: an 
ex-vivo organ culture model of post -infectious i rritable bowel syndrome  
 
Version: 0 Date: 29 Jan 2017  
 
Reviewer: Massimo Bellini  
 
Reviewer's report:  
 
It is a well written paper dealing with an interesting matter, the role of Lactobacillus casei DG  
and its postbiotic in modulating the inflammatory/immune -response in post -infectious IBS.  
The aim of the study is sufficiently defined  and the methods are very clearly described  
The data are easily understandable and the discussion and conclusions are well balanced and 
adequately supported by the data.  
 
Introduction  
It should be appreciable if the authors used to define IBS, instead of the Rome III criteria, the 
Rome IV. So, n. 3 Shih DQ…… should change into "Lacy BE, Mearin F,….. Bowel Disorders; 
Gastroenterology 2016…"  
 
Patients and Methods  
- Were the patients consecutively enrolled?  
 
- What are the "normal findings…. at histological exam inations"?:  as in their discussion the 
authors state that a "chronic low grade inflammation of the intestinal mucosa" is "typically 
observed in IBS patients" .  
 
Results  
- pag.9 "IL -6 mRNA levels were higher in colonic than in ileal mucosa while IL -8 mRNA 
levels were higher in ileal than in colonic mucosa"  
 
- pag.10 "Interestingly, the protective effect was more evident in ileal than in colonic mucosa"  
Are the authors able to provide an explanation for these findings? If they have one they  should 
briefly d iscuss these points, otherwise they should underline they could be very interesting issues 
for possible further investigations.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls ? 
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in r elation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer revie w policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as  confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: Lactobacillus casei DG and its postbiotic reduce the inflammatory mucosal response: an 
ex-vivo organ culture model of post -infectious i rritable bowel syndrome  
 
Version: 0 Date: 29 Jan 2017  
 
Reviewer: Massimo Bellini  
 
Reviewer's report:  
 
It is a well written paper dealing with an interesting matter, the role of Lactobacillus casei DG  
and its postbiotic in modulating the inflammatory/immune -response in post -infectious IBS.  
The aim of the study is sufficiently defined  and the methods are very clearly described  
The data are easily understandable and the discussion and conclusions are well balanced and 
adequately supported by the data.  
 
Introduction  
It should be appreciable if the authors used to define IBS, instead of the Rome III criteria, the 
Rome IV. So, n. 3 Shih DQ…… should change into "Lacy BE, Mearin F,….. Bowel Disorders; 
Gastroenterology 2016…"  
 
Patients and Methods  
- Were the patients consecutively enrolled?  
 
- What are the "normal findings…. at histological exam inations"?:  as in their discussion the 
authors state that a "chronic low grade inflammation of the intestinal mucosa" is "typically 
observed in IBS patients" .  
 
Results  
- pag.9 "IL -6 mRNA levels were higher in colonic than in ileal mucosa while IL -8 mRNA 
levels were higher in ileal than in colonic mucosa"  
 
- pag.10 "Interestingly, the protective effect was more evident in ileal than in colonic mucosa"  
Are the authors able to provide an explanation for these findings? If they have one they  should 
briefly d iscuss these points, otherwise they should underline they could be very interesting issues 
for possible further investigations.  
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls ? 
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, please specify what aspects require further  
assessment in your comments to the editors.  
 
Not relevant to this manuscript  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way gain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in r elation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests  
 
I agree to the open peer revie w policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Commons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as  confidential comments  
to the editors, which will not be published.  
 
I agree to the open peer review policy of the journal  
assistant