Clinical trial validation: Probiotic adjuvant to COVID-19 treatment launches in Singapore

GenieBiome Limited is a spin-off of the Center of Gut Microbiota Research under The Chinese University of Hong Kong (CUHK).

The centre has been studying the Asian gut microbiome for the past 10 years. A government-funded research body, it has to commercialise its research findings, which led to the birth of GenieBiome and G-NiiB – a probiotic supplement brand.

There are currently two probiotic products under the brand, namely G-NiiB Immunity Pro and G-NiiB Immunity Plus.

Both products were developed prior to the outbreak of COVID-19 for addressing GI and skin problems.

However, during the pandemic, the formula was tested on COVID-19 patients, which yielded favourable results.

“The formulation was not developed specifically for COVID-19, it was a formulation that was developed originally for immunity, for Asians, and also other functions that probiotic serves, like for GI problems or skin problems, asthma.​

“But when COVID-19 hit, the researchers did some clinical study of the immunity formulation on COVID-19 patients and the results were very positive,” ​Jonathan Wong, regional business manager at GenieBiome told NutraIngredients-Asia.​

Both G-NiiB Immunity Pro and G-NiiB Immunity Plus, which come in sachet powder, contain pre and probiotics.

The main difference between the two is in their dosage amount.

The former contains a probiotic count of 10bn CFU and requires prescription, while the latter contains 2bn CFU and can be purchased from pharmacies.

Three probiotic strains and prebiotics are microencapsulated into the final products.

First launched in Hong Kong in December 2020, the products are now sold via the company’s website, in over 300 Mannings outlets, over 200 clinics, and eight private hospitals.

“I can say that the market response we have received in Hong Kong is very good. It is very successful and is fast growing.”​

Wong revealed that for the first two months this year, the company recorded US$2.5m of revenue from the G-NiiB Immunity formulas.

This is 16 times higher than the revenue of US$150k recorded in the same period last year when the product was just launch.

He said that the company was expecting to generate US$15m in revenue this year. 

G-NiiB Immunity Plus has also launched in Singapore in March and is sold in Guardian, Watsons, and e-commerce stores such as Shopee and Lazada.

“We are launching in Singapore because there are many similarities between Singapore and Hong Kong in terms of lifestyle and diets,” ​Wong said. 

The products are also sold into China and Malaysia via cross-border e-commerce (CBEC).

Bifidobacterium ​​strains​

All three probiotics strains come from the Bifidobacterium ​genus.

“The researchers have done a metagenomics sequencing study on the gut microbiome of many Asians and through the analysis, they have found that these three bacteria strains are the most important and also have positive correlation of the creation of other bacteria. ​

“They act as a trigger point to trigger the entire ecosystem of the gut microbiome ecosystem to be built,” ​Wong said.

One of the strains is Bifidobacterium adolescentis. ​

“Bifidobacterium adolescentis is a strain that is received from birth and the level gradually decreases with age. Our study found that 85 per cent of the subjects were lacking this specific strain in their gut. ​

“So most people would be lacking it and they can replenish this specific strain through the consumption of the product,” ​Wong said.

Wong declined to specify the other two strains used but said that the formula also included prebiotics such as galacto-oligosaccharides (GOS), xylo-oligosaccharides (XOS), and resistant dextrin.

Effects on COVID patients ​

Supplementation of the above probiotics formula was shown to reduce plasma pro-inflammatory markers and restore depleted beneficial organisms and was associated with a reduction in nasopharyngeal viral load in COVID-19 patients.

During the open-label, proof-of-concept study, the intervention group – which consisted of 25 patients – received two doses of the probiotics known as SIM01 daily for 28 days. Each dose consists of 100bn CFU.

The control group – consisting of 30 patients – received the same treatment protocol but not the probiotics.

“​​Our study showed that SIM01 formula was associated with a significant reduction in pro-inflammatory immune markers of IL-6, MCP-1, M-CSF, TNF-α and IL-1RA compared with controls. This supports our hypothesis that treatment with SIM01 has a potent anti-inflammatory action in hospitalised COVID-19 patients.​

“Importantly, we found that certain commensal bacteria depleted in COVID-19 patients were significantly increased after receiving SIM01 [the probiotics],” ​said the researchers.

For example, patients receiving the probiotics had an increase of Actinobacteria and Firmicutes, on top of Bifidobacterium. ​

“Our results indicated that SIM01 not only replenished Bifidobacteria alone but also favored the co-existence of other commensal bacteria…We also found that harmful bacterial species enriched in COVID-19 ​were significantly decreased after receiving SIM01.”​

The findings were published in the Journal of Gastroenterology and Hepatology.​​

Better vaccine responses ​ 

A person whose gut microbiome is rich in Bifidobacterium adolescentis ​would have a better response to the COVID-19 vaccine, a joint research between the CUHK and the Hong Kong University found.

The study involved subjects who took either the SinoVac or BioNTech vaccination.

The researchers assessed the gut microbiome and amount of antibiotics in the subjects.

It was found that subjects with the richer Bifidobacterium adolescentis ​in the gut have a higher level of antibody.

“So the products are something that we encourage people to use for better vaccine response and higher level of antibody generation,” ​Wong said.  ​

Findings of the study was published in Gut.​​

New product pipeline ​

Moving forward, the company plans to launch a probiotic targeted at reducing the risk of colorectal cancer.

The idea was to improve the gut microbiome and eliminate harmful bacteria from the Lachnoclostridium species.

“​We previously showed that the bacteria in the probiotic formula can shrink colon cancer in laboratory experiments and reduce those bacterial genes associated with colon cancer in humans. One specific hostile gut bacterium related colon cancer is the M3 bacteria,”​ said Wong.

Wong also said that there were plans to develop formulas for infants, addressing allergies, skin problems, obesity, autism, and even hair loss.