Clinical trial: Efficacy of a Low FODMAP Diet in Paediatric Irritable Bowel Syndrome—A Randomised Crossover Trial With Exploratory Metabolomic Analysis Fernanda Cristofori, Giuseppe Celano, Vanessa Nadia Dargenio, Carmen Aurora Apa, Monica Amendolara, et al. Alimentary Pharmacology and Therapeutics, 2026 Background Evidence supporting the low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) diet in paediatric irritable bowel syndrome (IBS) remains limited. Mechanisms underlying inter‐individual variability in dietary response in children are poorly understood. Aim To compare the clinical efficacy of a low FODMAP diet (LFD) versus a dietitian‐guided habitual diet (HD; standard FODMAP intake) in children with IBS and to identify faecal and urinary metabolomic signatures associated with treatment response. Methods Single‐centre, randomised assessor‐blinded crossover trial. Children with Rome IV‐defined IBS underwent a 2‐week run‐in, followed by 14 days of LFD or dietitian‐guided HD, a 2‐week washout, and crossover to the alternate diet. The primary outcome was treatment success (≥ 50% reduction in abdominal pain; period‐specific baseline VAS). Secondary outcomes included IBS Severity Scoring System (IBS‐SSS), stool pattern, and metabolomic profiling. Results Sixty‐six children (mean age 10.2 years) completed the trial. Treatment success was achieved in 57.6% during LFD versus 30.3% during HD ( p = 0.024), with the greatest benefit observed in children with severe baseline pain (VAS > 5). LFD was associated with significant reductions in IBS‐SSS scores and bloating. Targeted SCFA analyses showed lower faecal acetic acid during LFD than during HD, while exploratory faecal and urinary volatilome analyses identified candidate features associated with response categories. Conclusion In this randomised crossover trial, a LFD improved abdominal pain and symptom severity in children with IBS, with the greatest benefit in those with severe baseline pain. Exploratory faecal and urinary metabolomic analyses identified candidate features associated with non‐response, warranting further validation. Trial Registration ClinicalTrials.gov identifier: NCT06618677
Genetically Modified Lactic Acid Bacteria in the EU Food Chain: Applications, Benefits, and Risk Assessment Mirco Vacca, Francesco Maria Calabrese, Pasquale Filannino, Maria De Angelis International Journal of Molecular Sciences, 2026 Genetically modified (GM) lactic acid bacteria (LAB) are gaining attention as tools for innovation in the food sector, health applications, and industrial processes. LAB have long been used safely due to their GRAS/QPS status, making them suitable for improving fermentation and synthesizing specific and beneficial metabolites. Advances in genomics and gene editing have significantly expanded the available tools, ranging from classical mutagenesis to site-specific recombination, homologous recombination in non-coding regions, CRISPR-based systems, and food-grade chromosomal integration. These approaches enable the insertion of desired genes and the development of engineered strains with tailored functionalities. GM-LAB are also being studied as live delivery systems for therapeutic molecules, including cytokines, hormones, antimicrobial peptides, and vaccine antigens. Engineered strains of Lactococcus lactis and Lactobacillus spp. have yielded promising outcomes in applications such as mucosal immunization, modulation of inflammatory and metabolic responses, and inhibition of pathogenic microorganisms, including multidrug-resistant bacteria. From an industrial perspective, several studies highlight their potential for cost-effective recombinant protein production and the synthesis of high-value metabolites through fermentation. However, within the European Union, their use is subject to stringent regulatory oversight, requiring comprehensive molecular and environmental risk assessments, careful evaluation of horizontal gene transfer, and a preference for markerless chromosomal integrations. Despite these constraints, GM-LAB offer significant potential to improve food quality, sustainability, and human health.
Comparative Evaluation of Functional Properties of Cow, Goat, and Donkey Milks Fermented with Lactic Acid Bacteria Giusy Rita Caponio, Alessandro Annunziato, Mirco Vacca, Mariasimona Cavaliere, Ilenia Ceglie, et al. Antioxidants, 2025 Milk represents not only a source of essential nutrients but also a versatile matrix for the development of functional foods when combined with lactic acid bacteria (LAB) fermentation. While cow milk is the most widely consumed, alternative matrices such as goat and donkey milk possess distinctive compositional features that may influence the bioactivity of fermented products. In this work, fifteen different strains belonging to LAB and bifidobacteria were initially tested for their ability to ferment cow, goat, and donkey milk. Fermented samples showing the best acidification rate were further screened for total phenolic content (TPC), radical scavenging activity (RSA), and effects in human colon epithelial cells and Caco-2 adenocarcinoma cells. The results showed that fermentation modulated TPC in a strain- and matrix-dependent manner, with donkey milk showing the most consistent increases. RSA was significantly enhanced in fermented samples, particularly those inoculated with Lacticaseibacillus casei BGP93 and LC4P1 strains and Limosilactobacillus reuteri ATCC23272. Cell viability assays confirmed the absence of cytotoxicity, and fermented milk extracts reduced ROS under induced oxidative stress. Antimicrobial assay showed that Lactiplantibacillus plantarum LPAL selectively inhibited Listeria monocytogenes, with the strongest effect observed in donkey milk. These findings suggest that LAB-fermented milks from goats and donkeys may represent safe functional foods with improved antioxidant and antimicrobial activities.
Genetically Modified Lactic Acid Bacteria in the EU Food Chain: Applications, Benefits, and Risk Assessment M Vacca, FM Calabrese, P Filannino, M De Angelis International Journal of Molecular Sciences 27 (9), 3759 , 2026 2026
Semi-industrial scale-up of functional biscuits enriched with wine lees: nutritional enhancement and consumer acceptance GR Caponio, R Miolla, M Vacca, M De Angelis, S Spinelli, G Difonzo Applied Food Research, 101983 , 2026 2026
Leishmania Infection: A Bioorganic Model Under the Light of Benchtop Low Field Nuclear Magnetic Resonance J Mendoza-Roldan, P Albanese, C Di Spiridione, M Vacca, M Spagnuolo, ... Biological Procedures Online , 2026 2026
Addressing bacteria with tannins chemistry: an innovative food inspired organic lauryl-gallate-based coating to increase probiotics resistance M Vacca, M Cavaliere, G Celano, D Pinto, A De Stradis, M Spagnuolo, ... International Journal of Biological Macromolecules, 150164 , 2026 2026 Citations: 1
Clinical trial: Efficacy of a Low FODMAP Diet in Paediatric Irritable Bowel Syndrome-A Randomised Crossover Trial With Exploratory Metabolomic Analysis F Cristofori, G Celano, VN Dargenio, CA Apa, M Amendolara, M Stella, ... Alimentary pharmacology & therapeutics , 2026 2026
Cholesterol‐Lowering and Radical Scavenging Potential of Fermented Black Kale ( Brassica oleracea var. acephala ): From Pilot‐Scale Production to in Vivo Study M Vacca, A Tarantini, M Khalil, D Vona, FM Calabrese, G Celano, CA Apa, ... ChemFoodChem 1 (2), e00035 , 2025 2025 Citations: 2
Comparative Evaluation of Functional Properties of Cow, Goat, and Donkey Milks Fermented with Lactic Acid Bacteria GR Caponio, A Annunziato, M Vacca, M Cavaliere, I Ceglie, M Ranieri, ... Antioxidants 14 (11), 1331 , 2025 2025 Citations: 2
Nutritional, Rheological, and Sensory Effect of Oat Okara Enrichment in Plant-Based Ice Cream GR Caponio, D De Angelis, L Mansueto, M Vacca, R Silletti, M De Angelis, ... LWT, 118490 , 2025 2025 Citations: 3
Phenolic characterization and nutraceutical evaluation of by‐products from different globe artichoke cultivars GR Caponio, M Vacca, L Scalvenzi, A Annunziato, R Silletti, C Ruta, ... Journal of the Science of Food and Agriculture 105 (9), 5062-5073 , 2025 2025 Citations: 6
Innovative approaches for the fermentation of black cabbage with improved nutritional and health-promoting traits A Tarantini, L Mancini, M Vacca, G Celano, G Romano, L D'Amico, ... LWT 226, 117961 , 2025 2025 Citations: 3
Incorporating Fresh Durum Wheat Semolina Pasta Fortified with Cardoncello ( Pleurotus eryngii ) Mushroom Powder as a Mediterranean Diet Staple M Calasso, A Lisi, A Ressa, GR Caponio, G Difonzo, F Minervini, ... Antioxidants 14 (3), 284 , 2025 2025 Citations: 5
Microencapsulation of Probiotics for Enhanced Stability and Health Benefits in Dairy Functional Foods: A Focus on Pasta Filata Cheese V D’Amico, M Cavaliere, M Ivone, C Lacassia, G Celano, M Vacca, ... Pharmaceutics 17 (2), 185 , 2025 2025 Citations: 56
Pasta Filata Cheeses: Traditional Varieties M Vacca, FM Calabrese, G Costantino, M De Angelis Cheese, 1093-1107 , 2025 2025 Citations: 1
Agreeability and gastrointestinal motility responses to fully characterized experimental pasta enriched in wheat by-products M Vacca, M Khalil, A Rampino, G Celano, E Lanza, GR Caponio, ... Journal of Functional Foods 123, 106598 , 2024 2024 Citations: 9
Gut microbiota and fecal volatilome profile inspection in metabolically healthy and unhealthy obesity phenotypes FM Calabrese, VA Genchi, N Serale, G Celano, M Vacca, G Palma, ... Journal of Endocrinological Investigation 47 (12), 3077-3090 , 2024 2024 Citations: 10
Nutritional, Biochemical, and Functional Properties of Spinach Leaf-Enriched Dough: A Healthier Alternative to Conventional Pasta I Iacobellis, A Lisi, M Vacca, CA Apa, G Celano, L Mancini, F Minervini, ... Foods 13 (22), 3608 , 2024 2024 Citations: 12
Anthocyanins from purple corn affect gut microbiota and metabolome in inflammatory bowel disease patients under infliximab infusion: the SiCURA pilot study M Vacca, EM Sommella, M Liso, G Verna, A Scarano, A Sila, M Curlo, ... Food Science and Human Wellness 13 (6), 3536-3543 , 2024 2024 Citations: 8
All Bio‐Based µ‐Beads from Microalgae for Probiotics Delivery D Vona, SR Cicco, FM la Forgia, M Vacca, A Porrelli, G Caggiano, ... Advanced Sustainable Systems 8 (11), 2400384 , 2024 2024 Citations: 10
Personalized identification of autism-related bacteria in the gut microbiome using explainable artificial intelligence P Novielli, D Romano, M Magarelli, D Diacono, A Monaco, N Amoroso, ... Iscience 27 (9) , 2024 2024 Citations: 23
Dynamic microbial and metabolic changes during Apulian Caciocavallo cheesemaking and ripening produced according to a standardized protocol M Vacca, G Celano, N Serale, G Costantino, FM Calabrese, M Calasso, ... Journal of Dairy Science 107 (9), 6541-6557 , 2024 2024 Citations: 14
MOST CITED SCHOLAR PUBLICATIONS
The Controversial Role of Human Gut Lachnospiraceae M Vacca, G Celano, FM Calabrese, P Portincasa, M Gobbetti, ... Microorganisms 8 (4), 573 , 2020 2020 Citations: 1792
Gut Microbiota and Short Chain Fatty Acids: Implications in Glucose Homeostasis P Portincasa, L Bonfrate, M Vacca, M De Angelis, I Farella, E Lanza, ... International Journal of Molecular Sciences 23 (3), 1105 , 2022 2022 Citations: 1086
Nutritional Therapy Modulates Intestinal Microbiota and Reduces Serum Levels of Total and Free Indoxyl Sulfate and P-Cresyl Sulfate in Chronic Kidney Disease (Medika Study) BR Di Iorio, MT Rocchetti, M De Angelis, C Cosola, S Marzocco, ... Journal of clinical medicine 8 (9), 1424 , 2019 2019 Citations: 154
Fecal microbiota transplantation modulates renal phenotype in the humanized mouse model of IgA nephropathy G Lauriero, L Abbad, M Vacca, G Celano, JM Chemouny, M Calasso, ... Frontiers in Immunology 12, 694787 , 2021 2021 Citations: 81
Metabolic framework of spontaneous and synthetic sourdough metacommunities to reveal microbial players responsible for resilience and performance FM Calabrese, H Ameur, O Nikoloudaki, G Celano, M Vacca, WJFL Junior, ... Microbiome 10 (1), 1-37 , 2022 2022 Citations: 71
A Low Glycemic Index Mediterranean Diet Combined with Aerobic Physical Activity Rearranges the Gut Microbiota Signature in NAFLD Patients FM Calabrese, V Disciglio, I Franco, P Sorino, C Bonfiglio, A Bianco, ... Nutrients 14 (9), 1773 , 2022 2022 Citations: 67
Effect of Seasonality on Microbiological Variability of Raw Cow Milk from Apulian Dairy Farms in Italy G Celano, M Calasso, G Costantino, M Vacca, A Ressa, O Nikoloudaki, ... Microbiology spectrum 10 (5), e00514-22 , 2022 2022 Citations: 62
Bile Acids and GPBAR-1: Dynamic Interaction Involving Genes, Environment and Gut Microbiome P Portincasa, A Di Ciaula, G Garruti, M Vacca, M De Angelis, DQH Wang Nutrients 12 (12), 3709 , 2020 2020 Citations: 61
Microbiome preterm birth DREAM challenge: Crowdsourcing machine learning approaches to advance preterm birth research JL Golob, TT Oskotsky, AS Tang, A Roldan, V Chung, CWY Ha, RJ Wong, ... Cell Reports Medicine 5 (1) , 2024 2024 Citations: 59
Microencapsulation of Probiotics for Enhanced Stability and Health Benefits in Dairy Functional Foods: A Focus on Pasta Filata Cheese V D’Amico, M Cavaliere, M Ivone, C Lacassia, G Celano, M Vacca, ... Pharmaceutics 17 (2), 185 , 2025 2025 Citations: 56
Prenatal and postnatal determinants in shaping offspring’s microbiome in the first 1000 days: study protocol and preliminary results at one month of life B Raspini, D Porri, R De Giuseppe, M Chieppa, M Liso, RM Cerbo, ... Italian Journal of Pediatrics 46, 1-14 , 2020 2020 Citations: 55
Early life microbiota colonization at six months of age: a transitional time point B Raspini, M Vacca, D Porri, R De Giuseppe, FM Calabrese, M Chieppa, ... Frontiers in cellular and infection microbiology 11, 590202 , 2021 2021 Citations: 47
Functional and Therapeutic Potential of Cynara scolymus in Health Benefits C Porro, T Benameur, A Cianciulli, M Vacca, M Chiarini, M De Angelis, ... Nutrients 16 (6), 872 , 2024 2024 Citations: 46
A Bronze-Tomato Enriched Diet Affects the Intestinal Microbiome under Homeostatic and Inflammatory Conditions M Liso, S De Santis, A Scarano, G Verna, M Dicarlo, V Galleggiante, ... Nutrients 10 (12), 1862 , 2018 2018 Citations: 46
The establishment of the gut microbiota in 1-year-aged infants: from birth to family food M Vacca, B Raspini, FM Calabrese, D Porri, R De Giuseppe, M Chieppa, ... European Journal of Nutrition 61 (5), 2517-2530 , 2022 2022 Citations: 43
Selection of Gut-Resistant Bacteria and Construction of Microbial Consortia for Improving Gluten Digestion under Simulated Gastrointestinal Conditions M De Angelis, S Siragusa, M Vacca, R Di Cagno, F Cristofori, M Schwarm, ... Nutrients 13 (3), 992 , 2021 2021 Citations: 43
Ketoanalogs’ effects on intestinal microbiota modulation and uremic toxins serum levels in chronic kidney disease (Medika2 Study) MT Rocchetti, BR Di Iorio, M Vacca, C Cosola, S Marzocco, I di Bari, ... Journal of clinical medicine 10 (4), 840 , 2021 2021 Citations: 42
Advances in understanding the potential therapeutic applications of gut microbiota and probiotic mediated therapies in celiac disease R Francavilla, F Cristofori, M Vacca, M Barone, M De Angelis Expert review of gastroenterology & hepatology 14 (5), 323-333 , 2020 2020 Citations: 40
Wine lees as functional ingredient to produce biscuits fortified with polyphenols and dietary fibre GR Caponio, R Miolla, M Vacca, G Difonzo, M De Angelis LWT 198, 115943 , 2024 2024 Citations: 38
A Comprehensive Review on the Biogenic Amines in Cheeses: Their Origin, Chemical Characteristics, Hazard and Reduction Strategies G Natrella, M Vacca, F Minervini, M Faccia, M De Angelis Foods 13 (16), 2583 , 2024 2024 Citations: 37