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Efficacy of Lactococcus lactis Strain Plasma in Patients with Mild COVID-19: A Multicenter, Double-Blinded, Randomized-Controlled Trial (PLATEAU Study)

Yamamoto et al., Infectious Diseases and Therapy, doi:10.1007/s40121-025-01246-8, PLATEAU, jRCTs071210097, Oct 2025
https://c19early.org/yamamoto2.html
Recovery 26% improvement lower risk ← → higher risk Viral clearance, relativ.. 62% Probiotics  PLATEAU  EARLY TREATMENT RCT Is early treatment with probiotics beneficial for COVID-19? Double-blind RCT 91 patients in Japan (December 2021 - April 2022) Improved viral clearance with probiotics (not stat. sig., p=0.21) c19early.org Yamamoto et al., Infectious Diseases a.., Oct 2025 0 0.5 1 1.5 2+ RR
Probiotics for COVID-19
19th treatment shown to reduce risk in March 2021, now with p = 0.00000044 from 29 studies.
No treatment is 100% effective. Protocols combine treatments.
6,200+ studies for 180+ treatments. c19early.org
RCT 100 outpatients with mild COVID-19 showing no significant difference in overall symptom severity with Lactococcus lactis strain Plasma (LC-Plasma). However, post hoc analysis revealed a significantly higher proportion of patients without smell and taste disturbances in the LC-Plasma group at later time points (97.8% vs 82.6% on day 13, p=0.030). LC-Plasma showed earlier viral load reduction by day 4 and increased plasmacytoid dendritic cell counts. Authors hypothesize LC-Plasma may suppress neurological damage through pDC activation, facilitating immune response against upper airway symptoms. There were no serious adverse events.
Probiotic efficacy depends on the specific strains used. Specific microbes may decrease or increase COVID-19 risk1.
Standard of Care (SOC) for COVID-19 in the study country, Japan, is very poor with very low average efficacy for approved treatments2. Only expensive, high-profit treatments were approved for early treatment. Low-cost treatments were excluded, reducing the probability of early treatment due to access and cost barriers, and eliminating complementary and synergistic benefits seen with many low-cost treatments.
risk of no recovery, 26.0% lower, RR 0.74, p < 0.001, treatment mean 0.76 (±0.18) n=45, control mean 1.02 (±0.3) n=46, relative total severity score, day 14.
risk of no viral clearance, 61.6% lower, RR 0.38, p = 0.21, treatment mean 27.9 (±29.3) n=45, control mean 10.7 (±87.5) n=46, relative decrease in viral load, mid-recovery, day 4.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Yamamoto et al., 25 Oct 2025, Double Blind Randomized Controlled Trial, placebo-controlled, Japan, peer-reviewed, 29 authors, study period December 2021 - April 2022, trial jRCTs071210097 (PLATEAU). Contact: kazukomd@cs.u-ryukyu.ac.jp.
Efficacy of Lactococcus lactis Strain Plasma in Patients with Mild COVID-19: A Multicenter, Double-Blinded, Randomized-Controlled Trial (PLATEAU Study)
Kazuko Yamamoto, Tsuyoshi Inoue, Takaya Ikeda, Toyomitsu Sawai, Yosuke Nagayoshi, Koji Hashiguchi, Yoji Futsuki, Yuichi Matsubara, Yosuke Harada, Nobuyuki Ashizawa, Susumu Fukahori, Naoki Iwanaga, Takahiro Takazono, Takashi Kido, Hiroshi Ishimoto, Naoki Hosogaya, Noriho Sakamoto, Masato Tashiro, Takeshi Tanaka, Chizu Fukushima, Kenta Jounai, Ryohei Tsuji, Daisuke Fujiwara, Kenji Ota, Kosuke Kosai, Akitsugu Furumoto, Katsunori Yanagihara, Koichi Izumikawa, Hiroshi Mukae
Infectious Diseases and Therapy, doi:10.1007/s40121-025-01246-8
Introduction: Coronavirus disease 2019 , caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is still an ongoing public health threat. COVID-19 can be accompanied by prolonged symptoms, known as "long COVID", however, no pharmaceutical treatments are currently available for these symptoms. Lactococcus lactis strain Plasma (LC-Plasma; Lactococcus lactis subsp. lactis JCM 5805) directly activates human plasmacytoid dendritic cells (pDCs) and triggers antiviral immune responses. We hypothesized that LC-Plasma reduced SARS-CoV-2 viral load and eased symptoms in patients with mild COVID-19. Methods: This PLATEAU study enrolled 100 patients with mild COVID-19 during Omicron
Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
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DOI record: { "DOI": "10.1007/s40121-025-01246-8", "ISSN": [ "2193-8229", "2193-6382" ], "URL": "http://dx.doi.org/10.1007/s40121-025-01246-8", "alternative-id": [ "1246" ], "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "17 August 2025" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "2 October 2025" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "25 October 2025" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Conflict of Interest", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "Kazuko Yamamoto received research funds from Kirin Holdings Co., Ltd. for this study and another research grant from Fisher & Paykel Healthcare Ltd. Tsuyoshi Inoue received research funds from Kirin Holdings Co., Ltd. for this study. It belonged to a donated course from Kyowa Kirin Co., Ltd. Kenta Jounai, Ryohei Tsuji, and Daisuke Fujiwara are employees of Kirin Holdings Co. Ltd. Koichi Izumikawa received a research grant for this study from Kirin Holdings Co., Ltd. Hiroshi Mukae received a research grant from Taisho Pharmaceutical Co. Ltd. All funding agencies, except Kirin Holdings Co., Ltd., played no role in the study design, data collection and analysis, decision to publish, or manuscript preparation. Takaya Ikeda, Toyomitsu Sawai, Yosuke Nagayoshi, Koji Hashiguchi, Yoji Futsuki, Yuichi Matsubara, Yosuke Harada, Nobuyuki Ashizawa, Susumu Fukahori, Naoki Iwanaga, Takahiro Takazono, Takashi Kido, Hiroshi Ishimoto, Naoki Hosogaya, Noriho Sakamoto, Masato Tashiro, Takeshi Tanaka, Chizu Fukushima, Kenji Ota, Kosuke Kosai, Akitsugu Furumoto, and Katsunori Yanagihara declare no conflicts of interest." }, { "group": { "label": "Ethical Approval", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "The study protocols were inspected and approved (approval no. CRB21-009) in November 2021 by the Clinical Research Review Board of Nagasaki University. This study was registered with the Japan Registry of Clinical Trials (jRCT) (registration number: jRCTs071210097) in December 2021. The trial protocol has been described previously [\n \n ]. Patient enrollment was conducted from December 2021 to April 2022. The study was conducted in accordance with the Declaration of Helsinki, Clinical Trials Act, and other current legal regulations in Japan. Written informed consent was obtained from all enrolled patients who met the eligibility criteria before the intervention. 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Please send us corrections, updates, or comments. c19early involves the extraction of 200,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. IMA and WCH provide treatment protocols.
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