| Title: | Prebiotic fructans have greater impact on luminal microbiology and CD3+ T cells in healthy siblings than patients with Crohn's disease: A pilot study investigating the potential for primary prevention of inflammatory bowel disease |
| Author(s): | Hedin CR; McCarthy NE; Louis P; Farquharson FM; McCartney S; Stagg AJ; Lindsay JO; Whelan K; |
| Address: | "King's College London, Department of Nutritional Sciences, London, UK; Queen Mary University of London, Blizard Institute, Centre for Immunobiology, London, UK. Queen Mary University of London, Blizard Institute, Centre for Immunobiology, London, UK. Rowett Institute, University of Aberdeen, Microbiology Group, Gut Health Theme, Aberdeen, UK. University College Hospitals NHS Foundation Trust, Department for Gastroenterology and Clinical Nutrition, London, UK. Queen Mary University of London, Blizard Institute, Centre for Immunobiology, London, UK; Barts Health NHS Trust, Royal London Hospital, Department of Gastroenterology, London, UK. King's College London, Department of Nutritional Sciences, London, UK. Electronic address: kevin.whelan@kcl.ac.uk" |
| DOI: | 10.1016/j.clnu.2021.05.033 |
| ISSN/ISBN: | 1532-1983 (Electronic) 0261-5614 (Linking) |
| Abstract: | "BACKGROUND & AIMS: Siblings of people with Crohn's disease (CD) share aspects of the disease phenotype (raised faecal calprotectin, altered microbiota), which are markers of risk for their own development of CD. The aim was to determine whether supplementation with prebiotic oligofructose/inulin induces a prebiotic response and impacts the risk phenotype in CD patients and siblings. METHODS: Patients with inactive CD (n = 19, CD activity index <150) and 12 of their unaffected siblings (with calprotectin >50 mug/g) ingested oligofructose/inulin (15 g/day) for three weeks. Faecal microbiota (qPCR), intestinal permeability (lactulose-rhamnose test), blood T cells (flow-cytometry) and calprotectin (ELISA) were measured at baseline and follow-up. RESULTS: Following oligofructose/inulin, calprotectin did not significantly change in patients (baseline mean 537 SD 535 mug/g; follow-up mean 974 SD 1318 mug/g, p = 0.08) or siblings (baseline mean 73 SD 90 mug/g: follow up mean 58 SD 72 mug/g, p = 0.62). Faecal Bifidobacteria and Bifidobacterium longum increased in patients and siblings; Bifidobacterium adolescentis and Roseburia spp. increased only in siblings. Compared with patients, siblings had a greater magnitude change in Bifidobacteria (+14.6% vs +0.4%, p = 0.028), B. adolescentis (+1.1% vs 0.0% p = 0.006) and Roseburia spp. (+1.5% vs -0.1% p = 0.004). Intestinal permeability decreased significantly in patients after oligofructose/inulin to a level that was similar to siblings. Blood T cell abundance reduced in siblings but not patients following oligofructose/inulin. CONCLUSIONS: Oligofructose/inulin supplementation did not significantly impact calprotectin, but the prebiotic effect was more marked in healthy siblings compared with patients with inactive CD and was associated with alterations in other CD risk markers. Future research should focus on dietary intervention, including with prebiotics, in the primary prevention of CD" |
| Keywords: | Adolescent Adult Crohn Disease/*microbiology/*prevention & control Feces/chemistry/microbiology Female Flow Cytometry Fructans/*administration & dosage Healthy Volunteers Humans Intestines/microbiology Inulin/administration & dosage Leukocyte L1 Antigen C; |
| Notes: | "MedlineHedin, Charlotte R McCarthy, Neil E Louis, Petra Farquharson, Freda M McCartney, Sara Stagg, Andrew J Lindsay, James O Whelan, Kevin eng Clinical Trial Research Support, Non-U.S. Gov't England 2021/08/08 Clin Nutr. 2021 Aug; 40(8):5009-5019. doi: 10.1016/j.clnu.2021.05.033. Epub 2021 Jun 23" |
