Consistent Prebiotic Effect on Gut Microbiota With Altered FODMAP Intake in Patients with Crohn's Disease: A Randomised, Controlled Cross-Over Trial of Well-Defined Diets.
Consistent Prebiotic Effect on Gut Microbiota With Altered FODMAP Intake in Patients with Crohn's Disease: A Randomised, Controlled Cross-Over Trial of Well-Defined Diets.
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DOI：
10.1038/ctg.2016.22
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发表时间：
2016-04-14
影响因子：
3.6
通讯作者：
Gibson PR
中科院分区：
文献类型：
--
作者：
Halmos EP;Christophersen CT;Bird AR;Shepherd SJ;Muir JG;Gibson PR
改变FODMAP（可发酵低聚糖、双糖、单糖和多元醇）的摄入对肠道微生物群有实质性影响。本研究旨在探讨改变FODMAP摄入量对克罗恩病患者结肠健康指标的影响。在对他们的习惯饮食进行评估后，9名临床静止的克罗恩病患者被随机分配到21天的低或典型（“澳大利亚”）FODMAP饮食中，中间有≥21天的洗脱期。在每次日粮结束时收集5天的粪便样本，分析钙保护蛋白、pH、短链脂肪酸（SCFA）和细菌丰度。每天记录胃肠道症状。八名参与者收集粪便并坚持饮食。FODMAP摄入量在低<习惯<澳洲饮食的三个饮食期有所不同。SCFA、pH和总细菌丰度保持不变，但与低FODMAP饲粮相比，澳大利亚产丁酸梭菌群XIVa （P=0.008）和与粘液相关的Akkermansia muciniphila （P=0.016）的相对丰度较高，而Ruminococcus torques的相对丰度较低（P=0.034）。习惯饮食组的结果与低FODMAP干预组相似，但与澳大利亚饮食组有显著差异。饮食对钙保护蛋白没有影响，但澳大利亚饮食的症状严重程度增加了一倍（n=9； P<0.001）。在临床静止的克罗恩病中，改变饮食中FODMAP的摄入量与粪便微生物群的显著变化有关，这与在肠易激/健康队列中显示的增加FODMAP的益生元效应最一致。这种策略可能有利于克罗恩病患者的肠道健康，但代价是诱发症状。
Altering FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) intake has substantial effects on gut microbiota. This study aimed to investigate effects of altering FODMAP intake on markers of colonic health in patients with Crohn's disease. After evaluation of their habitual diet, 9 patients with clinically quiescent Crohn's disease were randomised to 21 days of provided low or typical (“Australian”) FODMAP diets with ≥21-day washout in between. Five-day fecal samples were collected at the end of each diet and analyzed for calprotectin, pH, short-chain fatty acids (SCFA) and bacterial abundance. Gastrointestinal symptoms were recorded daily. Eight participants collected feces and were adherent to the diets. FODMAP intake differed across the three dietary periods with low<habitual<Australian diet. SCFA, pH and total bacterial abundance remained unaltered, but relative abundance was higher for butyrate-producing Clostridium cluster XIVa (P=0.008) and mucus-associated Akkermansia muciniphila (P=0.016), and lower for Ruminococcus torques (P=0.034) during the Australian compared with low FODMAP diet. Results during habitual diet were similar to the low FODMAP intervention, but significantly different to the Australian diet. The diets had no effects on calprotectin, but symptoms doubled in severity with the Australian diet (n=9; P<0.001). In clinically quiescent Crohn's disease, altering dietary FODMAP intake is associated with marked changes in fecal microbiota, most consistent with a prebiotic effect of increasing FODMAPs as shown in an irritable bowel/healthy cohort. This strategy might be favorable for gut health in Crohn's disease, but at the cost of inducing symptoms.