Prebiotic inulin causes ‘beneficial changes’ in microbiome of children with IBD
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Key takeaways:
- Supplementation with inulin altered the fecal and mucosal microbiome in children with IBD as early as week 4.
- Beta-fructofuranosidase and butyrate increased 2 months after inulin discontinuation.
LAS VEGAS — Supplementation with prebiotic oligofructose-enriched inulin resulted in short-term microbiome changes as early as 4 weeks among children with inflammatory bowel disease, according to a presenter at Crohn’s & Colitis Congress.
“We know that diet is one of the key players in the normal gut microenvironment and one of the more obvious factors linking the impact of industrialization with the worldwide increased incidence of IBD,” Jessica Breton, MD, MSTR, a pediatric gastroenterologist at the Children’s Hospital of Philadelphia, told Healio. “One interesting group of dietary factors that links microbiota to gut health is dietary fibers. Evidence has been mounting in the last decade in support of the importance of fibers and their fermentation products, including butyrate, in IBD.”
Image: Healio
Breton continued: “We hypothesized that prebiotic inulin supplementation will benefit children with IBD by increasing the abundance of protective [ short-chain fatty acid]-producing bacteria and their metabolites, resulting in a decrease in gut inflammation.”
In a single-center, double-blind, placebo-controlled trial at the Children’s Hospital of Philadelphia, Breton and colleagues randomly assigned 68 children with subclinical active colonic IBD 1:1 to consume prebiotic oligofructose-enriched inulin (OI) or maltodextrin placebo for 8 weeks. Of those, 59 were part of the efficacy analyses.
Researchers obtained fecal and rectal swab samples at baseline and weeks 4, 8 and 16 for calprotectin, microbiome profiling and matching metabolomics.
“Inulin supplementation induced selective shifts in both fecal and mucosal microbiome composition that were observed as early as week 4 — that is, halfway through the intervention period,” Breton told Healio. “Specifically, we saw a strong bifidogenic effect with an increase in relative abundance of Bifidobacterium, but also an increase in butyrate-producer Anaerostipes. This effect was transient, with return to baseline following prebiotic discontinuation.”
Breton noted there were additional insulin shifts observed in other microbial taxa, including “a decrease in Bacteroides, Porphyromonas and Prevotella, which may be clinically relevant as pathobionts.”
Although fecal metabolite profiles remained unchanged during the 8-week intervention, at week 16 — 2 months after discontinuation of inulin — researchers reported an increase in beta-fructofuranosidase, an essential enzyme in inulin fermentation, coupled with a rise in butyrate.
“This finding is very interesting, as it appears that the functional impact of prebiotic is delayed with respect to change in microbiome composition,” Breton said.
Further, microbiome shifts during inulin consumption were associated with a change in intestinal inflammation, with researchers noting a negative correlation between calprotectin levels and relative abundance of Bifidobacterium and Anaerostipes.
“These results open new perspectives for development of microbiome-targeted dietary interventions in pediatric IBD, showing inulin as a potential tool in preventing relapse in children with subclinical disease activity,” Breton told Healio.
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Breton J, et al. The modulatory effects of oligofructose-enriched inulin on the microbiome profile of children with inflammatory bowel disease: A double-blind randomized controlled trial. Presented at: Crohn’s & Colitis Congress; Jan. 25-27, 2024; Las Vegas.
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