Abstract

Background and AimsProbiotics, prebiotics and synbiotics have been suggested as dietary strategies to improve intestinal barrier function. This study aimed to assess the effect of two weeks synbiotic supplementation on intestinal permeability under basal and stressed conditions. Secondary aims were the assessment of two weeks synbiotic supplementation on systemic immune function and gastrointestinal symptoms including defecation pattern.DesignTwenty healthy adults completed a double-blind, controlled, randomized, parallel design study.InterventionGroups either received synbiotic (1.5 × 1010 CFU Ecologic® 825 + 10 g fructo-oligosaccharides (FOS P6) per day) or control supplements for two weeks.OutcomesIntestinal segment specific permeability was assessed non-invasively by oral administration of multiple sugar probes and, subsequently, assessing the excretion of these probes in urine. This test was conducted at baseline and at the end of intervention, in the absence and in the presence of an indomethacin challenge. Indomethacin was applied to induce a compromised gut state. Plasma zonulin, cytokines and chemokines were measured at baseline and at the end of intervention. Gastrointestinal symptoms and stool frequency were recorded at baseline and daily during intervention.ResultsSignificantly more male subjects were in the synbiotic group compared to the control group (P = 0.025). Indomethacin significantly increased urinary lactulose/rhamnose ratio versus without indomethacin, both in the control group (P = 0.005) and in the synbiotic group (P = 0.017). Urinary sugar recoveries and ratios, plasma levels of zonulin, cytokines and chemokines, and gastrointestinal symptom scores were not significantly different after control or synbiotic intervention. Stool frequency within the synbiotic group was significantly increased during synbiotic intervention compared to baseline (P = 0.039) and higher compared to control intervention (P = 0.045).ConclusionTwo weeks Ecologic® 825/FOS P6 supplementation increased stool frequency, but did not affect intestinal permeability neither under basal nor under indomethacin-induced stressed conditions, immune function or gastrointestinal symptoms in healthy adults.

Highlights

  • Epithelium integrity of the gastrointestinal tract is pivotal for maintainance of the intestinal barrier

  • More male subjects were in the synbiotic group compared to the control group (P = 0.025)

  • Stool frequency within the synbiotic group was significantly increased during synbiotic intervention compared to baseline (P = 0.039) and higher compared to control intervention (P = 0.045)

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Summary

Introduction

Epithelium integrity of the gastrointestinal tract is pivotal for maintainance of the intestinal barrier. Patients with intestinal diseases such as inflammatory bowel disease (IBD) [1,2] or celiac disease [3,4] show increased intestinal permeability It is not clear whether increased intestinal permeability is a causal factor or a consequence of intestinal disorders, in a subset of relatives of symptom-free IBD patients intestinal permeability was found to be increased [5]. These subjects have a significantly inceased risk to develop IBD, suggesting that changes in intestinal permeability precede the development of intestinal disease. Secondary aims were the assessment of two weeks synbiotic supplementation on systemic immune function and gastrointestinal symptoms including defecation pattern.

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