Abstract
Abnormalities in the intestinal barrier are a possible cause of celiac disease (CD) development. In animal studies, the positive effect of prebiotics on the improvement of gut barrier parameters has been observed, but the results of human studies to date remain inconsistent. Therefore, this study aimed to evaluate the effect of twelve-week supplementation of a gluten-free diet (GFD) with prebiotic oligofructose-enriched inulin (10 g per day) on the intestinal permeability in children with CD treated with a GFD. A pilot, randomized, placebo-controlled nutritional intervention was conducted in 34 children with CD, being on a strict GFD. Sugar absorption test (SAT) and the concentrations of intestinal permeability markers, such as zonulin, intestinal fatty acid-binding protein, claudin-3, calprotectin, and glucagon-like peptide-2, were measured. We found that the supplementation with prebiotic did not have a substantial effect on barrier integrity. Prebiotic intake increased excretion of mannitol, which may suggest an increase in the epithelial surface. Most children in our study seem to have normal values for intestinal permeability tests before the intervention. For individuals with elevated values, improvement in calprotectin and SAT was observed after the prebiotic intake. This preliminary study suggests that prebiotics may have an impact on the intestinal barrier, but it requires confirmation in studies with more subjects with ongoing leaky gut.
Highlights
The intestinal barrier is a complex structure which separates the external environment from the internal milieu of the human body
Our results are in agreement with the results reported by Ho et al [43], who reported a lack of effect of prebiotic supplementation on intestinal permeability assessed by sugar absorption test (SAT) in children with type 1 diabetes
For the first time, described the effect of oligofructose-enriched inulin on the intestinal permeability in children with celiac disease (CD) treated with a gluten-free diet (GFD)
Summary
The intestinal barrier is a complex structure which separates the external environment from the internal milieu of the human body. This physical, selective barrier allows for the passage of essential ions, water, nutrients, and immune mediators, and, at the same time, strongly restricts the transport of potentially harmful microbes and antigens. The intestinal barrier plays a pivotal role in human body homeostasis, being responsible for digestion, absorption, and motility, as well as endocrine and immunological functions, of the intestinal tract [1]. The epithelium of small intestine is a monolayer containing different specialized cells, such as enterocytes, goblet cells, Paneth cells, endocrine cells, and intestinal stem cells, which are sealed. Intestinal epithelial cells are in constant turnover, renewing and replacing all the cells in a few days [3], and the functioning of the barrier restores itself even after short periods of ischemia [4]
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