Prebiotic Fructooligosaccharides Research Articles

Development of a synbiotic longan beverage: a nutritious and functional blend

Synbiotic foods, which synergistically combine probiotics and prebiotics, have garnered attention for their potential health benefits. In line with this trend, this study aimed to develop a synbiotic beverage using longan fruit as the base and fructo-oligosaccharides (FOS) as the prebiotic source. Two strains of Lactobacillus probiotics, Lactobacillus casei 431 and Lactobacillus plantarum KM001, were used to ferment the longan juice with and without FOS. Total soluble solids, reducing sugar, pH, total acid production, and viable cell count of Lactobacillus microorganisms were evaluated to determine the optimal fermentation duration. The findings indicated that fermenting the juice for 12 hrs at 37°C aligned with the criteria established by the FAO/WHO for probiotic foods. Furthermore, compared to L. casei 431, the longan juice containing FOS fermented with L. plantarum KM001 showed a better survival rate in a simulated gastrointestinal environment. Additionally, the microorganism count in this beverage remained relatively constant throughout its 28-days shelf life at 4°C. These findings underscore the synbiotic longan beverage as a functional drink that combines viable probiotics with prebiotic FOS.

Lactic Acid Bacteria from Northern Thai (Lanna) Fermented Foods: A Promising Source of Probiotics with Applications in Synbiotic Formulation.

Northern Thai culture offers a rich variety of traditional fermented foods beneficial for gastrointestinal health. In this study, we characterized lactic acid bacteria (LAB) from various indigenous fermented foods as potential probiotic candidates and determined their properties for application in commercial synbiotic formulation. Five isolates demonstrating high tolerance to low pH (2.0) and 0.3% bile salts were collected and characterized. These included three strains of Lactiplantibacillus plantarum isolated from nham (NB1, NP2, and NP11) and two strains of Limosilactobacillus fermentum isolated from pla-som (PS4 and PS7). All the selected LAB isolates exhibited γ-hemolytic activity, strong antimicrobial activity, and high resistance to gastric and duodenal digestion conditions. Among the LAB isolates, L. plantarum NB1 demonstrated the highest capacity for adhesion to Caco-2 cells, auto-aggregation, and antioxidant activity, differing significantly (p < 0.05) from the other isolates. Furthermore, the NB1 strain exhibited preferential growth in the presence of commercial prebiotics (fructooligosaccharide, lactose, and inulin) and good survival after lyophilization, which is a desirable characteristic for a powdered ingredient. Therefore, the NB1 strain is a suitable probiotic candidate for applications in synbiotic formulation or as a functional food ingredient.

Electrostatic spraying encapsulation of probiotic-loaded W/O/W emulsion in sodium alginate microspheres to enhance probiotic survival stability

Water-oil-water (W/O/W) double emulsions have been widely studied and applied in probiotic encapsulation. However, challenges remain in enhancing emulsion stability, protecting encapsulated probiotics from adverse environmental conditions, and improving their viability. This study aimed to optimize the functional components of each phase of the W/O/W emulsion to address these issues. First, the prebiotic fructooligosaccharide, which promotes bacterial growth, was incorporated into the inner water phase. The oil phase (O) was composed of sunflower oil, polyglyceryl polyricinoleate, and different proportions of cocoa butter to investigate the critical role of cocoa butter in maintaining emulsion stability. The effect of varying ratios of whey protein isolate and gum arabic complexes in the outermost water phase on emulsion stability was also systematically investigated. Finally, combined with electrostatic spraying technology, sodium alginate was used as the encapsulating wall material for the probiotic-encapsulated emulsion, and the stability of the system during in vitro gastrointestinal digestion was evaluated. This study utilized electrostatic spray technology to create a protective “armor” around the emulsion encapsulating probiotics. The combination of emulsion encapsulation and electrostatic spray encapsulation significantly improved the survival stability of probiotics, providing a method for maintaining high viability in complex food media.

Investigating the effect of synbiotic supplementation on inflammatory indices in critically ill septic children: a protocol study for randomized control trial

BackgroundSepsis, a severe inflammatory response to infection, is a global health priority due to its high mortality and long-term disability rates. Its pathophysiology involves both inflammation and immune suppression. Managing sepsis requires significant healthcare resources and expenditure, with sepsis being a leading cause of hospital costs. Gut microbiotas play a crucial role in sepsis, and probiotics show promise in managing it by restoring microbial balance. Despite advances, targeted therapies for sepsis remain elusive, necessitating innovative approaches such as probiotic therapy.MethodFifty-four eligible patients with sepsis will be randomly assigned to either the synbiotic or placebo group. The synbiotic supplement, KidiLact, comprises ten probiotic strains and prebiotic fructooligosaccharides. Participants will receive two sachets daily for 7 days, mixed with sterile water and administered orally or via gavage. Inflammatory factors including interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) will be evaluated. Anthropometric measurements, nutritional assessment, biochemical analysis, and clinical evaluation will be conducted to assess treatment outcomes. Statistical analysis will be performed to compare results between the two groups, employing SPSS version 19 with a significance level of P < .05.ConclusionThis randomized clinical trial aims to evaluate synbiotic supplementation effects on inflammatory markers and clinical outcomes in pediatric sepsis patients in the pediatric intensive care unit (PICU). Probiotics have shown promise in reducing proinflammatory cytokines like IL-6, TNF-α, and CRP, which are vital in the inflammatory response. Synbiotics can enhance gut integrity, preventing pathogen translocation and reducing inflammation. If our expectations regarding the effects of probiotics are correct, we can use them as a cost-effective supplement to improve the condition of pediatric sepsis in hospitals.Trial registrationIRCT,IRCT20230523058266N1 Registered 30 October 2023, https://irct.behdasht.gov.ir/trial/71397.

Impact of synbiotics on disease activity in systemic lupus erythematosus: Results from a randomized clinical trial.

Systemic lupus erythematosus (SLE) is an autoimmune disease that affects various organs in the body. In SLE, inflammatory cytokines play a crucial role in initiating and sustaining the inflammatory process. Synbiotics may help modulate these inflammatory cytokines. This randomized, double-blind, placebo-controlled clinical trial aimed to assess the impact of synbiotics intervention on interleukin-17A (IL-17A) levels, disease activity, and inflammatory factors in patients with SLE. Fifty SLE patients were randomly assigned to receive either standard therapy plus synbiotics (consisting of Streptococcus thermophilus, Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus rhamnosus, Lactobacillus salivarius, Lactobacillus reuteri, Bifidobacterium lactis, Bifidobacterium longum, Bifidobacterium bifidum, and the prebiotic fructooligosaccharides) or standard therapy alone for 2 months. The results demonstrated a significant reduction in both protein and mRNA levels of IL-17A, as well as in the Systemic Lupus Erythematosus Disease Activity Index 2000 score, within the synbiotics group after the intervention compared to baseline. In contrast, the placebo group did not experience significant changes in IL-17A levels or disease activity. Synbiotic supplementation shows potential as an adjunctive therapeutic approach for SLE management; however, further research is needed to elucidate its underlying mechanisms. PRACTICAL APPLICATION: This study explores the use of synbiotics as a supplementary treatment for systemic lupus erythematosus, which is typically managed with immunosuppressive therapies.

Effects of adding different levels of fructooligosaccharide to diet on productive performance, egg quality traits, immune response and blood metabolites in commercial laying hens.

A prebiotic is defined as an indigestible feed substance that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the large intestine, thereby improving host health and products. This study was conducted to determine the effects of supplementing prebiotic fructooligosaccharide (FOS) to the diets of Hy-Line W-36 laying hens. A total of 168 Hy-Line W-36 laying hens were allocated to four dietary levels of FOS (0, 1.0, 2.0, 3.0g/kg diet), 6 replicates of 7 birds each during 63-74. The experiment was performed using a completely randomized design. Productive performance was not significantly affected by the FOS supplementation. Body weight gain was linearly decreased with increasing FOS levels in the diet (p<0.01). However, eggshell strength, shell thickness and Ca and p percentages were not significantly affected, as were anti-sheep red blood cell titres, blood parameters and blood metabolites. In the first period of the experiment (63-65weeks), shape index and Haugh unit at the dose of 3.0g/kg FOS were significantly increased and decreased in comparison with control, respectively (p<0.05). In the third and fourth periods (69-71 and 72-74 weeks of age), the FOS had no significant effect on the internal egg quality traits. Furthermore, FOS had a linear decrease in the most saturated fatty acids (SFAs), including myristic, palmitic, margaric and stearic fatty acids; some of the mono-un-SFA (MUFA; palmitoleic and ginkgolic acids), and poly-unsaturated fatty acids (γ-linolenic and eicosatrienoic). Supplementing different levels of FOS to the diet of commercial laying hens had no significant effect on the layers' performance, immune response and blood parameters, whereas there was a significant effect on some of the internal egg quality traits and egg yolk fatty acid contents.

Prebiotic saccharides polymerization improves the encapsulation efficiency, stability, bioaccessibility and gut microbiota modulation of urolithin A liposomes

This work was to investigate the effect of four prebiotic saccharides gum arabic (GA), fructooligosaccharide (FOS), konjac glucomannan (KGM), and inulin (INU) incorporation on the encapsulation efficiency (EE), physicochemical stability, and in vitro digestion of urolithin A-loaded liposomes (UroA-LPs). The regulation of liposomes on gut microbiota was also investigated by in vitro colonic fermentation. Results indicated that liposomes coated with GA showed the best EE, bioaccessibility, storage and thermal stability, the bioaccessibility was 1.67 times of that of UroA-LPs. The UroA-LPs coated with FOS showed the best freeze-thaw stability and transformation. Meanwhile, saccharides addition remarkably improved the relative abundance of Bacteroidota, reduced the abundances of Proteobacteria and Actinobacteria. The UroA-LPs coated with FOS, INU, and GA exhibited the highest beneficial bacteria abundance of Parabacteroides, Monoglobus, and Phascolarctobacterium, respectively. FOS could also decrease the abundance of harmful bacteria Collinsella and Enterococcus, and increase the levels of acetic acid, butyric acid and iso-butyric acid. Consequently, prebiotic saccharides can improve the EE, physicochemical stability, gut microbiota regulation of UroA-LPs, and promote the bioaccessibility of UroA, but the efficiency varied based on saccharides types, which can lay a foundation for the application of UroA in foods industry and for the enhancement of its bio-activities.

Effect of Dietary Supplementation of Prebiotic and Acidifier Powder on Growth Performance and Haemato-biochemical Parameters in Broilers

Effect of Dietary Supplementation of Prebiotic and Acidifier Powder on Growth Performance and Haemato-biochemical Parameters in Broilers

Characterization of bioactive porphyran oligosaccharides produced using porphyranase from Bacillus sp. NIOA284

Macroalgae associated bacteria are the major source of polysaccharide hydrolyzing enzymes for efficient bioutilisation of macroalgal biomass. In this study, extracellular porphyranase, PB1 isolated from a macroalgae associated bacterium, Bacillus sp. NIOA284 was purified and characterized for hydrolysis of porphyran into porphyran oligosaccharides. The enzyme, PB1 showed the highest activity at the optimum conditions; the temperature of 35 ºC, pH 7 and 0.4 NaCl with 10 mM CoCl2. The structural characterization of the enzymatically produced POS using NMR spectroscopy and HRMS spectrometry showed that the enzyme acted on porphyran as β-porphyranase and produced di, tri and tetra saccharides. The bioactive potential of POS was determined based on its radical scavenging and prebiotic activity. Results show that POS exhibited higher antioxidant activity than parent porphyran and fructooligosaccharides. It was also capable to proliferate the beneficial gut bacterium Lactobacillus acidophilus and L. bulgaricus, it recorded a prebiotic activity score equivalent to model prebiotic compound fructooligosaccharides. Results show that the enzymatically produced POS has combined antioxidant and prebiotic activity. This highlights the significance of macroalgae associated bacteria as a source of enzymes capable of hydrolyzing polysaccharides into simple bioactive oligosaccharides for efficient management of chronic disorders caused due to oxidative stress.

Innovative application of a novel di-D-fructofuranose 1,2':2,3'-dianhydride hydrolase (DFA-IIIase) from Duffyella gerundensis A4 to burdock root to improve nutrition.

Burdock is native to Europe and Asia and rich in many functional ingredients, including biomacromolecule polysaccharide inulin. The prebiotic fructan inulin can provide energy to organisms via several pathways. One pathway is that inulin fructotransferase (IFTase) first converts inulin to III-type difructose anhydride (DFA-III), which has many beneficial physiological functions. Then, DFA-III is hydrolyzed to inulobiose, which is a Fn-type prebiotic fructo-oligosaccharide, via difructose anhydride hydrolase (DFA-IIIase). However, there has been no study on the application of IFTase or DFA-IIIase to process burdock to increase DFA-III or inulobiose. Moreover, only five DFA-IIIases have been reported to date and all of them are from the Arthrobacter genus. Whether other microbes except for the Arthrobacter genus can utilize DFA-III through DFA-IIIase is unknown. In this work, a DFA-IIIase from Duffyella gerundensis A4 (D. gerundensis A4), abbreviated as DgDFA-IIIase, was identified and characterized in detail. DgDFA-IIIase is a bifunctional enzyme, that is, besides its hydrolytic ability to DFA-III, it has the same catalytic ability as IFTase to inulin. The enzyme was applied to the burdock root aiming at inulin and DFA-III, and inulobiose was produced with an increase in Gn-type fructo-oligosaccharide. The work verifies that microorganisms of the non-Arthrobacter genus also have the potential ability to use DFA-III by DFA-IIIase, and DFA-IIIase is feasible to increase functional substances of burdock root instead of IFTase and endo-inulinase, which paves the way for the production of functional food utilizing the polysaccharide inulin to improve nutrition and health.

Dietary Intake of Fructooligosaccharides Protects against Metabolic Derangements Evoked by Chronic Exposure to Fructose or Galactose in Rats.

Diets rich in fat and sugars evoke chronic low-grade inflammation, leading to metabolic derangements. This study investigates the impact of fructose and galactose, two commonly consumed simple sugars, on exacerbation of the harmful effects caused by high fat intake. Additionally, the potential efficacy of fructooligosaccharides (FOS), a fermentable dietary fiber, in counteracting these effects is examined. Male Sprague-Dawley rats (six/group) are fed 8 weeks as follows: control 5% fat diet (CNT), 20% fat diet (FAT), FAT+10% FOS diet (FAT+FOS), FAT+25% galactose diet (FAT+GAL), FAT+GAL+10% FOS diet (FAT+GAL+FOS), FAT+25% fructose diet (FAT+FRU), FAT+FRU+10% FOS diet (FAT+FRU+FOS). The dietary manipulations tested do not affect body weight gain, blood glucose, or markers of systemic inflammation whereas significant increases in plasma concentrations of triacylglycerols, cholesterol, aspartate aminotransferase, and alanine aminotrasferase are detected in both FAT+FRU and FAT+GAL compared to CNT. In the liver and skeletal muscle, both sugars induce significant accumulation of lipids and advanced glycation end-products (AGEs). FOS supplementation prevents these impairments. This study extends the understanding of the deleterious effects of a chronic intake of simple sugars and demonstrates the beneficial role of the prebiotic FOS in dampening the sugar-induced metabolic impairments by prevention of lipid and AGEs accumulation.

Prebiotics and the Risk of Upper Digestive Tract and Stomach Cancers: The PrebiotiCa Study.

Fiber intake may lower digestive tract cancer risk, possibly by modulating the composition of gut microbiota. However, no data are available about the role of specific fiber fractions with prebiotic activity (e.g., inulin-type fructans (ITFs), fructo-oligosaccharides (FOSs) and galactooligosaccharides (GOSs)) on the risk lower digestive tract cancers. The objective was to assess the association between prebiotic intake and the risk of cancers of the upper digestive tract and stomach. Within the PrebiotiCa study, data were derived from a network of Italian case-control studies conducted between 1992 and 2009. Participants' usual diet was assessed using a food frequency questionnaire. ITFs, and selected FOSs (nystose, kestose, and 1F-β-fructofuranosylnystose) and GOSs (raffinose and stachyose) were quantified in several food products via laboratory analyses. Participants' prebiotic intake was calculated by multiplying food frequency questionnaire intake by the prebiotic content of each food item. Cases were patients admitted to major hospitals with incident histologically confirmed cancers; there were 946 cases of cancer of the oral cavity/pharynx, 198 of the nasopharynx, 304 of the esophagus, 230 of the stomach. More than 4,000 patients admitted to the same hospitals for acute nonneoplastic and not diet-related conditions were selected as control subjects. The outcomes were oral and pharyngeal, nasopharyngeal, esophageal, and stomach cancers. The odds ratios and corresponding 95% CIs of the various cancers were derived using logistic regression models adjusted for major confounders and energy intake. No association was observed between intake of prebiotics and risk of cancers of the oral cavity and pharynx, nasopharynx, and esophagus. High raffinose intake reduced stomach cancer risk (odds ratio for the third vs the first tertile 0.6, 95% CI 0.3 to 0.9); no other prebiotic was associated with stomach cancer. The current study does not support a major role of prebiotic fibers on selected upper digestive tract cancers. The association between high raffinose intake and reduced stomach cancer risk needs further investigation.

Bioactive Compounds, Amino Acids, Fatty Acids, and Prebiotics in the Seed of Mahuad (Lepisanthes rubiginosa (Roxb.) Leenh)

The seeds of Mahuad (Lepisanthes rubiginosa (Roxb.) Leenh (LRL) were analyzed for proximate composition and the contents of phenolic acids, flavonoids, and sugars/oligosaccharides. The LRL seeds contained approximately 29% moisture, 10% protein, 2% fat, 16% fiber, 2% ash, and 42% carbohydrate. The major phenolic acids were vanillic acid and p-hydroxybenzoic acid, accounting for 30% and 26% of total phenolic content, respectively. The predominant flavonoids were quercetin (62% of total flavonoid content) followed by myricetin (22%). Proline, methionine, and arginine were the dominant amino acids, constituting 35%, 19%, and 13% of total amino acid content, respectively. Prebiotic fructooligosaccharide (5.3 mg/g) and stachyose (4.2 mg/g) were also found in the LRL seeds. The major fatty acids were palmitic acid (C 16:0, 41%), oleic acid (C 18:1n9, 27%), and linoleic acid (C 18:2n6, 19%). This information reveals useful information about LRL seeds as a potential source of bioactive compounds for future use in various aspects including food, feeds, pharmaceuticals, and cosmetics.

Effects of Synbiotic Lacticaseibacillus paracasei, Bifidobacterium breve, and Prebiotics on the Growth Stimulation of Beneficial Gut Microbiota.

The gut microbiota is a complex community of microorganisms that plays a vital role in maintaining overall health, and is comprised of Lactobacillus and Bifidobacterium. The probiotic efficacy and safety of Lacticaseibacillus paracasei and Bifidobacterium breve for consumption were confirmed by in vitro experiments. The survival rate of the probiotics showed a significant decline in in vitro gut tract simulation; however, the survival rate was more than 50%. Also, the probiotics could adhere to Caco-2 cell lines by more than 90%, inhibit the pathogenic growths, deconjugate glycocholic acid and taurodeoxycholic acid through activity of bile salt hydrolase (BSH) proteins, and lower cholesterol levels by over 46%. Regarding safety assessment, L. paracasei and B. breve showed susceptibility to some antibiotics but resistance to vancomycin and were examined as γ-hemolytic strains. Anti-inflammatory properties of B. breve with Caco-2 epithelial cell lines showed the significantly highest value (p < 0.05) for interleukin-10. Furthermore, probiotics and prebiotics (inulin, fructooligosaccharides, and galactooligosaccharides) comprise synbiotics, which have potential effects on the increased abundance of beneficial microbiota, but do not affect the growth of harmful bacteria in feces samples. Moreover, the highest concentration of short chain fatty acid was of acetic acid, followed by propionic and butyric acid.

Production of fructooligosaccharide-containing bakery and sweet paste products using invertase.

This study investigated the production of bakery and sweet paste products containing the prebiotic fructooligosaccharide (FOS) using an in situ method with invertase. The FOS formation method was optimized for each product to ensure high quality and appropriate sweetness. The method effectively decreased the sugar content in the final product by 12.7-68.4% while maintaining quality. The FOS content was 3.8-4.8% in castella, 0.6-3.6% in sweet dough bread, and 7.5-8.5% in sweet chickpea paste. By contrast, the commercial method of adding FOS decreased product quality; castella product height decreased by 20.8%, and hardness increased by 79%. The specific volume of the sweet dough bread decreased by 17.4% and hardness increased by 59%. Therefore, we developed a commercially feasible method to efficiently utilize FOS in sugar-containing foods while maintaining their quality.

Fructooligosaccharides and galactooligosaccharides improve hepatic steatosis via gut microbiota-brain axis modulation

Studies have shown that gut dysbiosis is associated with the steatotic liver disease associated with metabolic dysfunction (MALSD) and its severity. This study evaluated the effects of two commercially available prebiotics fructooligosaccharides (FOS) and galactooligosaccharides(GOS) on hepatic adipogenesis, inflammation, and gut microbiota in high-fat diet-induced MALSD. The results indicated that FOS and GOS effectively reduced insulin resistance, hyperglycaemia, triglyceridemia, cholesterolaemia, and IL-1β serum levels. Moreover, FOS and GOS modulated the lipogenic (SREBP-1c, ACC, and FAS) and lipolytic (ATGL) signalling pathways, and reduced inflammatory markers such as p-NFκB-65, IL-6, iNOS, COX-2, TNF-α, IL-1β, and nitrotyrosine. FOS and GOS also enhanced the abundance of acetate producers’ bacteria Bacteroides acidifaciens and Bacteroides dorei. FOS and GOS also induced positive POMC/GPR43 neurons at the arcuate nucleus, indicating hypothalamic signalling modulation. Our results suggest that FOS and GOS attenuated MALSD by reducing the hepatic lipogenic pathways and intestinal permeability through the gut microbiota-brain axis.

Nutritional supplement of FOS enhances growth and immune system in tilapia larvae (Oreochromis niloticus)

Aquaculture is an essential economic activity worldwide, supplying the requirements of various nations. The larval stage is one of the most critical periods during the production cycle in aquaculture. To contribute to amplifying the knowledge related to viable methods to enhance this activity, the present study investigated the effects of prebiotic fructooligosaccharide (FOS) and the synthetic peptide GHRP-6 in the growth of fish, as well as its repercussions on a series of digestive enzyme activities and immune response parameters. Tilapias (Oreochromis niloticus) larvae were divided into three groups: group 1, fed with pre-formulated feed; group 2, fed with feed + FOS; group 3, fed with feed + GHRP-6. We measured the gain in size and weight at 72 and 87 days after starting the diets. At the end of treatment, we continue feeding the animals with a standard diet using the pre-formulated feed. We measured immune system parameters and digestive enzyme activities on larvae homogenate, focusing on lysozyme and antiprotease activity and α-amylase, trypsin and esterase activity, respectively. Results show a significant increment in size and weight in those fish fed with feed + FOS. Meanwhile, the primary enzyme activity was detected in those fish fed with feed + GHRP-6. On rough terms, both food combinations stimulated the immune system. Our study suggests that FOS and GHRP-6 could be desirable additives to incorporate into the tilapia larvae feeding and increase production efficiency. Keywords: aquaculture, digestive enzymes activity, FOS, GHRP-6, immune system, larvae

Energy- and evolution-based design of inulosucrase for enhanced thermostability and inulin production.

Inulosucrase from Lactobacillus reuteri 121 (LrInu) exhibits promise in the synthesis of prebiotic inulin and fructooligosaccharides. However, for its use in industry, LrInu's thermostability is a crucial consideration. In this study, the computational program FireProt was used to predict the thermostable variants of LrInu. Using rational criteria, nine variants were selected for protein expression and characterization. The G237P variant was determined to be the greatest designed candidate due to its greatly enhanced stability and activity in comparison to the wild-type enzyme. The optimum temperature of G237P increased from 50 to 60°C, with an over 5-fold increase in the half-life. Spectroscopy studies revealed that the G237P mutation could prevent the structural change in LrInu caused by heat or urea treatment. Molecular dynamics (MD) simulations showed that the enhanced thermostability of the G237P variant resulted from an increase in structural rigidity and the number of native contacts within the protein molecule. In addition, G237P variant synthesizes inulin with greater efficiency than WT. KEY POINTS: • Thermostable inulosucrase variant(s) were designed by Fireprot server. • G237P variant showed significantly improved thermostability compared to the wild type. • Inulin is synthesized more efficiently by G237P variant.

The Effect of Synbiotic Supplementation on Uremic Toxins, Oxidative Stress, and Inflammation in Hemodialysis Patients-Results of an Uncontrolled Prospective Single-Arm Study.

Introduction: Numerous studies to date have shown that the development of dysbiotic gut microbiota is a characteristic finding in chronic kidney disease (CKD). A number of uremic toxins progressively accumulate in the course of CKD, some of them generated by the intestinal microbiome, such as indoxyl sulfate (IS) and p-cresyl sulfate (p-CS). They are found to be involved in the pathogenesis of certain complications of uremic syndrome, including low-grade chronic inflammation and oxidative stress. The aim of the present study is to research the serum concentration of IS and p-CS in end stage renal disease (ESRD) patients undergoing conventional hemodialysis, as well as to study the possibilities of influencing some markers of inflammation and oxidative stress after taking a synbiotic. Materials and Methods: Thirty patients with end-stage renal disease (ESRD) undergoing hemodialysis treatment who were taking a synbiotic in the form of Lactobacillus acidophilus La-14 2 × 1011 (CFU)/g and prebiotic fructooligosaccharides were included in the study. Serum levels of total IS, total p-CS, Interleukin-6 (IL-6), and Malondialdehyde (MDA) were measured at baseline and after 8 weeks. Results. The baseline values of the four investigated indicators in the patients were significantly higher-p-CS (29.26 ± 58.32 pg/mL), IS (212.89 ± 208.59 ng/mL), IL-6 (13.84 ± 2.02 pg/mL), and MDA (1430.33 ± 583.42 pg/mL), compared to the results obtained after 8 weeks of intake, as we found a significant decrease in the parameters compared to the baseline-p-CS (6.40 ± 0.79 pg/mL, p = 0.041), IS (47.08 ± 3.24 ng/mL, p < 0.001), IL-6 (9.14 ± 1.67 pg/mL, p < 0.001), and MDA (1003.47 ± 518.37 pg/mL, p < 0.001). Conclusions: The current study found that the restoration of the intestinal microbiota in patients with CKD significantly decreases the level of certain uremic toxins. It is likely that this favorably affects certain aspects of CKD, such as persistent low-grade inflammation and oxidative stress.

Effect of Synbiotic Supplementation on Maternal and Neonatal Outcomes in Pregnant Women With Pre-eclampsia: Study Protocol for a Triple Blind Randomized Controlled Clinical Trial

Objectives: Background: Preeclampsia is one of the main causes of premature birth, growth restriction, and intrauterine death of fetus. Probiotics has the potential to modulate inflammatory and oxidative stress biomarkers that implicated in the pathophysiology of preeclampsia. The aim of the present study is to establish the impact of synbiotic supplements, comprising of probiotic and prebiotic fructooligosaccharide, in comparison to placebo, on the maternal and neonatal outcome outcomes in women afflicted with mild preeclampsia. Methods: This is a study protocol of a randomized, controlled, phase 3, triple-blind, randomized clinical trial. The classification is based on the gestational age at the time of diagnosis of mild preeclampsia (early-onset or late-onset preeclampsia). Participants will be 128 pregnant women with mild pre-eclampsia (systolic blood pressure between 140-160 mm Hg or diastolic blood pressure between 90-110 mm Hg, along with other preeclampsia symptoms). Participants will divide into two intervention and control groups using a 1:1 random allocation ratio randomly. They will receive one oral capsule (the concentration of 109 CFU) or placebo daily from admission until delivery. Primary outcomes included mean systolic and diastolic blood pressure, mean gestational age from diagnosis to delivery, and mean birth weight. Also, secondary outcomes included proteinuria, serum creatinine level, the incidence of severe PE, the use of antihypertensive drugs, the rate of natural delivery, incidence of serious complications, maternal blood factors such as platelet count, and serum levels of liver enzymes such as ALT, AST, bilirubin, and LDH. Discussion: The present trial can importantly contribute to the selection of an appropriate Synbiotic supplement as safe pharmaceutical adjuvants in the treatment of pregnant women with mild preeclampsia and prevention of maternal and neonatal complications. Trial Registration: IRCT20110606006709N20. Registered on August 13, 2022.