Randomised clinical trial: gut microbiome biomarkers are associated with clinical response to a low <scp>FODMAP</scp> diet in children with the irritable bowel syndrome
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- B. P. Chumpitazi
- Department of Pediatrics Baylor College of Medicine Houston TX USA
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- J. L. Cope
- Department of Pathology & Immunology Baylor College of Medicine Houston TX USA
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- E. B. Hollister
- Department of Pathology & Immunology Baylor College of Medicine Houston TX USA
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- C. M. Tsai
- Department of Pediatrics Baylor College of Medicine Houston TX USA
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- A. R. McMeans
- Children's Nutrition Research Center Houston TX USA
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- R. A. Luna
- Department of Pathology & Immunology Baylor College of Medicine Houston TX USA
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- J. Versalovic
- Department of Pathology & Immunology Baylor College of Medicine Houston TX USA
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- R. J. Shulman
- Department of Pediatrics Baylor College of Medicine Houston TX USA
Description
<jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>A low fermentable oligosaccharides, disaccharides, monosaccharides and polyols (<jats:styled-content style="fixed-case">FODMAP</jats:styled-content>) diet can ameliorate symptoms in adult irritable bowel syndrome (<jats:styled-content style="fixed-case">IBS</jats:styled-content>) within 48 h.</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>To determine the efficacy of a low <jats:styled-content style="fixed-case">FODMAP</jats:styled-content> diet in childhood <jats:styled-content style="fixed-case">IBS</jats:styled-content> and whether gut microbial composition and/or metabolic capacity are associated with its efficacy.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>In a double‐blind, crossover trial, children with Rome <jats:styled-content style="fixed-case">III IBS</jats:styled-content> completed a 1‐week baseline period. They then were randomised to a low <jats:styled-content style="fixed-case">FODMAP</jats:styled-content> diet or typical American childhood diet (<jats:styled-content style="fixed-case">TACD</jats:styled-content>), followed by a 5‐day washout period before crossing over to the other diet. <jats:styled-content style="fixed-case">GI</jats:styled-content> symptoms were assessed with abdominal pain frequency being the primary outcome. Baseline gut microbial composition (16S <jats:styled-content style="fixed-case">rRNA</jats:styled-content> sequencing) and metabolic capacity (<jats:styled-content style="fixed-case">PICRUS</jats:styled-content>t) were determined. Metagenomic biomarker discovery (<jats:styled-content style="fixed-case">LE</jats:styled-content>fSe) compared Responders (≥50% decrease in abdominal pain frequency on low <jats:styled-content style="fixed-case">FODMAP</jats:styled-content> diet only) vs. Nonresponders (no improvement during either intervention).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Thirty‐three children completed the study. Less abdominal pain occurred during the low <jats:styled-content style="fixed-case">FODMAP</jats:styled-content> diet vs. <jats:styled-content style="fixed-case">TACD</jats:styled-content> [1.1 ± 0.2 (<jats:styled-content style="fixed-case">SEM</jats:styled-content>) episodes/day vs. 1.7 ± 0.4, <jats:italic>P</jats:italic> < 0.05]. Compared to baseline (1.4 ± 0.2), children had fewer daily abdominal pain episodes during the low <jats:styled-content style="fixed-case">FODMAP</jats:styled-content> diet (<jats:italic>P</jats:italic> < 0.01) but more episodes during the <jats:styled-content style="fixed-case">TACD</jats:styled-content> (<jats:italic>P</jats:italic> < 0.01). Responders were enriched at baseline in taxa with known greater saccharolytic metabolic capacity (e.g. <jats:italic>Bacteroides</jats:italic>,<jats:italic> Ruminococcaceae</jats:italic>,<jats:italic> Faecalibacterium prausnitzii</jats:italic>) and three Kyoto Encyclopedia of Genes and Genomes orthologues, of which two relate to carbohydrate metabolism.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>In childhood <jats:styled-content style="fixed-case">IBS</jats:styled-content>, a low <jats:styled-content style="fixed-case">FODMAP</jats:styled-content> diet decreases abdominal pain frequency. Gut microbiome biomarkers may be associated with low <jats:styled-content style="fixed-case">FODMAP</jats:styled-content> diet efficacy.</jats:p><jats:p><jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="http://ClinicalTrials.gov">ClinicalTrials.gov</jats:ext-link> identifier: <jats:styled-content style="fixed-case">NCT</jats:styled-content>01339117.</jats:p></jats:sec>
Journal
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- Alimentary Pharmacology & Therapeutics
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Alimentary Pharmacology & Therapeutics 42 (4), 418-427, 2015-06-24
Wiley
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Details 詳細情報について
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- CRID
- 1364233269045567872
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- ISSN
- 13652036
- 02692813
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- Data Source
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- Crossref