Prebiotic fructans have greater impact on luminal microbiology and CD3+ T cells in healthy siblings than patients with Crohn’s disease: a pilot study investigating the potential for primary prevention of inflammatory bowel disease

Charlotte R Hedin, Neil E McCarthy, Petra Louis, Freda Farquharson, Sara McCartney, Andrew J Stagg, James O Lindsay, Kevin Whelan* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background & Aims Siblings of people with Crohn’s disease (CD) share aspects of the disease phenotype (raised faecal calprotectin, altered microbiota), which are markers of risk for their own development of CD. The aim was to determine whether supplementation with prebiotic oligofructose/inulin induces a prebiotic response and impacts the risk phenotype in CD patients and siblings.MethodsPatients with inactive CD (n=19, CD activity index <150) and 12 of their unaffected siblings (with calprotectin >50μg/g) ingested oligofructose/inulin (15g/day) for three weeks. Faecal microbiota (qPCR), intestinal permeability (lactulose-rhamnose test), blood T cells (flowcytometry) and calprotectin (ELISA) were measured at baseline and follow-up.ResultsFollowing oligofructose/inulin, calprotectin did not significantly change in patients (baseline mean 537 SD 535µg/g; follow-up mean 974 SD 1318µg/g, p=0.08) or siblings (baseline mean 73 SD 90µg/g: follow up mean 58 SD 72µg/g, p=0.62). Faecal Bifidobacteria and Bifidobacterium longum increased in patients and siblings; Bifidobacterium adolescentis and Roseburia spp. increased only in siblings. Compared with patients, siblings had a greater magnitude change in Bifidobacteria (+14.6% vs +0.4%, p=0.028), B. adolescentis (+1.1% vs 0.0% p=0.006) and Roseburia spp. (+1.5% vs -0.1% p=0.004). Intestinal permeability decreased significantly in patients after oligofructose/inulin to a level that was similar to siblings. Blood T cell abundance reduced in siblings but not patients following oligofructose/inulin.ConclusionsOligofructose/inulin supplementation did not significantly impact calprotectin, but theprebiotic effect was more marked in healthy siblings compared with patients with inactive CD and was associated with alterations in other CD risk markers. Future research should focus on dietary intervention, including with prebiotics, in the primary prevention of CD.
Original languageEnglish
JournalClinical Nutrition
Publication statusAccepted/In press - 1 Jun 2021

Keywords

  • Prebiotics
  • Crohn’s disease
  • microbiota
  • Pre-disease
  • first-degree relative
  • prevention

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