Prebiotic May Help Patients With Intestinal Failure Grow New and Better Gut

Fructooligosaccharides (FOS)

Adding the right prebiotic to the diets of pediatric patients with intestinal failure could replace intravenous feeding, says a new University of Illinois study.

“When we fed the carbohydrate fructooligosacharide (FOS) as a prebiotic, the gut grew and increased in function,” said Kelly A. Tappenden, a U of I professor of nutrition and gastrointestinal physiology. “The study showed that using the correct pre- and probiotic in combination could enhance these results even more.”

When FOS enters the intestines, bacteria convert it into butyrate, a short-chain fatty acid that increases the size of the gut and its ability to digest and absorb nutrients, she said.

But today’s IV solutions don’t contain butyrate and adding it would entail drug development trials and regulatory red tape. She wanted to see if adding this carbohydrate to the diet while continuing to provide most nutrients intravenously would cause the gut to start producing butyrate on its own. It worked.

According to Tappenden, at least 10,000 U.S. patients are totally reliant on intravenous feeding because their intestines have been surgically shortened.

Many of these patients are premature infants who develop necrotizing enterocolitis, a kind of gangrene of the intestine. In the U.S., one in eight infants is a preemie, and removing necrotized, or dead, intestine is the most common surgical emergency in these babies.

“Surgery saves their lives, but with so much intestine removed, they’re unable to digest or absorb nutrients. These babies are also at risk for long-term complications, such as bone demineralization and liver failure. Our goal is to take kids who’ve had this resection and cause their gut to grow and adapt,” she said.

She tested her hypothesis about butyrate using newborn piglets, an excellent model for the human infant in metabolism and physiology. Piglets with intestinal failure were assigned to one of four groups: a control group; a group whose diet contained FOS, a carbohydrate given as a prebiotic to stimulate the production of butyrate by beneficial bacteria; a probiotic, or actual live bacteria; and a combination of pre- and probiotics.

“We believed that bacteria in the gut would use the prebiotic to make butyrate and support intestinal growth. But we thought that might only happen in the group that received both pre- and probiotics because we didn’t know if the newborn gut would have enough bacteria to make this important short-chain fatty acid.”

Actually, the neonatal piglets did have enough bacteria in their guts, and the prebiotic alone was effective in increasing intestinal function and structure, she said.

“In fact, the probiotic that we used in one of the groups eliminated the beneficial effect of the prebiotic. That shows us that we need to be exceptionally careful in selecting the probiotic we use, matching it to the specific disease,” she noted. Many consumers believe all probiotics are equal, but the effect of specific bacterial strains is different, she said.

“At this point, we can only recommend consumption of the FOS prebiotic alone,” she added.

 

Reference 

Barnes JL, Hartmann B, Holst JJ, Tappenden KA. Intestinal adaptation is stimulated by partial enteral nutrition supplemented with the prebiotic short-chain fructooligosaccharide in a neonatal intestinal failure piglet model. JPEN J Parenter Enteral Nutr 2012; 36 (5):  524-37.

Researchers Show Prebiotic Can Reduce Severity of Colitis

MSU food science and human nutrition researcher Jenifer Fenton

Researchers at Michigan State University have shown a prebiotic may help the body’s own natural killer cells fight bacterial infection and reduce inflammation, greatly decreasing the risk of colon cancer.

Prebiotics are fiber supplements that serve as food for the trillions of tiny bacteria living in the gut. When taken, they can stimulate the growth of the “good” bacteria. The evolution of prebiotic supplements (as well as probiotics, which are actual bacteria ingested into the system) provide new therapeutic targets for researchers and physicians.

In research published in the Journal of Nutrition, MSU’s Jenifer Fenton reports that mice given the prebiotic galacto-oligosaccharide, or GOS, saw the severity of their colitis (one of the main forms of inflammatory bowel disease) significantly reduced.

In fact, the mice fed GOS – a synthetic compound that is known to stimulate beneficial bacteria and is found in foods such as biscuits and infant formula – saw a 50 percent reduction in colitis.

Research has shown certain types of foods and fibers can reduce colon cancer risk, said Fenton of the Department of Food Science and Human Nutrition.

“There is something unique about certain types of fibers, such as GOS, and how they alter cells and influence the immune system to change disease risk, either for the good or bad,” she said. “Our overall goal is to identify either dietary patterns or diet components to reduce inflammation and cancer risk.

“In this case, we used prebiotics to stimulate changes in bacteria in the gut that may have a beneficial impact on the colon.”

Fenton worked closely on the project with Elizabeth Gardner, also with the Department of Food Science and Human Nutrition and who previously has looked at the impact diet plays in fighting off the flu. In applying some of the lessons learned in those studies to mice with bacterially induced colitis, the researchers found mice given GOS had significantly less inflammation and fewer abnormal cells, two precursors for colon cancer.

It appeared, Fenton said, the positive results were linked to the significant enhancement of the body’s own natural killer cells, found in the immune system and crucial in fighting off new infections in the body.

“Our results suggest GOS may be effective in reducing colitis severity by priming the innate immune system,” she said.

The next step is to verify how that mechanism works; finding that link could help researchers apply the lessons learned to other intestinal ailments.

 

References

Gopalakrishnan A, Clinthorne JF, Rondini EA, McCaskey SJ, Gurzell EA, Langohr IM, Gardner EM, Fenton JI. Supplementation with Galacto-Oligosaccharides Increases the Percentage of NK Cells and Reduces Colitis Severity in Smad3-Deficient Mice. 2012 Apr 11. [Epub ahead of print]

Department of Food Science & Human Nutrition, Michigan State University (06.06.2012)