Resistant starch type-2 enriched cookies modulate uremic toxins and inflammation in hemodialysis patients: a randomized, double-blind, crossover and placebo-controlled trial

2020 ◽  
Vol 11 (3) ◽  
pp. 2617-2625 ◽  
Author(s):  
Marta Esgalhado ◽  
Julie Ann Kemp ◽  
Bruna R. de Paiva ◽  
Jessyca Sousa Brito ◽  
Ludmila F. M. F. Cardozo ◽  
...  
Keyword(s):  
Transcription Factors ◽  
Gut Microbiota ◽  
Mrna Expression ◽  
Resistant Starch ◽  
Controlled Trial ◽  
Hemodialysis Patients ◽  
Uremic Toxins ◽  
Double Blind

The study evaluated the effect of resistant starch enriched cookies supplementation on the mRNA expression of nuclear transcription factors involved with inflammation and uremic toxins levels produced by the gut microbiota in hemodialysis patients.

Could resistant starch supplementation improve inflammatory and oxidative stress biomarkers and uremic toxins levels in hemodialysis patients? A pilot randomized controlled trial

2018 ◽  
Vol 9 (12) ◽  
pp. 6508-6516 ◽  
Author(s):  
Marta Esgalhado ◽  
Julie A. Kemp ◽  
Renata Azevedo ◽  
Bruna R. Paiva ◽  
Milena B. Stockler-Pinto ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Resistant Starch ◽  
Controlled Trial ◽  
Hemodialysis Patients ◽  
Uremic Toxins ◽  
Oxidative Stress Biomarkers ◽  
Randomized Controlled ◽  
Stress Biomarkers ◽  
And Oxidative Stress ◽  
Pilot Randomized Controlled Trial

Prebiotic-resistant starch supplementation may be a good strategy to reduce inflammation, oxidative stress and uremic toxins in CKD patients.

scholarly journals Resistant Starch Type 2 from Wheat Reduces Postprandial Glycemic Response with Concurrent Alterations in Gut Microbiota Composition

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 645
Author(s):  
Riley L. Hughes ◽  
William H. Horn ◽  
Peter Finnegan ◽  
John W. Newman ◽  
Maria L. Marco ◽  
...  
Keyword(s):  
Gut Microbiota ◽  
Resistant Starch ◽  
Postprandial Glucose ◽  
Glycemic Response ◽  
Microbial Composition ◽  
Double Blind ◽  
Important Indicator ◽  
Distal Intestine ◽  
Standard Breakfast

The majority of research on the physiological effects of dietary resistant starch type 2 (RS2) has focused on sources derived from high-amylose maize. In this study, we conduct a double-blind, randomized, placebo-controlled, crossover trial investigating the effects of RS2 from wheat on glycemic response, an important indicator of metabolic health, and the gut microbiota. Overall, consumption of RS2-enriched wheat rolls for one week resulted in reduced postprandial glucose and insulin responses relative to conventional wheat when participants were provided with a standard breakfast meal containing the respective treatment rolls (RS2-enriched or conventional wheat). This was accompanied by an increase in the proportions of bacterial taxa Ruminococcus and Gemmiger in the fecal contents, reflecting the composition in the distal intestine. Additionally, fasting breath hydrogen and methane were increased during RS2-enriched wheat consumption. However, although changes in fecal short-chain fatty acid (SCFA) concentrations were not significant between control and RS-enriched wheat roll consumption, butyrate and total SCFAs were positively correlated with relative abundance of Faecalibacterium, Ruminoccocus, Roseburia, and Barnesiellaceae. These effects show that RS2-enriched wheat consumption results in a reduction in postprandial glycemia, altered gut microbial composition, and increased fermentation activity relative to wild-type wheat.

scholarly journals Resistant starch supplementation effects on plasma indole 3-acetic acid and aryl hydrocarbon receptor mRNA expression in hemodialysis patients: Randomized, double blind and controlled clinical trial

2020 ◽  
Vol 42 (3) ◽  
pp. 273-279
Author(s):  
Renata Azevedo ◽  
Marta Esgalhado ◽  
Julie Ann Kemp ◽  
Bruna Regis ◽  
Ludmila FMF Cardozo ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Acetic Acid ◽  
Gut Microbiota ◽  
Mrna Expression ◽  
Resistant Starch ◽  
Plasma Levels ◽  
Controlled Clinical Trial ◽  
Double Blind ◽  
Aryl Hydrocarbon ◽  
Indole 3 Acetic Acid

ABSTRACT Introduction: Gut microbiota imbalance is linked to high uremic toxins production such as indole-3-acetic acid (IAA) in chronic kidney disease patients. This toxin can activate the aryl hydrocarbon receptor (AhR), a ligand-activated transcription factor involved with inflammation. Strategies to restore gut microbiota balance can be associated with reduced production of IAA and its deleterious effects. This study aimed to evaluate prebiotic resistant starch (RS) supplementation effects on IAA plasma levels and AhR mRNA expression in CKD patients on hemodialysis (HD). Methods: This randomized, double-blind and placebo-controlled clinical trial evaluated forty-two stable HD patients allocated in RS (n=22) or placebo (n=20) groups. Patients received, alternately, cookies and sachets containing 16 g/day of RS (Hi-Maize 260®) or manioc flour for four weeks. Fasting pre-dialysis blood samples were collected and IAA plasma levels measured by high performance liquid chromatography. Peripheral blood mononuclear cells were isolated and processed for AhR and nuclear factor kappa B (NF-κB) mRNA expression analyzes by quantitative real-time PCR. Anthropometric and biochemical parameters, as well as food intake were also evaluated. Results: Thirty-one patients completed the study, 15 in the RS group and 16 in the placebo group. Although there was no significant alteration in IAA plasma levels, neither in AhR mRNA expression and NF-κB mRNA expression after RS supplementation, a positive correlation (r=0.48; p=0.03) was observed between IAA plasma levels and AhR expression at baseline. Conclusion: Even though prebiotic RS supplementation did not influence IAA levels or AhR expression, their positive association reinforces a possible interaction between them.

The Impact of Enriched Resistant Starch Type‐2 Cookies on the Gut Microbiome in Hemodialysis Patients: A Randomized Controlled Trial

2021 ◽  
pp. 2100374
Author(s):  
Julie Ann Kemp ◽  
Bruna Regis Paiva ◽  
Henrique Fragoso dos Santos ◽  
Hugo Emiliano Jesus ◽  
Hannah Craven ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Gut Microbiome ◽  
Resistant Starch ◽  
Controlled Trial ◽  
Hemodialysis Patients ◽  
Randomized Controlled ◽  
The Impact

Uremic toxins levels from the gut microbiota seem not to be altered by physical exercise in hemodialysis patients

2021 ◽  
Author(s):  
Jessyca Sousa de Brito ◽  
Drielly Vargas ◽  
Greicielle Santos da Silva ◽  
Sandra Marinho ◽  
Natália Alvarenga Borges ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Gut Microbiota ◽  
Hemodialysis Patients ◽  
Uremic Toxins

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial of Nalbuphine ER Tablets for Uremic Pruritus

2017 ◽  
Vol 46 (6) ◽  
pp. 450-458 ◽  
Author(s):  
Vandana S. Mathur ◽  
Jayant Kumar ◽  
Paul W. Crawford ◽  
Howard Hait ◽  
Thomas Sciascia ◽  
...  
Keyword(s):  
Rating Scale ◽  
Numerical Rating Scale ◽  
Controlled Trial ◽  
Hemodialysis Patients ◽  
Opioid Antagonist ◽  
Opioid Agonist ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Uremic Pruritus ◽  
The Mean

Background: Pruritus is a distressing hallmark of the uremic condition, affecting approximately 60% of hemodialysis patients. Abnormal endogenous opioid ligand activity at μ and κ-opioid receptors has been postulated as a mechanism in uremic pruritus. Nalbuphine is a μ-opioid antagonist and κ-opioid agonist. Methods: In this multicenter, randomized, double-blind, placebo-controlled trial, 373 hemodialysis patients with moderate or severe uremic pruritus were randomized in a 1: 1:1 ratio to nalbuphine extended-release tablets 120 mg (NAL 120), 60 mg (NAL 60), or placebo and treated for 8 weeks. Three hundred seventy-one were analyzed for efficacy. The primary endpoint was the change from baseline to treatment weeks 7 and 8 in itching intensity on a Numerical Rating Scale (NRS, 0 [no itching]; 10 [worst possible itching]) using an intent-to-treat approach. The aim was to evaluate the safety and antipruritic efficacy of NAL. Results: The mean duration of itching was 3.2 years. From a baseline NRS of 6.9 (1.5), the mean NRS declined by 3.5 (2.4) and by 2.8 (2.2) in NAL 120 mg and the placebo groups, respectively (p = 0.017). There was no evidence of tolerance. A trend for less sleep disruption due to itching (p = 0.062, NAL 120 vs. placebo) was also observed. There were no significant differences between NAL 60 vs. placebo. Serious adverse events occurred in 6.7, 12.7, and 15.4% in the NAL 120, NAL 60, and placebo groups respectively. Conclusions: In this largest-to-date randomized controlled trial in uremic pruritus, NAL 120 durably and significantly reduced the itching intensity among hemodialysis patients.

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