1. Effects of Resistant Starch on Symptoms, Fecal Markers, and Gut Microbiota in Parkinson’s Disease — The RESISTA-PD Trial
- Author
-
Anouck Becker, Valentina Galata, Georges Pierre Schmartz, Eckart Meese, Jörn Walter, Andreas Keller, Sascha Tierling, Jacqueline Weiland, Laura Gröger, Andreas Schwiertz, Nadja Grammes, Marcus M. Unger, Gudrun Wagenpfeil, Hannah Philippeit, Nicole Ludwig, Klaus Faßbender, and Jörg Spiegel
- Subjects
medicine.medical_specialty ,Parkinson's disease ,food.ingredient ,medicine.medical_treatment ,Butyrate ,Gut flora ,Biochemistry ,Gastroenterology ,Feces ,food ,Internal medicine ,Genetics ,medicine ,Humans ,Resistant starch ,Molecular Biology ,Bacteria ,biology ,business.industry ,Prebiotic ,Resistant Starch ,Parkinson Disease ,Fatty Acids, Volatile ,medicine.disease ,biology.organism_classification ,Gastrointestinal Microbiome ,Butyrates ,Computational Mathematics ,Prebiotics ,Calprotectin ,business ,Leukocyte L1 Antigen Complex ,Biomarkers - Abstract
The composition of the gut microbiome is linked to multiple diseases, including Parkinson’s disease (PD). Bacteria producing short-chain fatty acids (SCFAs) and fecal SCFA concentrations are reduced in PD. SCFAs exert various beneficial functions in humans. In the interventional, monocentric, open-label clinical trial RESISTA-PD (NCT02784145) we aimed at altering fecal SCFAs by an 8-week prebiotic intervention with resistant starch (RS). We enrolled 87 subjects in three study-arms: 32 PD patients receiving RS (PD + RS), 30 control subjects receiving RS, and 25 PD patients receiving solely dietary instructions. We performed paired-end 100 base pair length metagenomic sequencing of fecal samples using the BGISEQ platform at an average of 9.9 GB. RS was well-tolerated. In PD + RS, fecal butyrate concentrations increased significantly and fecal calprotectin concentrations dropped significantly after 8 weeks of RS. Clinically, we observed a reduction in non-motor symptoms load in PD + RS. The reference-based analysis of metagenomes highlighted stable alpha-diversity and beta-diversity across the three groups, including bacteria producing SCFAs. Reference-free analysis suggested punctual, yet pronounced differences in the metagenomic signature in PD + RS. RESISTA-PD highlights that a prebiotic treatment with RS is safe and well-tolerated in PD. The stable alpha-diversity and beta-diversity alongside altered fecal butyrate and calprotectin concentrations calls for long-term studies, also investigating whether RS is able to modify the clinical course of PD.
- Published
- 2022