Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, RJ, Brazil.
Hospital Universitário Antônio Pedro, Rua Marquês do Paraná nº 303, 4º andar, Niterói, Rio de Janeiro, Brazil.
Int Urol Nephrol. 2020 Mar;52(3):549-555. doi: 10.1007/s11255-020-02392-3. Epub 2020 Feb 1.
In chronic kidney disease (CKD) patients, dysbiosis is associated with inflammation and cardiovascular risk, so many nutritional strategies are being studied to reduce these complications. Resistant starch (RS) can be considered a prebiotic that promotes many benefits, including modulation of gut microbiota which is linked to immune-modulatory effects. The aim of this study was to evaluate the effects of RS supplementation on proinflammatory cytokines in CKD patients on hemodialysis (HD).
A double-blind, placebo-controlled, randomized trial was conducted with sixteen HD patients (55.3 ± 10.05 years, body mass index (BMI) 25.9 ± 5.42 kg/m, 56% men, time on dialysis 38.9 ± 29.23 months). They were allocated to the RS group (16 g RS/day) or placebo group (manioc flour). The serum concentration of ten cytokines and growth factors was detected through a multiparametric immunoassay based on XMap-labeled magnetic microbeads (Luminex Corp, USA) before and after 4 weeks with RS supplementation.
After RS supplementation, there was a reduction of Regulated upon Activation, Normal T-Cell Expressed and Secreted (p < 0.001), platelet-derived growth factor (two B subunits) (p = 0.014) and interferon-inducible protein 10 (IP-10) (p = 0.027). The other parameters did not change significantly.
This preliminary result indicates that RS may contribute to a desirable profile of inflammatory markers in CKD patients.
在慢性肾脏病(CKD)患者中,肠道菌群失调与炎症和心血管风险相关,因此许多营养策略正在被研究以减少这些并发症。抗性淀粉(RS)可被视为一种益生元,可促进多种益处,包括调节肠道微生物群,这与免疫调节作用有关。本研究旨在评估 RS 补充剂对血液透析(HD)的 CKD 患者促炎细胞因子的影响。
进行了一项双盲、安慰剂对照、随机试验,纳入 16 名 HD 患者(55.3±10.05 岁,体重指数(BMI)25.9±5.42kg/m,56%为男性,透析时间 38.9±29.23 个月)。他们被分配到 RS 组(每天 16g RS)或安慰剂组(木薯粉)。在 RS 补充 4 周前后,通过基于 XMap 标记的磁性微珠(美国 Luminex 公司)的多参数免疫测定法检测十种细胞因子和生长因子的血清浓度。
RS 补充后,调节激活正常 T 细胞表达和分泌(Regulated upon Activation, Normal T-Cell Expressed and Secreted,RANTES)(p<0.001)、血小板衍生生长因子(两个 B 亚基)(p=0.014)和干扰素诱导蛋白 10(IP-10)(p=0.027)降低。其他参数无明显变化。
这一初步结果表明,RS 可能有助于改善 CKD 患者的炎症标志物谱。