表征慢性阻塞性肺疾病（COPD）患者的肠道微生物失调并探索补充益生元纤维的效果。

Characterizing gut microbial dysbiosis and exploring the effect of prebiotic fiber supplementation in patients with COPD.

作者信息

van Iersel Lieke E J, Beijers Rosanne J H C G, Simons Sami O, Schuurman Lisanne T, Shetty Sudarshan A, Roeselers Guus, van Helvoort Ardy, Schols Annemie M W J, Gosker Harry R

机构信息

Department of Respiratory Medicine, NUTRIM Institute of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre +, P.O. Box 5800, Maastricht, 6202 AZ, The Netherlands.

Danone Research & Innovation, Utrecht, The Netherlands.

出版信息

Eur J Nutr. 2025 Jun 7;64(5):210. doi: 10.1007/s00394-025-03733-7.

DOI:10.1007/s00394-025-03733-7

PMID:40481968

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12145321/

Abstract

PURPOSE

Chronic Obstructive Pulmonary Disease (COPD) is associated with poor dietary quality that may lead to gut microbiota imbalances. A healthy gut microbiome contributes to metabolic health and immune function through production of metabolites like short-chain fatty acids. Prebiotic fibers positively influence microbiota by promoting the production of beneficial metabolites. This study aimed to assess altered gut microbiota composition in patients with COPD and to explore the effects of targeted multi-nutrient supplementation including prebiotic fibers on these outcomes.

METHODS

An exploratory analysis was performed within the double-blinded placebo-controlled NUTRECOVER-trial to gain preliminary insights into the effects of the nutritional intervention. The cross-sectional baseline comparison included 32 patients with COPD and 32 age-matched healthy references. Subsequently, patients were randomly assigned to a multi-nutrient supplement including prebiotic fibers, vitamin D, tryptophan, and N-3 long-chain poly unsaturated fatty acids (n = 16) or placebo (n = 16) for three months. Stool samples, blood samples and food diaries were obtained before and after the intervention.

RESULTS

Higher relative abundance of Bacteroidota (0.50 ± 0.13 vs. 0.41 ± 0.14, p = 0.010), and lower Firmicutes (0.40 ± 0.14 vs. 0.49 ± 0.12, p = 0.007) were found in patients compared with healthy controls. Patients also showed lower alpha diversity (5.80 ± 0.32 vs. 5.99 ± 0.30, p = 0.017) and higher inter-individual variability (0.51 ± 0.16 vs. 0.48 ± 0.10, p < 0.001). No effects of the nutritional intervention on gut microbiome and systemic inflammation were shown at 3 months.

CONCLUSION

Patients with COPD exhibit differences in gut microbiota composition compared with healthy controls. Three months of multi-nutrient supplementation is insufficient to show changes in microbiome composition. The ongoing NUTRECOVER-trial will show the potential of long-term prebiotic fiber supplementation in this susceptible patient population.

TRIAL REGISTRATION NUMBER

clinicaltrials.gov: NCT03807310.

摘要

目的

慢性阻塞性肺疾病（COPD）与不良饮食质量相关，这可能导致肠道微生物群失衡。健康的肠道微生物群通过产生短链脂肪酸等代谢产物，对代谢健康和免疫功能有促进作用。益生元纤维通过促进有益代谢产物的产生，对微生物群产生积极影响。本研究旨在评估COPD患者肠道微生物群组成的变化，并探讨包括益生元纤维在内的针对性多种营养素补充对这些结果的影响。

方法

在双盲安慰剂对照的NUTRECOVER试验中进行探索性分析，以初步了解营养干预的效果。横断面基线比较包括32例COPD患者和32例年龄匹配的健康对照者。随后，患者被随机分为接受包括益生元纤维、维生素D、色氨酸和N-3长链多不饱和脂肪酸的多种营养素补充剂组（n = 16）或安慰剂组（n = 16），为期三个月。在干预前后采集粪便样本、血液样本和食物日记。

结果

与健康对照组相比，患者中拟杆菌门的相对丰度更高（0.50±0.13 vs. 0.41±0.14，p = 0.010），而厚壁菌门更低（0.40±0.14 vs. 0.49±0.12，p = 0.007）。患者还表现出较低的α多样性（5.80±0.32 vs. 5.99±0.30，p = 0.017）和较高的个体间变异性（0.51±0.16 vs. 0.48±0.10，p < 0.001）。在3个月时，未显示营养干预对肠道微生物群和全身炎症有影响。