Dietary Fibers (Gum Arabic) Supplementation Modulates Hepatic and Renal Profile Among Rheumatoid Arthritis Patients, Phase II Trial

Abstract

Background: Rheumatoid arthritis (RA) is an autoimmune disease that mainly affects the synovial joints with systemic manifestations. RA has a major impact on liver and kidney functions as part of the disease pathogenesis or as a sequel of disease medications or, mostly, both of them. The kidney and liver involvement increases the RA morbidity and mortality. Nowadays, dietary interventions are proposed as potential modifiers for disease severity. Gum Arabic (GA) is acacia senegal exudates; it is soluble fiber with prebiotic properties. GA has been discovered to be protective against experimental nephrotoxicity and hepatotoxicity, with comparable findings in human studies. This article addresses the effect of GA on hepatic and renal profile among RA patients.Methods: Forty patients aged 18–70 received GA daily for 12 weeks as a single dose of 30 g. The liver enzymes, total protein level, serum albumin, serum globulin level, urea, creatinine, and serum electrolytes have been measured as a baseline after 4 weeks and by the end of the study. Cobas C311 (Roche, Germany) automated chemistry analyzer directly determined the values for total protein, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and creatinine. The study ethically has been approved by the Ethical Committee of the National Medicines and Poisons Board. Trial Registration Identifier: NCT02804581.Results: Regarding the liver enzymes, GA has significantly decreased the liver enzymes apart from alkaline phosphatase, which showed no significant change. In contrast, GA has increased the serum albumin level with a minor impact on the serum globulin level. Furthermore, GA has also significantly decreased the level of urea (P = 0.0001) and level of Sodium (P = 0.002) with nonsignificant change on creatinine and potassium concentrations.Conclusion: GA presents hepatic and renal protective effects among RA patients, evidenced by the significant reduction of urea and liver enzymes. Thus, it can be recommended as a dietary supplement for RA patients. Nonetheless, we recommend further investigation to support our findings.

Effect of Arabic Gum (Acacia senegal) on Paracetamol-Induced Chronic Nephrotoxicity in Albino Rats

“…higher than that of NAC administration. This finding was following a recent finding conducted on a patient with rheumatoid arthritis suffering from renal affection to find that AG was able to decrease levels of urea in those patients 22 .…”

Gum acacia dietary fiber: Significance in immunomodulation, inflammatory diseases, and cancer

“…Furthermore, the same group demonstrated that GA significantly reduced liver enzymes and urea levels, while concurrently increasing serum albumin levels. These findings suggest the potential for GA to modulate the hepatic and renal profiles of patients with RA (Kamal et al, 2021). While a substantial portion of GA research has traditionally focused on its GI health benefits, there is an increasing interest in investigating its potential advantages for managing other inflammatory conditions, including RA, soon.…”

The arsenic-lowering effect of inulin-type prebiotics in end-stage renal disease: a randomized crossover trial

“…51 Dietary fiber supplementations have been reported to improve the residual renal and peritoneal function. 52 In addition, the biologic methylation of As promotes its urine elimination, and microbiota-driven therapies have been reported to significantly increase the methylation of As. 53,54 In the present study, a significant decrease in albumin loss by residual renal and peritoneum was observed with ITFs, accompanied by an increase in the clearance rate of As through the urine and dialysate, indicating the negative regulation of As clearance by dialysis and urine on the plasma As level with ITF intervention.…”