Microbiota changes induced by microencapsulated sodium butyrate in patients with inflammatory bowel disease

Abstract

Background Butyrate has shown anti‐inflammatory and regenerative properties, providing symptomatic relief when orally supplemented in patients suffering from various colonic diseases. We investigated the effect of a colonic‐delivery formulation of butyrate on the fecal microbiota of patients with inflammatory bowel diseases (IBDs). Methods In this double‐blind, placebo‐controlled, pilot study, 49 IBD patients (n = 19 Crohn's disease, CD and n = 30 ulcerative colitis, UC) were randomized to oral administration of microencapsulated‐sodium‐butyrate (BLM) or placebo for 2 months, in addition to conventional therapy. Eighteen healthy volunteers (HVs) were recruited to provide a healthy microbiota model of the local people. Fecal microbiota from stool samples was assessed by 16S sequencing. Clinical disease activity and quality of life (QoL) were evaluated before and after treatment. Key Results At baseline, HVs showed a different microbiota composition compared with IBD patients. Sodium‐butyrate altered the gut microbiota of IBD patients by increasing bacteria able to produce SCFA in UC patients (Lachnospiraceae spp.) and the butyrogenic colonic bacteria in CD patients (Butyricicoccus). In UC patients, QoL was positively affected by treatment. Conclusions and Inferences Sodium‐butyrate supplementation increases the growth of bacteria able to produce SCFA with potentially anti‐inflammatory action. The clinical impact of this finding requires further investigation.

The Usefulness of Microencapsulated Sodium Butyrate Add-On Therapy in Maintaining Remission in Patients with Ulcerative Colitis: A Prospective Observational Study

“…As a matter of fact, BLM has a strong anti-inflammatory and antioxidant activity, as well as a protective effect on the gut barrier; indeed, butyrate is an energy source for intestinal epithelial cells and contributes to their integrity [27]. As recently suggested, BLM was able to influence gut microbiome composition reducing inflammation of the colon [18].…”

“…IBD patient's microbiome was compared to that of 18 healthy volunteers. It was found that exogenous butyrate increased butyrate-producing bacteria, which in turn increased endogenous butyrate production, contributing to gut homeostasis [18]. Finally, in patients with active UC, administration of butyrate in association to standard therapy demonstrated a significant improvement of inflammatory parameters [19][20][21][22][23].…”

Reply Letter to “Oral butyrate modulates the gut microbiota in patients with inflammatory bowel disease, most likely by reversing proinflammatory metabolic reprogramming of colonocytes”

“…We thank Sitkin et al for their interest on our study and their valuable comments. 1 The authors speculated that the microbiota changes Slowly, as a very complex and hardly decodable puzzle, the therapeutic signaling of butyrate supplements is taking shape, but further larger studies are needed to confirm the usefulness and clinical efficacy of supplementing butyrate in patients with IBD.…”

Changes in fecal short‐chain fatty acids following fecal microbiota transplantation in patients with irritable bowel syndrome

“…Short‐chain fatty acids (SCFAs) are the main products of bacterial fermentation of undigested and unabsorbed carbohydrates in the intestine 3 . SCFAs are the main energy source for colonic epithelial cells, regulating gut barrier functions and local immune defenses 3 . Among the SCFAs, butyric acid has anti‐inflammatory and intestinal regenerative effects and administration of sodium butyrate to patients with inflammatory bowel disease changes the gut bacterial composition and induce the growth of butyric acid‐producing bacterial genera 3 …”