The Impact of Enriched Resistant Starch Type‐2 Cookies on the Gut Microbiome in Hemodialysis Patients: A Randomized Controlled Trial

Abstract

Introduction Resistant starch type‐2 (RS2) can mitigate inflammation and oxidative stress in hemodialysis (HD) patients. However, there is still a lack of knowledge on the impact of the RS2 on the gut microbiota community in these patients. Thus, this study aims to evaluate the effects of enriched RS2 cookies on the gut microbiome in HD patients. Methods and Results This comprises a randomized, double‐blind, placebo‐controlled trial of age‐, sex‐, and BMI‐matched patients and controls. The RS2 group receives enriched RS2 cookies (16 g d‐1 of Hi‐Maize 260, Ingredion) for 4 weeks, while the placebo group received cookies made with manioc flour. Fecal microbiota composition is evaluated by the 16S ribosomal RNA gene. Analysis of the microbiota reveals that Pielou's evenness is significantly decreased after RS2 supplementation. Notably, it is observed that RS2 intervention upregulates significantly 8 Amplicon Sequencing Variants (ASV's), including Roseburia and Ruminococcus gauvreauii, which are short‐chain fatty acids (SCFA) producers. Furthermore, it is associated with the downregulation of 11 ASVs, such as the pro‐inflammatory Dialister. Conclusions RS2 intervention for 4 weeks in HD patients effectively alters SCFA producers in the gut microbiota, suggesting that it could be a good nutritional strategy for patients with chronic kidney disease (CKD) on HD.

Effect of feeding raw potato starch on the composition dynamics of the piglet intestinal microbiome

“…Despite lack of significant changes at the phylum level, RPS feeding affected the abundance of several subtaxa and the bacterial composition at the genus and species levels. Compared to the control diet, consumption of 5% RPS significantly increased the abundance of Roseburia , similar to the results of previous studies on RS2 consumption in humans [ 18 , 30 ]. Bacteria are known to play an important role in intestinal epithelial permeability by fermenting polysaccharides and producing butyrate [ 18 ].…”

Preventive effect of Chinese dwarf cherry [Cerasus humilis (Bge.) Sok.] fermentation juice on dextran sulfate sodium-induced ulcerative colitis rats through the regulation of IgA and the intestinal immune barrier

“…AABR07065728.1, AABR07065811.1 and AABR07065815.1 were negatively correlated with Ruminococcus_gauvreauii_group . Ruminococcus_gauvreauii_group is a producer of SCFAs, 31 and norank_f__Erysipelotrichaceae belongs to the Erysipelotrichaceae family and is a colitis-promoting strain. 32 Its increased abundance tends to aggravate intestinal inflammation.…”

Natural products from plants and microorganisms: Novel therapeutics for chronic kidney disease via gut microbiota regulation

“…In a clinical trial of 60 peritoneal dialysis patients, Shen-Shuai-Ning granules could decrease IS serum concentration after 12 weeks of treatment ( Chen et al, 2018 ). Supplementation with the functional food HI-MAIZE ® 260 cookies (16 g/d resistant starch) could increase fiber intake, reduce IL-6 and IS plasma levels ( Esgalhado et al, 2018 ), decrease different growth factors ( De Paiva et al, 2020 ), and alter the SCFA-producing microbiota in HD patients ( Kemp et al, 2021 ), but no indole-3-acetic acid (IAA) levels or aryl hydrocarbon receptor (AhR) expression in patients with end-stage CKD ( Azevedo et al, 2020 ). However, the unripe banana flour (21 g/d, 48% resistant starch) only decreased IS in the subgroup of participants undergoing peritoneal dialysis (PD) ( De Andrade et al, 2021 ).…”