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Cited by 102Gut microbiota and healthParkinson's Disease Mechanisms and TreatmentsGastrointestinal motility and disorders

Effects of Resistant Starch on Symptoms, Fecal Markers, and Gut Microbiota in Parkinson’s Disease — The RESISTA-PD Trial

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Becker, Anouck, Schmartz, Georges Pierre, Gröger, Laura, Grammes, Nadja, Galata, Valentina, Philippeit, Hannah, Weiland, Jacqueline, Ludwig, Nicole +9 more·2022·Genomics, Proteomics & Bioinformatics
DOI 10.1016/j.gpb.2021.08.009PMC PMC9684155

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Abstract

The composition of the gut microbiota is linked to multiple diseases, including Parkinson’s disease (PD). Abundance of bacteria producing short-chain fatty acids (SCFAs) and fecal SCFA concentrations are reduced in PD. SCFAs exert various beneficial functions in humans. In the interventional, monocentric, open-label clinical trial “Effects of Resistant Starch on Bowel Habits, Short Chain Fatty Acids and Gut Microbiota in Parkinson ’s Disease” (RESISTA-PD; ID: NCT02784145), we aimed at altering fecal SCFAs by an 8-week prebiotic intervention with resistant starch (RS). We enrolled 87 subjects in three study-arms: 32 PD patients received RS (PD + RS), 30 control subjects received RS, and 25 PD patients received solely dietary instructions. We performed paired-end 100 bp length metagenomic sequencing of fecal samples using the BGISEQ platform at an average of 9.9 GB. RS was well-tolerated. In the PD + RS group, fecal butyrate concentrations increased significantly, and fecal calprotectin concentrations dropped significantly after 8 weeks of RS intervention. Clinically, we observed a reduction in non-motor symptom load in the PD + RS group. The reference-based analysis of metagenomes highlighted stable alpha-diversity and beta-diversity across the three groups, including bacteria producing SCFAs. Reference-free analysis suggested punctual, yet pronounced differences in the metagenomic signature in the PD + RS group. RESISTA-PD highlights that a prebiotic treatment with RS is safe and well-tolerated in PD. The stable alpha-diversity and beta-diversity alongside altered fecal butyrate and calprotectin concentrations call for long-term studies, also investigating whether RS is able to modify the clinical course of PD.

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  • Limited evidence from a few open-label studies suggests that pre- and pro-biotics can increase the abundance of SCFA-producing bacteria, reduce the abundance of pro-inflammatory bacteria, and reduce levels of intestinal inflammatory markers like calprotectin.

    “There is limited evidence of how pre- and pro-biotics influence gut microbiome composition and functionality, with only limited evidence from a few open-label studies to suggest that pre- and pro-biotics can increase the abundance of SCFA-producing bacteria, reduce the abundance of pro-inflammatory bacteria, and reduce levels of intestinal inflammatory markers like calprotectin [163, 177].”

    From The gut–brain axis in early Parkinson’s disease: from prodrome to prevention (2025) · cites this paper as [163]

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Authors
Becker, A., Schmartz, G. P., Gröger, L., Grammes, N., Galata, V., Philippeit, H., Weiland, J., Ludwig, N., Meese, E., Tierling, S., Walter, J., Schwiertz, A., Spiegel, J., Wagenpfeil, G., Faßbender, K., Keller, A., & Unger, M. M.
Affiliations
  • Saarland University (DE)
  • Institut für Mikroökologie (DE)
Corresponding author
Unger, Marcus M.
ORCID
Venue
Genomics, Proteomics & Bioinformatics
Publisher
Oxford University Press (OUP)
Published
2021-11-25
Volume
20
Issue
2
Pages
274-287
ISSN
  • 1672-0229 (ISSN-L)
  • 2210-3244
DOI
10.1016/j.gpb.2021.08.009
PMC
PMC9684155
OpenAlex
W3214815292
Cited by
102
References
59
Citations by year
2026: 16 · 2025: 31 · 2024: 28 · 2023: 13 · 2022: 12 · 2021: 2
FWCI
4.32
Type
journal article
Language
en
Open access
Licence
Locations
  • Genomics Proteomics & Bioinformatics (publishedVersion, cc-by)
  • medRxiv (acceptedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Publications of the UdS (Saarland University) (cc-by)
Funders
  • Fox Foundation for Parkinson’s Research (14603)
  • German Parkinson Society
  • Michael J Fox Foundation for Parkinson's Research
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
resistant starch, Parkinson's disease, gut microbiota, short-chain fatty acids, butyrate, calprotectin, non-motor symptoms, fecal microbiota, metagenomics, dietary intervention
MeSH terms
Gastrointestinal Microbiome, Resistant Starch, Bacteria, Butyrates, Fatty Acids, Volatile, Feces, Humans, Parkinson Disease, Biomarkers, Leukocyte L1 Antigen Complex, Prebiotics

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