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Clinical, microbiological, and immunological effects of fructo-oligosaccharide in patients with Crohn's disease
Open accessAbstract
BACKGROUND AND AIMS: The intestinal microbiota play a pivotal role in the inflammation associated with Crohn's disease through their interaction with the mucosal immune system. Some bifidobacteria species are immunoregulatory and induce increased dendritic cell interleukin 10 (IL-10) release in vitro. Fructo-oligosaccharides (FOS) increase faecal and mucosal bifidobacteria in healthy volunteers. The aim of this study was to assess the effect of FOS administration on disease activity, bifidobacteria concentrations, and mucosal dendritic cell function in patients with moderately active Crohn's disease. PATIENTS AND METHODS: Ten patients with active ileocolonic Crohn's disease received 15 g of FOS for three weeks. Disease activity was measured using the Harvey Bradshaw index. Faecal and mucosal bifidobacteria were quantified by fluorescence in situ hybridisation, and mucosal dendritic cell IL-10 and Toll-like receptor (TLR) expression were assessed by flow cytometry of dissociated rectal biopsies. RESULTS: FOS induced a significant reduction in the Harvey Bradshaw index from 9.8 (SD 3.1) to 6.9 (3.4) (p<0.01). There was a significant increase in faecal bifidobacteria concentration from 8.8 (0.9) log(10) to 9.4 (0.9) log(10) cells/g dry faeces (p<0.001). The percentage of IL-10 positive dendritic cells increased from 30 (12)% to 53 (10)% (p=0.06). Finally, the percentage of dendritic cells expressing TLR2 and TLR4 increased from 1.7 (1.7)% to 36.8 (15.9)% (p=0.08) and from 3.6 (3.6)% to 75.4 (3.4)% (p<0.001), respectively. CONCLUSIONS: FOS supplementation increases faecal bifidobacteria concentrations and modifies mucosal dendritic cell function. This novel therapeutic strategy appears to decrease Crohn's disease activity in a small open label trial and therefore warrants further investigation.
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“an open label trial of fructo-oligosaccharide in CD showed promise,79”
From The gut microbiota and host health: a new clinical frontier (2016) · cites this paper as [79]
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“Additionally, prebiotic use has been shown to improve mucosal dendritic cell function associated with TLR2 activity [62], and increase the expression of glucagon-like peptide 2, associated with GI barrier regulation [59].”
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“…no clinically relevant evidence base for the use of probiotics in CD and in terms of prebiotics, although an open label trial of fructo-oligosacchar-ide in CD showed promise, 79 and a subsequent randomised placebo-controlled trial of fructo-oligosaccharide did not support any clinical bene fi t. 80”
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Metadata
- Authors
- Lindsay, J. O.
- Affiliations
- Royal London Hospital (GB)
- Corresponding author
- Lindsay, J O
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2006-03-01
- Volume
- 55
- Issue
- 3
- Pages
- 348-355
- ISSN
- 0017-5749 (ISSN-L)
- PMC
- PMC1856087
- OpenAlex
- W2164571061
- Cited by
- 471
- References
- 55
- Citations by year
- 2026: 9 · 2025: 19 · 2024: 33 · 2023: 19 · 2022: 35 · 2021: 26 · 2020: 32 · 2019: 20 · 2018: 21 · 2017: 18 · 2016: 21 · 2015: 18 · 2014: 26 · 2013: 21 · 2012: 22
- FWCI
- 9.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- UEA Digital Repository (University of East Anglia) (submittedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Health Sciences › Nursing › Nutrition and Dietetics › Microbial Metabolites in Food Biotechnology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Keywords
- fructooligosaccharides, Crohn's disease, Bifidobacterium, dendritic cells, IL-10, TLR2, TLR4, gut microbiota, mucosal immunity, disease activity, prebiotics, rectal mucosa
- MeSH terms
- Adult, Bifidobacterium, Crohn Disease, Dendritic Cells, Feces, Female, Humans, Intestinal Mucosa, Male, Middle Aged, Oligosaccharides, Patient Compliance, Severity of Illness Index, Immunity, Mucosal, Toll-Like Receptors
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