Celiac Disease Clinical Trial
Official title:
Assessment of the Impact of Prebiotic Synergy 1 on the Intestine Permeability, Clinical Symptoms, and Selected Biochemical and Nutritional Parameters in the Children With Celiac Disease on a Gluten-free Diet
Prebiotics are known as substances affecting beneficially the organism by restoring the intestinal microbiota balance, stabilizing the intestinal barrier and modulating the endocrine and immune functions. In many persons suffering from celiac disease (CD), despite a gluten-free diet (GFD), an impaired intestinal barrier functionality, accompanied by altered intestinal microbiota and ongoing intestinal inflammation is observed. For these reasons, prebiotic could be a promising and low-risk adjuvant in the dietetic management of CD. It was hypothesize that prebiotic preparation Synergy 1 consumed by CD children as a supplement of a GFD will affect beneficial the intestinal permeability and intestinal microbiota without side effects.
Prebiotics, including inulin-type fructans (ITFs) are a group of the naturally occurring
plant carbohydrates stored in various amounts in tubers, bulbs and tuberous roots of several
edible fruits and vegetables and in particularly large amounts in the tubers of Helianthus
tuberosus (Jerusalem artichoke) and Cichorium intybus (chicory). Because of their unique
structural properties, they are not hydrolyzed by the enzymes of the upper intestinal
digestive tract and reach the colon unchanged, therefore are classified as prebiotics.
Prebiotics are defined as selectively fermented ingredients that allow specific changes in
the composition and/or balance of the microbiota. ITFs, particularly the mixture of short-
and long-chain polymers, indicate several beneficial effects, including the positive changes
in the histological picture of the intestine (proliferation in the crypts and Goblet cells,
longer intestinal villi) and modulation of the endocrine and immune functions. Moreover, they
have a great potential as agents improving or maintaining a balanced intestinal microbiota
both in the lumen and at the mucosal surface, to one in which bifidobacteria and lactobacilli
come to greater prominence. This, so-called healthier flora, should provide increased
resistance to gut infections and may also have immuno-modulatory properties. Until now,
inulin and fructooligosaccharide (FOS) have been tested mainly in animal models of
inflammatory bowel diseases (IBD). Reports on animal colitis model suggests that prebiotics
have the anti-inflammatory properties as they reduce the inflammation symptoms, along with
the increase in bifidobacteria or lactobacilli number, and in some reports, the increase in
the concentration of butyrate in the gut.
Prebiotics are known as substances affecting beneficially the organism by restoring the
intestinal microbiota balance, stabilizing the intestinal barrier and modulating the
endocrine and immune functions. In many persons suffering from celiac disease (CD), despite a
gluten-free diet (GFD), an impaired intestinal barrier functionality, accompanied by altered
intestinal microbiota and ongoing intestinal inflammation is observed. For these reasons,
prebiotics could be a promising and low-risk adjuvant in the dietetic management of CD. It
was hypothesized that Synergy 1 consumed by CD children as a supplement of a GFD will affect
beneficial the intestinal permeability and intestinal microbiota without side effects. The
primary objective of this randomized placebo-controlled study was to determine the effect of
3-months consumption of Synergy 1 versus placebo, as the supplements of a GFD, on the
intestinal permeability in CD children, in particular on the concentration of the intestinal
fatty acid binding protein (iFABP) as a biomarker of intestinal permeability. The secondary
objective was to determine the effect of Synergy 1 versus placebo applied in GFD on the
changes in the gut microbiota quantity and metabolism in CD children.
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