Artikel
Update MIKARA study: Double-blind randomized controlled intervention study unravelling the role of MCT and fiber supplementation in rheumatoid arthritis
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Autoren
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Monika Reuss-Borst
- Georg-August University of Göttingen, Department of Nephrology and Rheumatology, Göttingen
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Giulia Gaudioso
- Dr. Schär AG/SPA, Postal
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Nicola Francesco Rocco
- Dr. Schär AG/SPA, Postal
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Patrizia Zanon
- Dr. Schär R&D Centre, Padriciano
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Ombretta Polenghi
- Dr. Schär R&D Centre, Padriciano
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Inna Frohne
- Privatpraxis für Rheumatologie und ganzheitliche Medizin, Essen
| Veröffentlicht: | 18. September 2024 |
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Gliederung
Text
Introduction: To date, the role of nutrition in rheumatoid arthritis (RA) has not been fully investigated. The paucity and the small scale of human clinical trials still prevent the medical and scientific community from defining clinically meaningful nutritional guidelines. Here is why, despite few country-specific recommendation for a healthy and balanced diet, as the ones recently published by the German Society for Rheumatology (DGRh), very limited indications exist about which specific ingredients or food components positively impact RA activity and patient quality of life. This randomized, placebo-controlled, double-blind, monocentric study aimed to investigate the effect of supplementation of regular diet with medium-chain triglycerides (MCTs) with/without fiber on disease activity, measured as Simplified Disease Activity Index (SDAI) in RA patients. Furthermore, driven by several evidence outlining the role of human gut microbiota (GM) in RA pathogenesis and considering the role of colonic microbes in the metabolism of different beneficial food components, we performed both 16S rRNA and Shotgun metagenomics analysis to study how GM is affected by the tested nutritional approaches.
Methods: 61 RA patients on stable drug treatment were randomly assigned to either a test or a control group. Test group received a twice-daily formulation containing MCTs (30 g/day) for 8 weeks followed by a second twice-daily regimen of MCTs (30 g/day) plus fiber (30 g/day) combination for an additional 8 weeks. In the control group, dietary regimen contained long chain triglycerides (LCTs) instead of MCTs. SDAI measurements, stool samples and other assessments were collected at baseline (T0), week 8 (T2) and week 16 (T4).
Results: This amelioration was accompanied by a significant modulation of GM ecology of test group from T0 to T4, together with significant changes in bacterial relative abundances, mainly regarding Ruminiclostridium-5, Negativibacillus and Parabacteroides distasonis, both after MCT and MCT plus fiber supplementation.
Conclusion: This suggested a role of MCT plus fiber supplementation in shaping microbial abundances and provided new insights to our previously published data. Our results open new fields for the dietary management of RA.
Disclosures: Conflict of interest: G. G., N. R., P. Z., O. P. are employed by Dr. Schär AG/SPA, Postal, Italy.
Dr. R. B. and Dr. F. received a research grant from Dr. Schär AG/SPA, Postal, Italy.
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