Efficacy of 1-kestose supplementation in patients with mild to moderate ulcerative colitis: A randomised, double-blind, placebo-controlled pilot study

Shuji Ikegami, Masanao Nakamura, Takashi Honda, Takeshi Yamamura, Keiko Maeda, Tsunaki Sawada, Eri Ishikawa, Kenta Yamamoto, Satoshi Furune, Takuya Ishikawa, Kazuhiro Furukawa, Eizaburo Ohno, Masatoshi Ishigami, Fumie Kinoshita, Yoshihiro Kadota, Takumi Tochio, Yoshiharu Shimomura, Yoshiki Hirooka, Hiroki Kawashima

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background: Ulcerative colitis involves an excessive immune response to intestinal bacteria. Whether administering prebiotic 1-kestose is effective for active ulcerative colitis remains controversial. Aims: This randomised, double-blind, placebo-controlled pilot trial investigated the efficacy of 1-kestose against active ulcerative colitis. Methods: Forty patients with mild to moderate active ulcerative colitis were randomly treated with 1-kestose (N = 20) or placebo (maltose, N = 20) orally for 8 weeks in addition to the standard treatment. The Lichtiger clinical activity index and Ulcerative Colitis Endoscopic Index of Severity were determined. Faecal samples were analysed to evaluate the gut microbiome and metabolites. Results: The clinical activity index at week 8 was significantly lower in the 1-kestose group than in the placebo group (3.8 ± 2.7 vs. 5.6 ± 2.1, p = 0.026). Clinical remission and response rates were higher in the 1-kestose group than in the placebo group (remission: 55% vs. 20%, p = 0.048; response: 60% vs. 25%, p = 0.054). The Ulcerative Colitis Endoscopic Index of Severity at week 8 was not significantly different (2.8 ± 1.6 vs. 3.5 ± 1.6, p = 0.145). Faecal analysis showed significantly reduced alpha-diversity in the 1-kestose group, with a decreased relative abundance of several bacteria, including Ruminococcus gnavus group. The short-chain fatty acid levels were not significantly different between the groups. The incidence of adverse events was comparable between the groups. Discussion: Oral 1-kestose is well tolerated and provides clinical improvement for patients with mild to moderate ulcerative colitis through modulation of the gut microbiome.

Original languageEnglish
Pages (from-to)1249-1257
Number of pages9
JournalAlimentary Pharmacology and Therapeutics
Volume57
Issue number11
DOIs
Publication statusPublished - 06-2023

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology
  • Pharmacology (medical)

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