Marta Esgalhado1, Julie Ann Kemp1, Bruna R de Paiva1, Jessyca Sousa Brito2, Ludmila F M F Cardozo1, Renata Azevedo1, Diana Barbosa Cunha3, Lia S Nakao4, Denise Mafra5. 1. Post-Graduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil. kemp.julie@gmail.com. 2. Post-Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil. 3. Institute of Social Medicine, Department of Epidemiology, Rio de Janeiro State University, Rio de Janeiro, Brazil. 4. Basic Pathology Department, Federal University of Paraná (UFPR), Curitiba, PR, Brazil. 5. Post-Graduate Program in Cardiovascular Sciences, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil. kemp.julie@gmail.com and Post-Graduate Program in Medical Sciences, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
Abstract
BACKGROUND: The aim of this study was to evaluate the effect of resistant starch (RS) enriched cookies supplementation on mRNA expression of nuclear transcription factors (nuclear erythroid 2-related factor, Nrf2; nuclear factor kappa-B, NF-κB), involved with inflammation and on uremic toxins levels produced by the gut microbiota in hemodialysis (HD) patients. METHODS: A randomized, double-blind, placebo-controlled crossover study with 26 HD patients was conducted. The patients were assigned to either resistant starch enriched cookies (16 g of RS per day) or placebo cookies supplementation during the first four weeks. After the washout period, patients were supplemented again, in the form of a crossover, for another 4 weeks. Nrf2, NF-κB, and antioxidant enzymes mRNA expression were measured by rt-PCR and protein expression by western blotting assay from isolated peripheral blood mononuclear cells (PBMC). Oxidative stress and inflammatory biomarkers, as well as uremic toxins, were evaluated. Intention-to-treat analysis was performed, using the proc mixed procedure in SAS. RESULTS: In RS group, post-treatment mean mRNA Nrf2 expression was market increased from baseline values, associated with a high expression of NQO1 protein. Besides, IS plasma levels were reduced in the RS group. No significant difference was observed in the placebo group. CONCLUSION: Our results suggested that resistant starch enriched cookies may be a good nutritional strategy to reduce indoxyl sulfate levels derived from the gut microbiota and also attenuate the inflammation in hemodialysis patients.
RCT Entities:
BACKGROUND: The aim of this study was to evaluate the effect of resistant starch (RS) enriched cookies supplementation on mRNA expression of nuclear transcription factors (nuclear erythroid 2-related factor, Nrf2; nuclear factor kappa-B, NF-κB), involved with inflammation and on uremic toxins levels produced by the gut microbiota in hemodialysis (HD) patients. METHODS: A randomized, double-blind, placebo-controlled crossover study with 26 HD patients was conducted. The patients were assigned to either resistant starch enriched cookies (16 g of RS per day) or placebo cookies supplementation during the first four weeks. After the washout period, patients were supplemented again, in the form of a crossover, for another 4 weeks. Nrf2, NF-κB, and antioxidant enzymes mRNA expression were measured by rt-PCR and protein expression by western blotting assay from isolated peripheral blood mononuclear cells (PBMC). Oxidative stress and inflammatory biomarkers, as well as uremic toxins, were evaluated. Intention-to-treat analysis was performed, using the proc mixed procedure in SAS. RESULTS: In RS group, post-treatment mean mRNA Nrf2 expression was market increased from baseline values, associated with a high expression of NQO1 protein. Besides, IS plasma levels were reduced in the RS group. No significant difference was observed in the placebo group. CONCLUSION: Our results suggested that resistant starch enriched cookies may be a good nutritional strategy to reduce indoxyl sulfate levels derived from the gut microbiota and also attenuate the inflammation in hemodialysis patients.
Authors: Livia Alvarenga; Ludmila F M F Cardozo; Beatriz O Da Cruz; Bruna R Paiva; Denis Fouque; Denise Mafra Journal: Int Urol Nephrol Date: 2022-03-26 Impact factor: 2.266