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Tolerance and nutritional therapy of dietary fibre from konjac glucomannan hydrolysates for patients with inflammatory bowel disease (IBD)
Abstract
Carbohydrates may provide an alternative therapeutic approach for a number of digestive health disorders such as inflammatory bowel disease (IBD). The aim of this work was to characterise the tolerance and efficacy of low and high molecular weight konjac glucomannan hydrolysates within healthy volunteers and patients suffering from IBD and associated gut conditions. These conditions included constipation, Crohn's disease and ulcerative colitis. For general tolerance, fourteen patients participated whilst for the digestive disorder trial, there were twenty. Scores of taste/texture of the product, bowel movement, stool consistency, diarrhoea, existence/absence of blood in the faeces, abdominal pains, flatulence, vomiting, fever, improvement of life style after use, willingness to use in the future and clinician's statements about each patient's conditions before and after use were recorded. The results showed that the hydrolysates were tolerated well for patients with diarrhoea and had a significant improvement on bowel movement, stool consistency, abdominal pain and flatulence after ten days. With respect to effects on IBD, there was a significant health benefit after fourteen days of consumption for bowel movement, stool consistency, diarrhoea, existence/absence of blood in the faeces, abdominal pain, flatulence and vomiting. Most patients declared an improvement of their life style after consuming the hydrolysates. The use of konjac glucomannan hydrolysates as a therapeutic agent or adjunct to standard treatments could prove a successful tool for the treatment of a range of disorders; although large scale studies are required to characterise further the role of the carbohydrates.
... | 117 or limitations were not addressed. Two papers were classified as high quality, 43,44 nine as medium, [45][46][47][48][49][50][51][52][53] and four as low quality, [54][55][56][57] see Table 2. Due to the small number of retrieved citations, no studies were excluded from the review based on their quality. Reporting of disease activity or remission status of patients was absent in eight included studies. ...
... Of the 15 papers included in the review (Table 2), two were crosssectional surveys (n=555 respondents) 43,51 and 13 were intervention studies (n=370 total participants with IBD). [44][45][46][47][48][49][50][52][53][54][55][56][57] Three studies had a primary focus on pain, ie, the intervention was intended specifically to target abdominal pain, 47,49,54 and the remaining studies measured abdominal pain as a secondary outcome. ...
... Antibiotics for the treatment of small intestinal bacterial overgrowth,45 transdermal nicotine patches44 and loperamide oxide 57 all reported reduced abdominal pain. Mixed evidence was found for the effects of dietary intervention; a fermentable carbohydrate supplement (Glucomannan hydrolysates) reduced abdominal pain after a 7day period56 and alcoholic drinks with higher sugar content were associated with greater pain.47 However, an intervention investigating processed cereals and intestinal secretions found no effects on abdominal pain.50 ...
Background:
Abdominal pain is frequently reported by people with inflammatory bowel disease (IBD), including in remission. Pain is an under-treated symptom.
Aim:
To systematically review evidence on interventions (excluding disease-modifying interventions) for abdominal pain management in IBD.
Methods:
Databases (MEDLINE, EMBASE, PsycInfo, CINAHL, Scopus, Cochrane Library) were searched (February 2016). Two researchers independently screened references and extracted data.
Results:
Fifteen papers were included: 13 intervention studies and two cross-sectional surveys. A variety of psychological, dietary and pharmacological interventions were reported. Four of six studies reported pain reduction with psychological intervention including individualised and group-based relaxation, disease anxiety-related Cognitive Behavioural Therapy and stress management. Both psychologist-led and self-directed stress management in inactive Crohn's disease reduced pain compared with controls (symptom frequency reduction index=-26.7, -11.3 and 17.2 at 6-month follow-up, respectively). Two dietary interventions (alcoholic drinks with high sugar content and fermentable carbohydrate with prebiotic properties) had an effect on abdominal pain. Antibiotics (for patients with bacterial overgrowth) and transdermal nicotine patches reduced abdominal pain. Current and past cannabis users report it relieves pain. One controlled trial of cannabis reduced SF-36 and EQ-5D pain scores (1.84 and 0.7, respectively). These results must be treated with caution: data were derived from predominantly small uncontrolled studies of moderate to low quality.
Conclusions:
Few interventions have been tested for IBD abdominal pain. The limited evidence suggests that relaxation and changing cognitions are promising, possibly with individualised dietary changes. There is a need to develop interventions for abdominal pain management in IBD.
... Glucomannans as soluble fibres are often proposed for the management of the condition (Loening-Baucke, Miele, & Staiano, 2004 ). For chronic constipation , native and depolymerised glucomannans improve the symptoms and are well-tolerated (Suwannaporn et al., 2013). The polysaccharides decrease faecal transit time (Marzio, Del Bianco, Donne, Pieramico, & Cuccurullo, 1989 ). Low-fibre diets supplemented with glucomannans increase defaecation frequency in healthy adults, possibly by increasing the stool bulk (Chen et al., 2006; Staiano et al., 2000). ...
... Glucomannan and lactulose given to constipated (pregnant) women showed a return to normal stool frequency in addition to being able to control body weight (Signorelli, Croce, & Dede, 1996). Suwannaporn et al. (2013) conducted a trial with fourteen male and female participants suffering from diarrhoea (for a range of different reasons). Volunteers received 3.3 g per day extensively hydrolysed konjac glucomannan (<10,000 Da, 'glucomannan hydrolysates' GMH) dissolved/dispersed in 150 ml water for ten days. ...
... rial colonisation. Certain adherent E. coli species are the trigger for irritable bowel disease (Chassaing et al., 2011; Strober, 2011). Hence, this binding could prevent the pathogens ability to initiate and induce chronic immune inflammation of the bowel mucosa, especially chronic inflammation observed in Crohn's disease (Eaves-Pyles et al., 2008). Suwannaporn et al. (2013studied the efficacy of low and high molecular weight konjac glucomannan hydrolysates within healthy volunteers and patients suffering from IBD and associated gut conditions including constipation, CD and UC. The authors reported that the discomfort and symptoms associated with IBD had been eased by the hydrolysed glucomannan (Tester & A ...
The roles of native and depolymerised glucomannans in the diet are reviewed together with their impact in health and disease. The structure and properties of the carbohydrates are also considered together with their roles as microbiological substrates and their interactions with non-pathogens and pathogens. Native glucomannans have been consumed for centuries in Asia within food products and are permitted food thickeners through the world. However, their strong gel structures limit applications in the diet. Depolymerised and native glucomannans are considered therefore in this review with relevant dietary applications. These applications include swallowing (dysphagia), nutrient absorption control, satiety, dietary-fibre, inflammatory bowel disease, colonic benefits (such as prebiotic).
... Effective prebiotics depress pathogen growth by substrate competition, production of organic acids and antimicrobial compounds. The glucomannans are associated with broad health applications which include: weight loss (Sood et al., 2008; Vasques et al., 2008), cholesterol binding (Martino et al., 2005; Zhang et al., 2011), affecting beneficially blood glucose concentration (Sood et al., 2008), nutrient absorption control (Oku et al., 1982), inflammatory bowel disease (Suwannaporn et al., 2013), decreasing the risk of cancer (Wu et al., 2011), stimulating the immune system (Schley and Field, 2002;Yamada et al., 2003; Oomizu et al., 2006; Onishi et al., 2007; Suzuki et al., 2010 ) and restricting aflatoxin toxicity (Santillán et al., 2009). Digestive advantages of prebiotics may be mediated by the gut-associated lymphoid tissue (GALT) system (Schley and Field, 2002). ...
... The volunteers consumed drinks containing 3.0 g active glucomannan hydrolysates (AMH) for 14 days, after which time blood samples were retaken (Day 15). The AMH representing hydrolysed konjac glucomannan (Suwannaporn et al., 2013). Volunteers consumed the carbohydrate daily as a drink (dispersed in 200-250 ml water), supervised by a researcher at the clinic. ...
Purpose
– This paper aims to evaluate the effect of depolymerised glucomannan in regulating blood lipid and glucose concentrations.
Design/methodology/approach
– Twenty adult volunteers were recruited. Blood samples were taken at Day 0. The volunteers consumed drinks containing 3.0 g active glucomannan hydrolysates (AMH) for 14 days, after which time blood samples were retaken (Day 15). Blood samples were analysed to determine the blood lipid and glucose concentrations.
Findings
– The average fasting blood glucose at the start of the trial was 2.54 mmol/L but reduced slightly to 2.49 mmol/L after consumption of the glucomannan. The total average cholesterol at the start of the trial was higher (6.69 mmol/L) than desirable ( < 5.0 mmol/L). This was reduced after consuming the glucomannan to 6.44 mmol/L (3.74 per cent). The triglyceride content was also higher initially than recommended (2.88 mmol/L) but was reduced by 11.5 per cent. The high-density lipoprotein (HDL) was within the desirable range before and after consumption (1.57 and 1.52 mmol/L, respectively), while the average low-density lipoprotein (LDL) was higher than recommended ( < 3.0 mmol/L), representing 4.55 mmol/L and 4.40 mmol/L before and after consumption, respectively. Both parameters were reduced by over 3.0 per cent. The consumption of the glucomannan hydrolysates also reduced the total cholesterol/HDL and LDL/HDL ratios.
Originality/value
– The AMH was effective in lowering blood cholesterol and glucose concentrations. Consumption of such carbohydrates could prove useful for these physiological disorders. Further studies are desirable to characterise the exact mechanism.
... Therefore, humans would have to consume 185 g and 135 g per day, respectively, to be comparable. The impacts of ingesting glucomannans on health are not only limited to their prebiotic roles but also on disease states directly where they enhance the immune system; both within the gut and in other parts of the body (Tester & Al-Ghazzewi, 2009; Suwannaporn et al., 2013 ). Glucomannans induce immunomodulatory processes by suppressing the development of allergic rhinitis-like symptoms, prevent the increase of plasma immunoglobulin E, immunoglobulin G (Oomizu et al., 2006; Onishi et al., 2007a Onishi et al., , 2007b) and spontaneously occurring dermatitis (Onishi et al., 2005).Table 1 shows the beneficial characteristics of native konjac glucomannan and its hydrolysates.Fig. 1 – Mice body weights (W1¼ 0 day, W2¼ 2 days, W3¼ 5 days, W4¼ 7 days) recorded in Groups 1 (control – drinking water); 2 (control – drinking water containing 5% w/v GMH); 3 (test – drinking waterþpunched ear); and 4 (test – drinking water containing 5% w/v GMHþpunched ear).Fig. 2 – Healing score differences of rodent ear punches between Groups 3 and 4 over eight days. ...
... Therefore, humans would have to consume 185 g and 135 g per day, respectively, to be comparable. The impacts of ingesting glucomannans on health are not only limited to their prebiotic roles but also on disease states directly where they enhance the immune system; both within the gut and in other parts of the body ( Tester & Al-Ghazzewi, 2009;Suwannaporn et al., 2013). Glucomannans induce immunomodulatory processes by suppressing the development of allergic rhinitis-like symptoms, prevent the increase of plasma immunoglobulin E, immunoglobulin G ( Oomizu et al., 2006;Onishi et al., 2007aOnishi et al., , 2007b) and spontaneously occurring dermatitis ( Onishi et al., 2005). ...
The objective of this work was to determine the effects of ingested depolymerised glucomannans on wound healing. Mice were divided into four groups of twenty each: control - drinking water; control - drinking water containing 5% (w/v) glucomannan hydrolysate (GMH); test - drinking water with punched ear and; test - drinking water containing 5% (w/v) GMH with punched ear. Healing scores were recorded over eight days while body weight was taken four times over the trial period. There was faster healing for the group drinking water containing GMH. The consumption of hydrolysed glucomannan may encourage wound healing due to a number of immunosupportive effects.
... Konjac glucomannan is a plant-derived polysaccharide that has been used to treat gastrointestinal inflammatory disorders. For example, supplementation in IBD patients with konjac glucomannan hydrolysate for fourteen days resulted in improved bowel movement, fecal consistency and reduced abdominal pain, resulting in a better lifestyle (158). ...
Inflammatory bowel diseases (IBD) are chronic disabling conditions with a complex and multifactorial etiology, which is still not completely understood. In the last 20 years, anti-TNF-α antagonists have revolutionized the treatment of IBD, but many patients still do not respond or experience adverse events. Therefore, new biological therapies and small molecules, targeting several different pathways of gut inflammation, have been developed of which some have already been introduced in clinical practice while many others are currently investigated. Moreover, therapeutic procedures such as leukocytapheresis, fecal microbiota transplant and stem cell transplantation are currently being investigated for treating IBD. Lastly, complementary and alternative medicine has become a field of interest for gastroenterologist to reduce symptom burden in IBD patients. In this comprehensive and updated review, a novel classification of current and developing drugs is provided.
... Therefore, the KGM is widely used as an emulsifier, thickener, stabilizer, etc., in many food applications. Moreover, as a non-ionic hydrocolloid dietary fiber, KGM shows many health-promoting effects, including anti-diabetic, anti-obesity, laxative, prebiotic and anti-inflammatory activities ( Aoe, Kudo & Sakurai, 2015 ;Suwannaporn et al., 2013 ;Vázquez-Velasco et al., 2015 ). ...
Understanding the correlations between dietary fibers' physical properties and postprandial appetite response helps to design novel functional products with satiety enhancing capability. In the present study, the partially degraded konjac glucomannan (Pd-KGM) was obtained by applying the heterogeneous hygrothermal degradation method, and its flow behavior was studied for guiding the preparation of sols with equi-concentration but differed in viscosity. The appetite-regulating effects derived from the sol viscosity were explored by monitoring the appetite hormone response and the feeding behavior of rats after they were given the Pd-KGM sols. By lowering the secretion of ghrelin, elevating the plasma concentration of GLP-1, PYY3-36, and CCK-8, and stabilizing blood glucose and insulin fluctuation, the sol with increased viscosity showed an improved satiety-enhancing capability. Moreover, the transition point from feeding to resting was advanced in rats given a more viscous sol, resulting in a significantly decreased feed intake (p<0.05). We further explored the correlations between sol viscosity and its nutritional effects relating to appetite regulation depending on the quantitative data obtained in this study. Excluding the plasma glucose and CCK-8, a strong linear correlation (Pearson coefficient > 0.7) emerged between the appetite hormone and the sol viscosity, especially for the GLP-1, which its Pearson coefficient was 0.946, indicating a very highly correlated relationship between them. Thus, these results revealed the feasibility of regulating appetite by taking advantage of sol viscosity.
... Its tubers can produce many konjac glucomannan (KGM), which is widely used in medical fields [2]. Studies have found that KGM has therapeutic effects on many diseases, such as gastric cancer [3], inflammatory bowel disease [4], hyperglycemia, and hyperlipidemia [5,6], skin inflammation [7], and so on. KGM also has positive health effects, such as controlling body weight [8], maintaining a healthy intestinal flora ecology [9,10], etc. ...
Amorphophallus is widely distributed in Southeast Asia, Africa, and other places, with more than 170 species. Amorphophallus has high medicinal value and is commonly used in medicine. However, the current classification based on morphology is challenging in with regard to Amorphophallus and closely related species. This study used six barcodes, namely ITS2, matK, rcbL, nad1, trnH-psbA, and trnL-trnF, to evaluate their identification ability for three important Amorphophallus species, including A. konjac, A. albus, and A. muelleri. We recommend that trnH-psbA can be applied to the Amorphophallus trade, quickly identify the purity of A. konjac and A. albus and distinguish A. muelleri from its related species for A. konjac and A. albus genetic improvement.
... KGOS has been widely used as a dietary food in Asia (Liu et al., 2019). Studies have shown a variety of biological activities such as improving food quality, increasing human intestinal flora with intestinal detoxification properties, enhancing immunity, regulating blood sugar and reducing blood lipids (Suwannaporn et al., 2013). Moreover, these activities can be enhanced through chemical modification, such as sulfation, carboxymethylation, phosphorylation, selenization, acetylation, alkylation and degradation (Li et al., 2016;Yu, Shen, Song, & Xie, 2018). ...
Konjac glucomannan is safely and widely used in the functional food industry. Compared with glucomannan, glucomannan oligosaccharides have higher water solubility making them easier to absorb and utilize. These oligosaccharides are also associated with many biological activities. A novel glucomannan hydrolase PpGluA with high activity and substrate specificity which releases a series of konjac glucomannan oligosaccharides having DP 2–9 is described here. Selenium is one of the essential trace elements for humans. The selenium-modified glucomannan oligosaccharides were prepared by the sodium selenite-nitric acid method for the first time. Antitumor activity studies demonstrated that selenium-modified glucomannan oligosaccharides had better activity than inorganic sodium selenite and glucomannan oligosaccharides and inhibited tumor by inducing apoptosis through the mitochondrial pathway. This study suggests that selenium-modified glucomannan oligosaccharides may be have potential as a new functional food for inhibition of tumors.
... Subjects retained under precise germ-free conditions do not experienceinflammation unless microorganismis introduced (19,20) In patients with CD, the number of adherent mucosal bacteria is increased (21) Inflammation arises in intestinal regionswith the maximum number of bacteria (22) Luminal and mucosa-linked microflora of IBD subjects varies from healthy subjects (23,25) Alteration of the fecal stream triggers clinical progress in Crohn's patients (25) (50). Prebiotics aid as a source of food for probiotics to raise, proliferate and increase in numbers on the bowel microflora. ...
The present review is focused on the prebiotic impact of inulin on the management of the gastrointestinal disorder. Prebiotics can be described as "non-digestible food ingredient stimulating the growth of a certain number of bacteria in the colon, which can improve the host health". In 2004 this definition was modernized to include other areas that may benefit from selective targeting of particular microorganisms: "selectively fermented ingredients that alter the configuration and activity in the gastrointestinal microbiota that confer positive effect". The positive impact of prebiotics in experimental colitis and human inflammatory bowel disease (IBD) has already been established. Prebiotics shows a positive effect in the prevention of IBD by modulating the trophic functions of the flora. Inulin enhances the growth of indigenous lactobacilli and/or bifidobacteria by inducing colonic production of short chain fatty acids (SCFA's) and these properties are related to decreased mucosal lesion scores and diminished mucosal inflammation. Inulin shows a positive approach to retain microbial populations and to support epithelial barrier function by their prebiotic effect which helps in the host defense against invasion and pathogens translocation (endogenous and/or exogenous) and in the inhibition of gastrointestinal diseases and this impact should be verified in further clinical studies. In the present review, we discussed the positive effect of prebiotics in rat IBD models and in human subjects along with their potential protective mechanisms. Preclinical and clinical data revealed that the gut mucosal barrier would be improved by the use of prebiotics in IBD.
... 24 Konjac glucomannan (KGM) as a SDF is reported with remarkable amelioration in intestine peristalsis and valid for the prevention of the inflammatory bowel diseases. 25,26 Nevertheless, few data have been obtained about the fermentation properties of single or mixed fibers of BC and KGM by the colonic bacteria in vivo and their regulatory effects on gut microbiota, host health, and metabolism. Therefore, further studies are urgent to reveal the physiological functions of BC or KGM and explore its potential applications in the food industry. ...
This work was to assess possible impacts of novel insoluble fiber BC (8% bacterial cellulose), soluble fiber KGM (8% Konjac glucomannan) and their mixture (4% BC/4% KGM) on fatty acid metabolism and intestinal microbiota of C57BL/6J mice fed with high-fat diet (HFD). HFD-fed mice receiving the dietary fibers (DFs) for 16 weeks exhibited an improvement in lipid-associated cytokines and a decrease in inflammation factors, which was associated with the improved the hepatic and serum fatty acids composition. The DFs, notably the mixed BC/KGM, elevated the HFD-caused decrease in the contents of acetic acid (from 23.9±0.85 to 32.2±0.84 mM/g, p<0.05), propionic acid (from 6.53±0.28 to 12.8±0.58 mM/g, p<0.05) and butyric acid (from 7.73±0.43 to 13.5±0.47 mM/g, p<0.05). Furthermore, the mixed BC/KGM significantly decreased the abundance of Firmicutes (from 90.4% to 67.6%) and Mucispirillum (from 4.77% to 1.58%), and dramatically increased the abundance of Bacteroides (from 7.83% to 25.0%) and Akkermansia (from 0.69% to 2.80%) in the gut of HFD-fed mice at genus level. Moreover, correlation analysis revealed that the multiplicity of gut microbiota was useful in sustaining colonic integrity through producing short chain fatty acids to some extent. This finding suggests that a mixture of insoluble BC and soluble KGM has positive effects on modulation of intestinal microecosystem in mice.
... Konjac glucomannan is a plantderived polysaccharide that has been used to treat gastrointestinal inflammatory disorders. For example, supplementation with konjac glucomannan hydrolysate for fourteen days to IBD patients resulted in improved bowel movement, fecal consistence, reduced abdominal pain, and a better lifestyle [44] ( Table 2). βGlucan was orally administered to an animal model of IBD, which resulted in improved fecal output and reduced colorectal distension [45] . ...
Inflammatory bowel disease (IBD) is a serious health concern among western societies. The disease is also on the rise in some East Asian countries and in Australia. Health professionals and dietitians around the world are facing an unprecedented challenge to prevent and control the increasing prevalence of IBD. The current therapeutic strategy that includes drugs and biological treatments is inefficient and are associated with adverse health consequences. In this context, the use of natural products is gaining worldwide attention. In vivo studies and clinical evidence suggest that well-planned dietary regimens with specific nutrients can alleviate gastrointestinal inflammation by modulating inflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukin 1 (IL-1), IL-6, IL-1β, and IL-10. Alternatively, the avoidance of high-fat and high-carbohydrate diets is regarded as an effective tool to eliminate the causes of IBD. Many functional foods and bioactive components have received attention for showing strong therapeutic effects against IBD. Both animal and human studies suggest that bioactive functional foods can ameliorate IBD by downregulating the pro-inflammatory signaling pathways, such as nuclear factor κB, STAT1, STAT6, and pro-inflammatory cytokines, including IL-1β, IL-4, IL-6, COX-2, TNF-α, and interferon γ. Therefore, functional foods and diets have the potential to alleviate IBD by modulating the underlying pathogenic mechanisms. Future comprehensive studies are needed to corroborate the potential roles of functional foods and diets in the prevention and control of IBD.
... In vivo studies in healthy animals (Elamir et al., 2008;Qin et al., 2014;Wan et al., 2015;Wang et al., 2016a), ulcerative colitis animals (Feng et al., 2015;Liu et al., 2016), and humans suffering from IBD (Suwannaporn et al., 2013) (Table 2) verified the prebiotic effects of DKGM. Mechanism studies revealed that oral administration of DKGM not only promotes the proliferation of probiotics (mainly Lactobacillus and Bifidobacterium), which is consistent with the in vitro results, but also influences the intes-tinal environment (increasing intestinal villi height and SCFAs) and reduces the levels of inflammatory factors (malondialdehyde, inducible nitric oxide synthase, cyclooxygenase-2, tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β)). ...
Konjac glucomannan (KGM) is a water-soluble polysaccharide obtained from the roots and tubers of konjac plants. Recently, a degraded product of KGM, depolymerized KGM (DKGM), has attracted attention because of its low viscosity, improved hydrophily, and favorable physiological functions. In this review, we describe the preparation of DKGM and its prebiotic effects. Other health benefits of DKGM, covering antioxidant and immune activity, are also discussed, as well as its safety. DKGM could be a candidate for use as a tool for the treatment of various diseases, including intestinal flora imbalance, and oxidative- and immune-related disorders.
... It is a popular functional food, widely used for its various biological activities and health benefits, such as body weight loss, reducing cholesterol and blood sugar levels, and immuno-enhancement, etc. . β-1, 4 glycosidic bond makes it an optimal non-digestible dietary fibre and a great potential to be developed as prebiotic (Suwannaporn et al., 2013). Approximately 25,000 tons of KGM are produced annually worldwide (Chua, Baldwin, Hocking, & Chan, 2010;Tester & Al-Ghazzewi, 2016). ...
... Enhanced results in reducing fecal waterinduced DNA damage in Caco cells were obtained for the GMOS, mainly due to their prebiotic effects. In addition, in a study carried out with humans, the tolerance and therapeutic efficacy of low and high molecular weight KGM hydrolysates in patients suffering from inflammatory bowel disease, constipation, Crohn's disease, and ulcerative colitis were assessed by Suwannaporn et al. 66 In this case, the hydrolysates were well tolerated and had important health benefits in patients with ...
Glucomannans (GM) are polymers which can be found in natural resources, such as tubers, bulbs, roots, and in both hard- and softwoods. In fact, mannan-based polysaccharides represent the largest hemicellulose fraction in softwoods. In addition to their structural functions and their role as energy reserve, they have been assessed for their healthy applications, including their role as new source of prebiotics. This article summarizes the scientific literature regarding the manufacture and the functional properties of GM and their hydrolysis products with a special focus on their prebiotic activity.
... In concordance, phytochemical studies revealed the presence of fair amount of glucomannan in APAE and APME. In clinical studies, konjac glucomannan has demonstrated therapeutic effectiveness in inflammatory bowel disease (Suwannaporn et al. 2013) and suggests the contributing role of glucomannan in anticolitic effect of tuber. Hence, the beneficial effect of APME and APAE on UC may be attributed to the presence of betulinic acid, b-sitosterol and glucomannan. ...
Context: The tuber of Amorphophallus paeoniifolius (Dennst.) Nicolson (Araceae), commonly called Suran or Jimmikand, has high medicinal value and is used ethnomedicinally for the treatment of different gastrointestinal and inflammatory disorders.
Objective: The present study evaluated the effects of extracts of Amorphophallus paeoniifolius tubers on acetic acid-induced ulcerative colitis (UC) in rats.
Materials and methods: Wistar rats were orally administered methanol extract (APME) or aqueous extract (APAE) (250 and 500 mg/kg) or standard drug, prednisolone (PRDS) (4 mg/kg) for 7 days. On 6th day of treatment, UC was induced by transrectal instillation of 4% acetic acid (AA) and after 48 h colitis was assessed by measuring colitis parameters, biochemical estimations and histology of colon.
Results: APME or APAE pretreatment significantly (p < .05–.001) prevented AA-induced reduction in body weight and increase in colitis parameters viz. stool consistency, colon weight/length ratio and ulcer score, area and index. Extracts treatment attenuated (p < .001) increase in alkaline phosphatase and lactate dehydrogenase in serum and myeloperoxidase activity and cytokines in colon tissue due to AA administration. Extracts treatment prevented AA-induced elevation in lipid peroxidation and decline in activities of superoxide dismutase and catalase and reduced-glutathione content (p < .05–.001) along with histopathological alterations. PRDS also showed similar ameliorative effect on colitis.
Discussion and conclusion: APME and APAE showed a preventive effect on UC, and ameliorated inflammation and oxidative damage in colon. The effects may be attributed to presence of phytochemicals, betulinic acid, β-sitosterol, and glucomannan. In conclusion, the tuber of Amorphophallus paeoniifolius exhibited an anticolitic effect through anti-inflammatory and antioxidant action.
... Suwannaporn et al. [112] investigated the effect of low and high weight KGM hydrolysates within healthy volunteers and patients suffering from IBD and associated gut conditions. The KGM hydrolysates delivered several biological benefits such as capacity to bind pathogens and arrest them from binding epithelial cells of gut, stimulating topical healing, regulating immune systems, and ability to generate systemic immune responses. ...
Cellulose, present in renewable lignocellulosic material, is considered to be the most abundant organic substrate on earth for production of hexose and pentose sugars, feedstock for fuel, and for other chemicals. Research on cellulase has progressed very rapidly in the past few decades with an emphasis on enzymatic hydrolysis of cellulose to hexose sugars. The enzymatic hydrolysis of cellulose requires the use of cellulase [1,4-(1,3:1,4)-β-D-glucan glucanohydrolase, EC 3.2.1.4], a multiple enzyme system consisting of endo-1,4,-β-D-glucanases [1,4-β-D-glucanases (CMCase, EC 3.2.1.4)], exo-1,4,-β-D-glucanases [1,4-β-D glucan cellobiohydrolase, FPA, EC 3.2.1.91], and β-glucosidase (cellobiase) (β-D-glucoside glucanohydrolase, EC 3.2.1.21). Major impediments to exploit the commercial potential of cellulases are the economic yield, stability, specificity, and above all, the cost of production. In the last few years, emphasis has been devoted mainly to submerged fermentation and less attention has been given to solid state fermentation (SSF). SSF refers to the process whereby microbial growth and product fermentation occur on the surface of solid materials. This process occurs in the absence of "free" water, where the moisture is absorbed to the solid matrix. The direct applicability of the product, the high product concentration, lower production cost, easy product recovery, and reduced energy requirement make SSF a promising technology for cellulase production. This chapter covers the production of cellulase in SSF using various lignocellulosic substrates, the microorganisms involved, cultural conditions, process parameters (ie, moisture content and water activity, mass transfer processes: aeration and nutrients diffusion, substrate particle size, temperature, pH, surfactants, etc.), bioreactor designs, and the strategies to improve enzyme yield.
... Suwannaporn et al. [112] investigated the effect of low and high weight KGM hydrolysates within healthy volunteers and patients suffering from IBD and associated gut conditions. The KGM hydrolysates delivered several biological benefits such as capacity to bind pathogens and arrest them from binding epithelial cells of gut, stimulating topical healing, regulating immune systems, and ability to generate systemic immune responses. ...
In recent year, konjac glucomannan (KGM) has attracted more attention due to its non-harmful and non-toxic properties, good biocompatibility, biodegradability and hydrophilic ability. Moreover, KGM and their derivatives have several importances in the multidirectional research areas such as nutritional, biotechnological and fine chemical fields. In the previous article, we have reviewed the nutritional aspects of KGM covering the various aspects of functional foods, food additives and their derivatives. This review aims at highlighting the diverse biomedical research conducted on KGM in the past ten years, covering therapies for anti-obesity, regulation in lipid metabolism, laxative effect, anti-diabetic, anti-inflammatory, prebiotic to wound dressing applications. Moreover, this review deals with global health aspects of KGM and the disparate health related factors associated with diseases and their control measures.
... The tuber also contains nearly 70% of carbohydrates (Srivastava et al., 2014), and has high glucomannon content (Nguyen et al., 2009) which is apparent from presence of fair amount of glucomannan in APAE and APME. Glucomannan is also reported to have antioxidant property (Liu et al., 2015) and antiinflammatory activity (Bauerova et al., 2008;Suwannaporna et al., 2013) and might have contributed to curative effect of tuber. APME and APAE both showed significant ameliorative effect on showing severe inflammation*, hemorrhage, congestion and dilatation of blood vessels (arrow), degeneration and necrosis (arrow head). ...
Ethnopharmacological relevance:
Amorphophallus paeoniifolius (Dennst.) Nicolson (Family- Araceae) is a crop of south East Asian origin. In India, its tuber is widely used in ethnomedicinal practices by different tribes for the treatment of piles (hemorrhoid).
Aim:
The present study evaluated the effect of methanolic and aqueous extract of Amorphophallus paeoniifolius tuber on croton oil induced hemorrhoids in rats.
Materials and methods:
The methanolic extract was standardized with the major phenolic compound, betulinic acid, by HPLC. The hemorrhoids were induced by applying 6% croton oil preparation in the ano-rectal region. Rats were orally administered methanolic and aqueous extract at doses of 250 and 500mg/kg, each for 7 days. Pilex (200mg/kg) was used as reference anti-hemorrhoidal drug. Hemorrhoids were assessed on eighth day by measuring hemorrhoidal and biochemical parameters along with histology of ano-rectal tissue.
Results:
Croton oil application caused induction of hemorrhoids as indicated by significant (p<0.001) increase in plasma exudation of Evans blue in ano-rectal tissue, macroscopic severity score and ano-rectal coefficient as compared to normal rats. It significantly (p<0.001) elevated lactate dehydrogenase and cytokines (TNF- α and IL-6) levels in serum and increased myeloperoxidase activity and lipid peroxidation in ano-rectal tissue along with marked histological damage as compared to normal rats. Treatment with tuber extracts and pilex significantly (p<0.05-0.001) ameliorated Evans blue exudation, hemorrhoidal parameters and other biochemical parameters with attenuation of tissue damage compared to hemorrhoid control rats. The results indicate that tuber extracts exhibited curative action on hemorrhoids. The aqueous extract showed more pronounced effect than methanolic extract. The effects may be attributed to anti-inflammatory and antioxidant properties.
Conclusion:
Results indicate that tuber of Amorphophallus paeoniifolius exhibited curative action on hemorrhoids through anti-inflammatory and antioxidant properties. The study validates the ethnomedicinal use of tuber in hemorrhoids and implicates its therapeutic potential as an anti-hemorrhoidal agent.
... Suwannaporn et al. [112] investigated the effect of low and high weight KGM hydrolysates within healthy volunteers and patients suffering from IBD and associated gut conditions. The KGM hydrolysates delivered several biological benefits such as capacity to bind pathogens and arrest them from binding epithelial cells of gut, stimulating topical healing, regulating immune systems, and ability to generate systemic immune responses. ...
Amorphophallus konjac (konjac) is one among the major vegetable (tuber) crops grown in Asian
countries. In China and Japan, it has been used as food and food additives for more than 1000
years. Over the last few decades, the purified konjac flour, commonly known as konjac
glucomannan (KGM), a dietary fiber hydrocolloidal polysaccharide, has been introduced as a
food additives as well as dietary supplement in many Asian and European countries. The present
article reviews the literature (up to January 2015) covering the development of various functional
foods, food additives from KGMs and their derivatives, Also, this review deals with global
nutritional aspects and value added products of konjac corm.The bioprocessing techniques such
as preparation, purification, extraction of KGM from konjac flour and methods to improve
quality of KGM are discussed.
... Suwannaporn et al. [112] investigated the effect of low and high weight KGM hydrolysates within healthy volunteers and patients suffering from IBD and associated gut conditions. The KGM hydrolysates delivered several biological benefits such as capacity to bind pathogens and arrest them from binding epithelial cells of gut, stimulating topical healing, regulating immune systems, and ability to generate systemic immune responses. ...
Lignocellulose is the most plentiful non-food biomass and one of the most inexhaustible renewable resources on the planet, which is an alternative sustainable energy source for the production of second generation biofuels. Lignocelluloses are composed of cellulose, hemicellulose and lignin, in which the sugar polymers account for a large portion of the biomass. Cellulases belong to the glycoside hydrolase family and catalyze the hydrolysis of glyosidic linkages depolymerizing cellulose to fermentable sugars. They are multi-enzymatic complex proteins and require the synergistic action of three key enzymes: endoglucanase (E.C. 3.2.1.4), exoglucanase (E.C. 3.2.1.176) (E.C. 3.2.1.91) and β-glucosidase (E.C. 3.2.1.21) for the depolymerization of cellulose to glucose. Solid state fermentation, which holds growth of microorganisms on moist solid substrates in the absence of free flowing water, has gained considerable attention of late due its several advantages over submerged fermentation. The review summarizes the critical analysis of recent literature covering production of cellulase in solid state fermentation using advance technologies such as consolidated bioprocessing, metabolic engineering and strain improvement, and circumscribes the strategies to improve the enzyme yield.
Inflammatory bowel disease (IBD) is a long-term chronic disease, about 20% of IBD patients deteriorate to colorectal cancer. Currently, there is no radical cure for IBD. Natural plant polysaccharides (NPP) have low toxic and side effects, which have immune and prebiotic activities and possesses positive effect on alleviating IBD. In this review, we will focus on the alleviating effect of NPP on IBD in vitro and in vivo from three aspects: regulating intestinal flora imbalance, repairing intestinal barrier injury and improving immunity. The relationship between the chemical structure of natural plant polysaccharides and the therapeutic effect of IBD are highlighted. Finally, the synergistic role of NPP as a carrier of drugs or active molecules to reduce side effects and enhance targeting function are discussed, especially pectic polysaccharides. Broadly, this review provides a valuable reference for NPP to be developed as functional food or health products to alleviate IBD.
Scope: Konjac glucomannan oligosaccharides (KMOS) are prebiotics and may improve intestinal immunity through modulation of macrophage function. However, the underlying molecular mechanisms are still not clear. Methods and Results: Using a mouse model of dextran sulfated sodium (DSS)-induced acute colitis, we demonstrate here that KMOS (400 mg/kg/d) can ameliorate intestinal inflammation in a macrophage dependent manner. Oral exposure to KMOS prevented DSS-induced intestinal pathology, improved epithelium integrity, and decreased accumulation of colonic inflammatory leukocytes and cytokines. The therapeutic effects of KMOS are dependent on the function of macrophages, as depletion of macrophages abolished the effects. In colonic lamina propria of DSS-treated mice, as well as in vitro culture of bone marrow derived macrophages (BMDMs), KMOS skewed reprogramming of classically activated macrophages (CAM/M1) into alternatively activated macrophages (AAM/M2). We further determine that the activation of SIGNR1/phospho-c-Raf (S338)/phospho-p65 (S276)/acetyl-p65 (K310) pathway is responsible for KMOS-induced AAM/M2 polarization. Blockage of SIGNR1 abolished KMOS-induced AAM/M2 polarization of activated macrophages, expression of phospho-p65 (S276) in colonic macrophages, and alleviation of DSS-induced colitis in mice, suggesting that SIGNR1 is critical for macrophage responses to KMOS. Conclusions: This study reveals a SIGNR1-mediated macrophage-dependent pathway that supports regulatory function of KMOS in host immunity and intestinal homeostasis.
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Background and Objective: Carob pods are natural sources of fermentable fibers and polyphenols, which have been shown to have health benefits. Konjac is a plant known for its dietary fiber, health benefits and food applications. The utilization of carob and konjac as prebiotic sources could serve as novel substrates for improving probiotics viability and stability. This study examined the effect of carob and konjac (2.5 and 5%) on the growth of four probiotic strains (Bifidobacterium bifidum, Lactobacillus paracasei, Lactobacillus acidophilus and Streptococcus thermophilus) and the effects of fermentation on total phytochemical contents and antioxidant activity. Materials and Methods: Total viable counts and pH were measured for assessing prebiotic activity. Total phenolics, total flavonoids, DPPH, FRAP, TEAC and ORAC were measured in fermented and unfermented samples. The analysis was conducted in triplicates. Results: The highest growth fold (Log CFU) was noted with a combination of L. acidophilus and 5% carob after 48 hrs incubation (2.02 Log CFU) and L. paracasei and 2.5% konjac after 24 hrs incubation (2.13 Log CFU). Total phenolic contents and total flavonoids were highest after 48 hrs fermentation of 2.5% carob with B. bifidum (518.07 mg GA 100 g–1 and 344.37 mg CE 100 g–1). The DPPH, TEAC and FRAP activity ranged from (12.15-92.85%, 4.13-24.8 mM Trolox g–1 and 11.25-31.4 mM FeSO4 g–1, respectively) in all samples. For ORAC, the majority of fermented extracts showed better values (0.04-5.46 uM Trolox g–1). Conclusion: Accordingly, carob pods and konjac extracts may be considered as effective prebiotic for increasing probiotics growth and viability and particularly carob as a source of antioxidants.
Probiotics and natural products can promote humoral transport and effectively relieve intestinal motility. This study investigated the effects of probiotics with konjac glucomannan (KGM) and an aqueous extract of Prunus persica on constipation. The growth promotion effect of these natural products on probiotics was investigated using co-culture in vitro. The combined effect of probiotics with natural products on constipation were observed in mice. The tryptophan, tryptamine and short-chain fatty acid levels were determined using enzyme-linked immunosorbent assay, reverse-phase high-performance liquid chromatography, and gas chromatography. The key genes and proteins involved in humoral transport were identified using real-time polymerase chain reaction, western blotting and fluorescence immunoassay. KGM promoted the growth of Bifidobacterium animalis F1-7 in vitro, and a mixture of KGM and B. animalis F1-7 effectively promoted defaecation in mice, increased faecal content in water, shortened defaecation time and improved the gastrointestinal transit rate. In mice, the KGM + F1-7 mixture reduced the tryptophan level and increased the levels of tryptamine, acetic acid, propionic acid, butyric acid and valeric acid. In addition, the KGM + F1-7 mixture effectively increased the mRNA level of 5-HT4-G-protein-coupled receptors (5-HT4GPCR)/mucins-2 (MUC-2) and reduced the level of aquaporins (AQP3); furthermore, it upregulated the protein level of 5-HT4GPCR/MUC-2 and downregulated the protein level of AQP3. These findings indicated that the KGM + F1-7 mixture effectively improved intestinal motility and alleviated constipation through humoral transport-related pathways.
Objective
Various probiotics and natural products are able to relieve constipation. This study aimed to explore the effects of relieving constipation and potential mechanism of the combination laxative Konjac glucomannan-probiotic.
Research Methods & Procedures
This study evaluated the gastrointestinal tract viability of probiotics in vitro. A constipation model was constructed in BALB/c mice, and the efficacies of the combinations regarding their bowel movement-promoting effects were verified, including the first black stool defecation time and gastrointestinal transit rates of mice. Colonization by the probiotics was determined by quantitative real-time PCR (qRT-PCR). Hematoxylin-eosin staining (HE), gas chromatography (GC), ELISA, qRT-PCR and Western blot (WB) were also used for analysis.
Results
Lactobacilli paracasei X11 (X11) and Lactobacilli casei YRL577 (YRL577) had outstanding gastrointestinal tract viability. Konjac Glucomannan (KGM) + X11, Prunus persica+X11, and Prunus persica+YRL577 significantly relieved constipation. In addition, KGM promoted the colonization of L. paracasei X11. Meanwhile, KGM+X11 effectively promoted the metabolism of short-chain fatty acids (SCFAs) in mice better than others and the 5-HT content in the KGM + X11 group was the highest among all the groups. Therefore, KGM + X11 was selected for further research. The combination laxative promoted the secretion of 5-HT, upregulated the mRNA and protein levels of 5-HT receptor 4 (5-HT4R) and serotonin transporter (SERT) via the 5-HT pathway and effectively relieved constipation.
Conclusion
The combination laxative Konjac glucomannan-probiotic (KGM+X11) promoted defecation in constipated mice, possibly by increasing short chain fatty acid metabolism and 5-hydroxytryptamine hormone release.
Treatments for inflammatory bowel disease (IBD) are typically immunosuppressive. Despite a range of treatment options, limited efficacy, systemic toxicities like bone marrow suppression, infections and malignancy are their serious setbacks. There exists an unmet medical need for novel therapeutic agents without safety concerns resulting from chronic, systemic immunosuppression. Of late, several natural agents with better therapeutic potential have been reported. It is very likely that restricting the release of the active molecules to the intestine would further improve their clinical efficacy and safety. To this end, novel polymer-based micro/nano formulations protect the drug from gastric environment and slowly release the drug in the colon. However, cost and side-effects associated to synthetic polymers have led to the development of biocompatible, economic and pharmaceutically well-accepted biomacromolecules in exploring their potential in IBD. Since last few years, biological proteins, polysaccharides and their combinations have shown great efficacy in colitis induced animal models. In this review, micro/nano formulations developed using biomacromolecules like chitosan, zein, pectin, casein, alginate, dextran, glucomannan and hyaluronic acid have been reviewed focusing on their potential in protecting active cargo, avoiding premature release, distal colon targeting along with their impact on reshaping the altered gut microbiota and how it can ameliorate the colitis conditions.
The potential effects of Komagataeibacter hansenii CGMCC 3917 cells on the alcohol-induced liver injury and its probable mechanisms were investigated. Male Kunming mice were orally administrated with alcohol (10 mL/kg BW) alone or in combination with administration of K. hansenii CGMCC 3917 cells at 2×108 and 2×106 CFUs for 10 weeks. Administration of strain CGMCC 3917 cells, especially the high dose administration, decreased the liver weights, fat gain, and fatty-acid metabolism-related enzymes SCD-1, ACC and FAS expressions and endotoxin release, which were elevated by alcohol treatment. Furthermore, the total contents of long chain fatty acids of the liver and serum in alcohol-treated mice supplemented with high dose of strain CGMCC 3917 cells were decreased to 5.44±0.19 μg/mL and 3.66±0.15 μg/mL from 6.65±0.31 μg/mL and 4.52±0.21 μg/mL, respectively. Conversely, the SCFAs decreased by ethanol treatment, particularly the acetic acid, propionic acid and butyric acid, were obviously enhanced in the faeces, colon and cecum of the mice supplemented with strain CGMCC 3917 cells. Moreover, strain CGMCC 3917 cells could regulate gut microbiome by significantly decreasing the abundance of Actinobacteria, Proteobacteria and Firmicutes, and dramatically increasing the abundance of Bacteroidetes in alcohol-treated mice. These findings suggest that K. hansenii CGMCC 3917 cells alleviates alcohol-induced liver damage via regulating fatty acid metabolism and intestinal microbiota diversity in mice.
Polysaccharides that contain many sugar monomers include starch and non-starch polysaccharides (NSPs) together with resistant starch (RS). Dietary polysaccharides are well known to have a wide range of biological benefits for bowel health. Gut microbiota and their fermentative products, short chain fatty acids (SCFA), which have recently been highlighted as metabolic regulators, are thought to mediate the function of dietary complex carbohydrates and bowel health. We discuss the influence of various polysaccharides on human bowel health and the mechanisms underlying these effects. We also describe their biological effects on intestinal health and the mechanisms underlying their activity; the polysaccharides were divided into three categories: dietary, microbial, and host-derived polysaccharides. Physiological impacts of non-starch polysaccharides (NSPs) and resistant starch (RS), both of which pass through the small intestine nearly intact and can be fermented by gut microbiota in the large intestine, are similar to each other. They exert a wide range of beneficial effects including anti-inflammation, gut epithelial barrier protection, and immune modulation through both microbiota-dependent and -independent mechanisms. Bacterial polysaccharides usually found in the cell wall generally act as immune modulators, and host-derived polysaccharides not only protect host cells from pathogenic microbial neighbors but also affect overall intestinal health via interactions with gut microbes. Considering these observations, further studies on polysaccharides will be important for bowel health.
Glucomannans (GMs) from diverse natural plants have great potentiality in enhancing host immune system. Protective effects of three GMs on the intestinal mucosal immunity in colitis mice were investigated and compared in this study. The three GMs (KGM, AGP, and DOP) were achieved from Amorphophallus rivieri, Aloe vera, and Dendrobium officinale, respectively, having different weight-average molecular weights (Mw), acetyl group content, and molar ratios of mannose to glucose (M/G). The three fractions were administrated with or without dextran sodium sulfate (DSS) containing drinking water. Macroscopic observations (health state, crypt depth, and bowel thickness of colon tissue) were conducted. Furthermore, related cytokines and mRNA expressions of TLRs were measured by ELISA and RT-qPCR, respectively. Results showed that administration of three GMs improved the health state of colitis mice, such as the recovery of body weight, increase of immune organ index, crypt depth, bowel wall thickness, and total number of immune cells. The integrity of intestinal mucosa was maintained by the increasing number of goblet cells and mucin proteins production. Further studies showed that GMs kept the balance of pro- and anti-inflammatory cytokines, and also regulated the expressions of TLR-2, TLR-4, TLR-6, and TLR-9. The above results suggested that GMs could attenuate the intestinal epithelial injury and regulate the intestinal mucosal immunity. Structural features including the M/G ratio, Mw, and content of acetyl group jointly influence the protective effects of GMs on the colitis mice.
Konjac glucomannan (KGM) is a dietary fiber hydrocolloidal polysaccharide isolated from the tubers of Amorphophallus konjac. Over the last few decades, the purified KGM has been offered as a food additive as well as a dietary supplement in many countries. Also, a diet containing konjac flour or KGM is considered as healthier, and these foods are popular in many Asian and European markets. Further, due to the adhesive property of KGM, it can form a defensive covering on the surface of the intestine. Additionally, KGM can reduce the levels of glucose, cholesterol, triglycerides, and blood pressure and can enable weight loss. Its wide-ranging effects prevent many chronic diseases through the regulation of metabolism. In this review, the recent studies on the health benefits such as anti-diabetic, anti-obesity, laxative, prebiotic, and anti-inflammatory activities of KGM were discussed. Also, this review deals with the applications of KGM and its derivatives in bio-technical, pharmaceutical, tissue engineering, fine chemical fields, etc.
Irregular and long time work schedules not only makes people feel fatigue, but also brings great risks of diseases, due to gastrointestinal disorder and immune dysfunction. Therefore, it has positive significance to help challenged people stay energetic and healthy with food supplement. Konjac oligosaccharide has shown various physiological benefits and been recommended in the fortification of functional foods. However, there have been few reports on its application aimed to simultaneously relieve physical fatigue and keep body healthy. In this paper, the potential prebiotic, immunoregulatory, and antifatigue activities of konjac oligosaccharide were evaluated in vitro and in vivo. The results showed that konjac oligosaccharide could promote probiotics growth and short chain fatty acids production in mice cecum. At the concentration of 50 to 200 μg/mL, konjac oligosaccharide could activate murine macrophage RAW 264.7 to secret NO and cytokines of IL‐10 and IL‐6. Moreover, this oligosaccharide could alleviate physical fatigue by prolonging exhaustive time, improving the level of superoxide dismutases and glutathione peroxidase, increasing the content of blood glucose, and decreasing the content of blood urea nitrogen. The results suggested that konjac oligosaccharide had prebiotic, immunoregulatory, and antifatigue effects, providing its application potential in functional food aimed at people with irregular and long time work.
Konjac glucomannan (KGM) is an important functional polysaccharide in food research. However, unstable dispersibility of KGM inhibits its in-depth study and wide application. In this study, a degraded KGM (100 kGy-KGM), which showed excellent dispersibility and specific physicochemical properties, were obtained by γ-irradiation in a dosage of 100 kGy. We investigated the protective effect of 100 kGy-KGM against H2O2 induced oxidative damage in LO2 cells. Our results demonstrated that pretreatment of LO2 cells with 100 kGy-KGM not only significantly increased cellular survivals and activities of GSH-Px and CAT, but also reduced levels of LDH, MDA and intracellular accumulation of ROS. The marked protective effect against oxidative damage and excellent dispersibility in 100 kGy-KGM allowed its possible use as an antioxidant. Our study provided fundamental knowledge to understand the structure-functions relationships of degraded-KGM, which could result in a theoretical guidance for the future application of KGM.
The impact of ingesting glucomannans on health are not only limited to colonic focussed fermentation into short chain fatty acids (SCFAs) which might have some local health benefits, but also towards helping to treat disease states and enhance the body's immune system, both within the gut and in/on other parts of the body. The local and systemic role of hydrolysed glucomannans, especially konjac glucomannans in the mouth, oesophagus, stomach, small intestine, large intestine, gut-associated lymphoid tissue (GALT), skin and vagina are highlighted. Therapeutic applications are discussed.
The human gut is colonized with a vast and diverse microbial ecosystem, and these bacterium play fundamental roles in the well-being of our bodies. Gut-associated lymphoid tissues, the largest mucosal immune system, should never be overlooked for its profound effect in maintaining the host immunity. Therefore, we discussed the relationship between gut immunity and host health, primarily from two aspects: the homeostasis of gut microbiota, and the function of gut-associated lymphoid tissues. Polysaccharides, widely concerned as bioactive macromolecules in recent centuries, have been proved to benefit the intestinal health. Dietary polysaccharides can improve the ratio of probiotics, regulate the intestinal microenvironment like decreasing the gut pH, and stimulate the macrophages or lymphocytes in gut tissues to fight against diseases like cancer. Based on various experimental and clinical evidence, the impacts of dietary polysaccharides on intestinal health are summarized, in order to reveal the possible immunomodulatory mechanisms of polysaccharides.
Crohn's disease (CD), a subcategory of inflammatory bowel disease, is an immune-related disorder characterized by inflammation of the gastrointestinal mucosa, which can take place in any region along the alimentary tract. The most important gene involved in the etiology of CD is NOD2/CARD15 located on chromosome 16. It has been shown that CARD15 is overexpressed in monocytes of CD patients. The common treatment for the disease is anti-TNF-alpha drugs, the most hopeful of which are probably infliximab and etanercept. Infliximab rapidly reduces signs and symptoms of active Crohn's disease. In contrast, etanercept shows no such effect. In the present study, we evaluated the effects of the CARD15 gene overexpression in monocytic cell line U937 in the production of anti-inflammatory cytokine, IL-10, and proinflammatory cytokine, Il-1 beta, produced after incubation with infliximab, adalimumab, and etanercept separately. Our results show that infliximab and adalimumab significantly decreased IL-10 and IL-1beta secretion levels. However, etanercept inhibition of secretion was less compared with infliximab or adalimumab. In all three cases, suppression of cytokine production is reduced by CARD15 overexpression.
Copyright © 2015. Published by Elsevier B.V.
The rationale for using probiotics, prebiotics, and antibiotics in inflammatory bowel diseases (IBD) is based on convincing evidence that intestinal bacteria are implicated in the pathogenesis of these diseases. Probiotics are living organisms, which upon ingestion in certain numbers, exert health benefits beyond inherent basic nutrition. Several mechanisms have been proposed to account for the action of probiotics. VSL#3, a highly concentrated cocktail of probiotics has been shown to be effective in the prevention of pouchitis onset and relapses. Results on the use of probiotics in UC are promising, both in terms of the prevention of relapses and the treatment of mild-to-moderate attacks. Results in Crohns disease are not yet clear because of conflicting data and the limited number of well-performed studies. Prebiotics are dietary substances, usually nondigestible carbohydrates, which beneficially affect the host by selectively stimulating the growth and activity of protective commensal enteric bacteria. Evidence supporting the use of these nutriceuticals in IBD is still limited. Antibiotics have an essential role in treating the septic complications of Crohns disease, including intrabdominal and perianal abscesses and perianal fistulae. The use of antibiotics in UC is not supported by the available studies while their use in pouchitis is largely justified although proper controlled trials have not been conducted.
Konjac glucomannan is a kind of neutral polysaccharides with excellent biocompatibility and biodegradable activities. The recent studies on the applications of konjac glucomannan and its derivatives in pharmaceutical, bio-technical, fine chemical fields etc. were reviewed.
Crohn disease (CD) is a multifactorial disease in which an abnormal immune response in the gastrointestinal (GI) tract leads to chronic inflammation. The small intestine, particularly the ileum, of patients with CD is colonized by adherent-invasive E. coli (AIEC)--a pathogenic group of E. coli able to adhere to and invade intestinal epithelial cells. As the earliest inflammatory lesions are microscopic erosions of the epithelium lining the Peyer's patches (PPs), we investigated the ability of AIEC bacteria to interact with PPs and the virulence factors involved. We found that AIEC bacteria could interact with mouse and human PPs via long polar fimbriae (LPF). An LPF-negative AIEC mutant was highly impaired in its ability to interact with mouse and human PPs and to translocate across monolayers of M cells, specialized epithelial cells at the surface of PPs. The prevalence of AIEC strains harboring the lpf operon was markedly higher in CD patients compared with controls. In addition, increased numbers of AIEC, but not LPF-deficient AIEC, bacteria were found interacting with PPs from Nod2(-/-) mice compared with WT mice. In conclusion, we have identified LPF as a key factor for AIEC to target PPs. This could be the missing link between AIEC colonization and the presence of early lesions in the PPs of CD patients.
The human bowel contains a large and biodiverse bacterial community known as the microbiota or microbiome. It seems likely that the microbiota, fractions of the microbiota, or specific species comprising the microbiota provide the antigenic fuel that drives the chronic immune inflammation of the bowel mucosa that is characteristic of Crohn's disease and ulcerative colitis. At least twenty years of microbiological research have been expended on analysis of the composition of the bowel microbiota of inflammatory bowel disease patients in comparison to that of control subjects. Despite extensive speculations about the aetiological role of dysbiosis in inflammatory bowel diseases, knowledge that can be easily translated into effective remedies for patients has not eventuated. The causes of this failure may be due to poorly defined and executed bacteriological studies, as well as the overwhelming complexity of a biome that contains hundreds of bacterial species and trillions of bacterial cells.
The different compartments of the gastrointestinal tract are inhabited by populations of micro-organisms. By far the most important predominant populations are in the colon where a true symbiosis with the host exists that is a key for well-being and health. For such a microbiota, 'normobiosis' characterises a composition of the gut 'ecosystem' in which micro-organisms with potential health benefits predominate in number over potentially harmful ones, in contrast to 'dysbiosis', in which one or a few potentially harmful micro-organisms are dominant, thus creating a disease-prone situation. The present document has been written by a group of both academic and industry experts (in the ILSI Europe Prebiotic Expert Group and Prebiotic Task Force, respectively). It does not aim to propose a new definition of a prebiotic nor to identify which food products are classified as prebiotic but rather to validate and expand the original idea of the prebiotic concept (that can be translated in 'prebiotic effects'), defined as: 'The selective stimulation of growth and/or activity(ies) of one or a limited number of microbial genus(era)/species in the gut microbiota that confer(s) health benefits to the host.' Thanks to the methodological and fundamental research of microbiologists, immense progress has very recently been made in our understanding of the gut microbiota. A large number of human intervention studies have been performed that have demonstrated that dietary consumption of certain food products can result in statistically significant changes in the composition of the gut microbiota in line with the prebiotic concept. Thus the prebiotic effect is now a well-established scientific fact. The more data are accumulating, the more it will be recognised that such changes in the microbiota's composition, especially increase in bifidobacteria, can be regarded as a marker of intestinal health. The review is divided in chapters that cover the major areas of nutrition research where a prebiotic effect has tentatively been investigated for potential health benefits. The prebiotic effect has been shown to associate with modulation of biomarkers and activity(ies) of the immune system. Confirming the studies in adults, it has been demonstrated that, in infant nutrition, the prebiotic effect includes a significant change of gut microbiota composition, especially an increase of faecal concentrations of bifidobacteria. This concomitantly improves stool quality (pH, SCFA, frequency and consistency), reduces the risk of gastroenteritis and infections, improves general well-being and reduces the incidence of allergic symptoms such as atopic eczema. Changes in the gut microbiota composition are classically considered as one of the many factors involved in the pathogenesis of either inflammatory bowel disease or irritable bowel syndrome. The use of particular food products with a prebiotic effect has thus been tested in clinical trials with the objective to improve the clinical activity and well-being of patients with such disorders. Promising beneficial effects have been demonstrated in some preliminary studies, including changes in gut microbiota composition (especially increase in bifidobacteria concentration). Often associated with toxic load and/or miscellaneous risk factors, colon cancer is another pathology for which a possible role of gut microbiota composition has been hypothesised. Numerous experimental studies have reported reduction in incidence of tumours and cancers after feeding specific food products with a prebiotic effect. Some of these studies (including one human trial) have also reported that, in such conditions, gut microbiota composition was modified (especially due to increased concentration of bifidobacteria). Dietary intake of particular food products with a prebiotic effect has been shown, especially in adolescents, but also tentatively in postmenopausal women, to increase Ca absorption as well as bone Ca accretion and bone mineral density. Recent data, both from experimental models and from human studies, support the beneficial effects of particular food products with prebiotic properties on energy homaeostasis, satiety regulation and body weight gain. Together, with data in obese animals and patients, these studies support the hypothesis that gut microbiota composition (especially the number of bifidobacteria) may contribute to modulate metabolic processes associated with syndrome X, especially obesity and diabetes type 2. It is plausible, even though not exclusive, that these effects are linked to the microbiota-induced changes and it is feasible to conclude that their mechanisms fit into the prebiotic effect. However, the role of such changes in these health benefits remains to be definitively proven. As a result of the research activity that followed the publication of the prebiotic concept 15 years ago, it has become clear that products that cause a selective modification in the gut microbiota's composition and/or activity(ies) and thus strengthens normobiosis could either induce beneficial physiological effects in the colon and also in extra-intestinal compartments or contribute towards reducing the risk of dysbiosis and associated intestinal and systemic pathologies.
The purpose of this study was to clarify effects of selected oligosaccharides on concentrations of cecal short-chain fatty acids (SCFAs), total large bowel wet weight and wall weight, and cecal microbiota levels in mice. Mice were respectively given gavage of selected fructooligosaccharides (FOS), galactooligosaccharides (GOS), mannanoligosaccharides (MOS), and chitooligosaccharides (COS) [1000 mg/(kg body weight.d)]. Control group was given physiological saline solution. After 14 d treatment, SCFAs and lactate in mice cecum were significantly increased (P<0.05) by intake of oligosaccharides, especially FOS and GOS. Thus, providing these oligosaccharides as ingredients in nutritional formulas may benefit the gastrointestinal tract.
Several clinical trials have investigated the impact of glucomannan on plasma lipids, body weight, fasting blood glucose (FBG), and blood pressure (BP), but have yielded conflicting results and had only modest sample sizes.
The objective was to perform a meta-analysis of randomized controlled trials of glucomannan to better characterize its impact on plasma lipids, FBG, body weight, and BP.
A systematic literature search of MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane Library, and the Natural Medicines Comprehensive Database was conducted from the earliest possible date through November 2007. A random-effects model was used to calculate the weighted mean difference (WMD) and 95% CIs as the difference between the mean for the glucomannan and control groups. Standard methods for assessing statistical heterogeneity and publication bias were used.
Fourteen studies (n = 531) met the inclusion criteria. The use of glucomannan significantly lowered total cholesterol [weighted mean difference (WMD): -19.28 mg/dL; 95% CI: -24.30, -14.26], LDL cholesterol (WMD: -15.99 mg/dL; 95% CI: -21.31, -10.67), triglycerides (WMD: -11.08 mg/dL; 95% CI: -22.07, -0.09), body weight (WMD: -0.79 kg; 95% CI: -1.53, -0.05), and FBG (WMD: -7.44 mg/dL; 95% CI: -14.16, -0.72). The use of glucomannan did not appear to significantly alter any other study endpoints. Pediatric patients, patients receiving dietary modification, and patients with impaired glucose metabolism did not benefit from glucomannan to the same degree.
Glucomannan appears to beneficially affect total cholesterol, LDL cholesterol, triglycerides, body weight, and FBG, but not HDL cholesterol or BP.
Thirty-two patients with Crohn's disease were treated with a fibre-rich, unrefined-carbohydrate diet in addition to conventional management and followed for a mean of four years and four months. Their clinical course was compared retrospectively with that of 32 matched patients who had received no dietary instruction. Hospital admissions were significantly fewer and shorter in the diet-treated patients, who spent a total of 111 days in hospital compared with 533 days in the non-diet-treated control group. Whereas five of the controls required intestinal operation, only one diet-treated patient needed surgery. This is in strong contrast to general experience with this disease. Treatment with a fibre-rich, unrefined-carbohydrate diet appears to have a favourable effect on the course of Crohn's disease and does not lead to intestinal obstruction.
Both chitosan and glucomannan have demonstrated hypocholesterolemic effects. A recent study in rats indicates that the combination of the two is also a potent hypocholesterolemic agent that increases fecal fat excretion. The objective of the present study was to determine the hypocholesterolemic effect of a supplement containing equal amounts of chitosan and glucomannan on blood lipid concentrations and fecal excretion of fat, neutral sterols and bile acids.
Twenty-one overweight normocholesterolemic subjects (11 males and 10 females) were fed 2.4 g/day of a supplement containing equal amounts of chitosan and glucomannan. Prior to taking the supplement (initial period) and after 28 days (final period), blood was drawn for measurement of serum lipids and a three-day fecal sample collected for determination of fat, neutral sterol and bile acid excretion. Subjects maintained their normal dietary and activity patterns during the study.
Caloric intake and intake of fat and dietary fiber (excluding the supplement) did not differ between the initial and final periods. Serum total, HDL and LDL cholesterol concentrations were significantly lower (p < 0.05) in the final period compared to the initial period. Serum triacylglycerol concentration did not change between periods. There was a trend towards greater fecal excretion of neutral sterols and bile acids (p = 0.13 and 0.16, respectively) in the final period. However, fecal fat excretion did not differ between periods.
Serum cholesterol reduction by a chitosan/glucomannan supplement is likely mediated by increased fecal steroid excretion and is not linked to fat excretion.
Fructooligosaccharides (FOS) increase the growth of lactic acid bacteria (LAB) and promote butyrate and lactate production. Because of these properties, FOS may benefit intestinal inflammation. The purpose of this study was to investigate the effect of FOS on colitis in rats and determine which factors are involved. Groups of rats with intracolonic trinitrobenzene sulfonic acid (TNBS)-induced colitis received intragastric infusions of 9 g/L NaCl, 1 g/d FOS or 10(11) colony-forming units (cfu)/d LAB (Experiment 1), or intracolonic infusions of 9 g/L NaCl, butyrate, lactate or butyrate + lactate with or without 10(9.5) cfu/d LAB (Experiment 2). Each infusion was administered twice daily for 14 d. Intragastric FOS reduced the gross score for inflammation (P < 0.001), myeloperoxidase (MPO) activity (P < 0.001) and pH (P < 0.001), and increased lactate (P = 0.02) and butyrate concentrations (P < 0.001) as well as LAB counts in the cecum (P < 0.01). Intragastric LAB (10(11) cfu/d) had the same beneficial effects as FOS and modified the cecal composition similarly. High doses of intracolonic butyrate and lactate reduced the indices of inflammation (P < 0.001), whereas administration of the lower concentrations found in the colon tended to decrease (P < 0.1) the gross score for inflammation and MPO activity. Addition of LAB (10(9.5) cfu/d) to the organic acids was necessary to reproduce the significant FOS-induced effects on these variables. Thus, under the experimental conditions used, FOS reduced intestinal inflammatory activity mainly by increasing LAB counts in the intestine.
Butyrate is recognised as efficient in healing colonic inflammation, but cannot be used as a long-term treatment. Dietary fibre that produces a high-butyrate level when fermented represents a promising alternative. We hypothesised that different types of dietary fibre do not have the same efficiency of healing and that this could be correlated to their fermentation characteristics. We compared short-chain fructo-oligosaccharides (FOS) and type 3 resistant starch (RS) in a previously described dextran sulfate sodium (DSS)-induced colitis model. Seventy-two Sprague-Dawley rats received water (control rats) or DSS (50 g DSS/l for 7 d then 30 g DSS/l for 7 (day 7) or 14 (day 14) d). The rats were fed a basal diet (BD), or a FOS or RS diet creating six groups: BD-control, BD-DSS, FOS-control, FOS-DSS, RS-control and RS-DSS. Caeco-colonic inflammatory injuries were assessed macroscopically and histologically. Short-chain fatty acids (SCFA) were quantified in caeco-colon, portal vein and abdominal aorta. At days 7 and 14, caecal and distal macroscopic and histological observations were improved in RS-DSS compared with BD-DSS and also with FOS-DSS rats. Caeco-colonic SCFA were reduced in FOS-DSS and RS-DSS groups compared with healthy controls. The amount of butyrate was higher in the caecum of the RS-DSS rats than in the BD-DSS and FOS-DSS rats, whereas distal butyrate was higher in FOS-DSS rats. Partially explained by higher luminal levels of SCFA, especially butyrate, the healing effect of RS confirms the involvement of some types of dietary fibre in inflammatory bowel disease. Moreover, the ineffectiveness of FOS underlines the importance of the type of dietary substrate.
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.
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.
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.
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.
Inflammatory diseases of the intestinal tract are a major health concern both in the United States and around the world. Evidence now suggests that a new category of Escherichia coli, designated Adherent Invasive E. coli (AIEC) is highly prevalent in Crohn's Disease (CD) patients. AIEC strains have been shown to colonize and adhere to intestinal epithelial cells (IEC). However, the role AIEC strains play in the induction of an inflammatory response is not known. Therefore, we examined several E. coli strains (designated LF82, O83:H1, 6604 and 6655) that were isolated from CD patients for their ability to induce inflammation in two IEC, Caco-2BBe and T-84 cells. Results showed that each strain had varying abilities to adhere to and invade IEC as well as induced cytokine secretion from polarized IEC. However, E. coli O83:H1 displayed the best characteristics of AIEC strains as compared to the prototype AIEC strain LF82, inducing cytokine secretion from IEC and promoting immune cell migration through IEC. Upon further analysis, E. coli O83:H1 did not harbor virulence genes present in known pathogenic intestinal organisms. Further characterization of E. coli O83:H1 virulence determinants showed that a non-flagellated O83:H1 strain significantly decreased the organism's ability to adhere to and invade both IEC and elicit IEC cytokine secretion compared to the wild type and complemented strains. These findings demonstrate that E. coli O83:H1 possesses the characteristics of the AIEC LF82 strain that may contribute to the low-grade, chronic inflammation observed in Crohn's disease.
The environmental conditions that contribute to poor oral health can be altered by changing the nutrient source of bacteria using prebiotics, which are fermentable carbohydrates whose metabolism produce a favorable shift in the balance of bacteria in the oral microbiome.
Objectives: The objective of this investigation was to test the prebiotic potential of Konjac glucomannan hydrolysate (GMH) to produce a decrease in the number of cariogenic bacteria, such as Streptococcus mutans, while increasing the number of probiotic bacteria such as lactobacilli under different environmental conditions.
Methods: The effect of GMH was tested on the in vitro multi-species, HA disc biofilm model. Biofilms were grown under different conditions and the relative presence of lactobacilli and S. mutans were tested both by conventional plating and also by extracting bacterial genomic DNA and quantifying using qPCR.
Results: Both S. mutans and L. acidophilus were able to metabolize GMH when cultured separately in planktonic culture. However, in the biofilm model, presence of GMH resulted in an increase in lactobacilli and a decrease in S. mutans. The prebiotic effect of GMH was not influenced by the presence of glucose; however, the effect was impeded by the presence of sucrose. We observed a reduction of this effect under anaerobic conditions and in the presence of TCA cycle inhibitor.
Conclusions: Using the in vitro multi-species biofilm model, we have demonstrated that the presence of GMH can reduce the number of cariogenic S. mutans and enhance the number of lactobacilli under aerobic conditions. This effect was also dependent on a functional TCA cycle. Mechanistic understanding of this phenomenon may lead to development of prebiotic for optimizing the oral ecology.
Malnutrition, nutrient deficiencies and osteoporosis are common in patients with Crohn's disease, regardless of disease activity. While the role of diet in the pathogenesis of the disease remains inconclusive, upon diagnosis, nutrition therapy plays an integral role in patient care. Successful nutrition intervention involves appropriate nutritional assessment, supplemental nutrition and individualised counselling and support.
Stabilisers, thickeners and gelling agents are extracted from a variety of natural raw materials and incorporated into foods to give the structure, flow, stability and eating qualities desired by consumers. These additives include traditional materials such as starch, a thickener obtained from many land plants; gelatine, an animal by-product giving characteristic melt-in-the-mouth gels; and cellulose, the most abundant structuring polymer in land plants. Seed gums and other materials derived from sea plants extend the range of polymers. Recently-approved additives include the microbial polysaccharides of xanthan, gellan and pullulan. This book is a highly practical guide to the use of polymers in food technology to stabilise, thicken and gel foods, resulting in consistent, high quality products. The information is designed to be easy to read and assimilate. New students will find chapters presented in a standard format, enabling key points to be located quickly. Those with more experience will be able to compare and contrast different materials and gain a greater understanding of the interactions that take place during food production. This concise, modern review of hydrocolloid developments will be a valuable teaching resource and reference text for all academic and practical workers involved in hydrocolloids in particular, and food development and production in general.
There is a 1000-year written history of konjac tubers being consumed as a high-grade food, offered as presents to the Samurai and noble classes and used as a cure for certain diseases in China and Japan. It did not become an industrialized food product in Japan until the Mito clan cultivated konjac and developed a way of drying and separating the glucomannan from the starch and cellulose in the tuber. This allowed the konjac flour, also known as konjac gum, to be stored and distributed. Processing the tuber from the Amorphophallus konjac plant by this method made konjac flour available to the common people in Japan.
Book abstract: A hydrocolloid is defined as a colloid system wherein the colloid particles are dispersed in water. A hydrocolloid has colloid particles spread throughout water and depending on the quantity of water available that can take place in different states, e.g., gel or sol (liquid). Hydrocolloids can be either irreversible (single-state) or reversible. For example, agar, a reversible hydrocolloid of seaweed extract, can exist in a gel and sol state, and alternate between states with the addition or elimination of heat. Many hydrocolloids are derived from natural sources. Agar-agar and carrageenan are extracted from seaweed; gelatin is produced by hydrolysis of proteins of bovine and fish origins, and pectin is extracted from citrus peel and apple pomace. Gelatin desserts like jelly or Jell-O are made from gelatin powder, another effective hydrocolloid. Hydrocolloids are employed in food mainly to influence texture or viscosity. This new and important book gathers the latest research from around the globe in the study of food hydrocolloids and highlights such topics as: collagen and gelatin extracted from skate skin, sucrose pectin interaction, utiliztion of glucomannans for health and others.
Adhesion of pathogens is required for colonization and subsequent development of disease, and when adhered, they are more likely to survive, as their resistance to cleansing mechanisms, bacteriolytic enzymes and antibiotics is higher than in the free state. Therefore, prevention of adhesion at an early stage after exposure of the host should prevent disease. Many oligosaccharides from human milk are considered to be soluble receptor analogues of epithelial cell surface carbohydrates; they display structural homology to host cell receptors and thus function as receptor decoys to which pathogens bind instead of to the host. Most research in this area has focused on human milk oligosaccharides; however, the techniques used can readily be applied to the investigation of oligosaccharides produced in other milk types, e.g., milk of domestic animals. These milk types may therefore become an attractive source of anti-adhesive oligosaccharides with potential for future incorporation into functional foods.
The prebiotic potential of a konjac glucomannan hydrolysate (GMH) was investigated in vitro using batch cultures inoculated with human faeces. Bacterial enumeration was carried out using the culture independent technique, fluorescent in situ hybridisation (FISH), and short chain fatty acid (SCFA) production was monitored by gas chromatography. The populations of Bifidobacterium genus, Lactobacillus–Enterococcus group and the Atopobium group all significantly increased after GMH and inulin fermentation. The Bacteroides–Prevotella group had a lower end population after GMH fermentation while inulin gave an increase, although these differences were not significant. No significant differences in SCFA concentrations were observed between inulin and GMH. As with inulin, GMH produced selective stimulation of beneficial gut microbiota and a favourable SCFA profile. In order to confirm a beneficial effect of GMH further in vivo studies involving healthy human volunteers should be considered.
Purpose
– The aim of this study is to determine the effects of depolymerised mannans and specifically konjac glucomannan hydrolysates (GMH) on the colonic microflora of mice. Blood glucose and cholesterol were also measured.
Design/methodology/approach
– Two groups (n = 20) of 12‐week old Wister mice were used for a period of 14 weeks. One group (treatment group) were fed diets containing 5 per cent konjac GMH dissolved in drinking water in addition to the control (group) standard diet. Faecal microflora, feed consumption, body weight, blood glucose and cholesterol were determined.
Findings
– The GMH promoted the growth of anaerobes and lactobacilli in the treatment group where this was statistically, highly significant (P < 0.001). Also, the hydrolysate was able to reduce highly significantly (P < 0.001) faecal Clostridium perfringens and Escherichia coli counts. A significant increase in average daily feed consumption (P < 0.05) and weekly body weight (P < 0.001) was found for the treatment group. The mean ± SD (mmol/l) of blood glucose and cholesterol was lower in the treatment group.
Originality/value
– In addition to modulating the gut microflora, GMH seems to lower the blood glucose and cholesterol in mice. Although this needs to be verified by further studies, GMH could also be a candidate for possible treatment of subjects with high cholesterol and for diabetics.
Konjac glucomannan hydrolysate was derived enzymatically from konjac flour under optimal conditions. A number of culture strains of lactobacilli and bifidobacteria were grown on De Man, Rogosa and Sharpe (MRS) media supplemented with the hydrolysate. This hydrolysate stimulated the growth of all strains examined. Colony sizes of those strains grown on konjac hydrolysate were significantly (P = 0.001) bigger than those grown on pectin or xylan hydrolysates. Bacterial growth profiles were also conducted on nutrient agar (MRS or modified MRS agar containing konjac hydrolysate) using single strains of lactobacilli or bifidobacteria (Lactobacillus acidophilus, Lactobacillus casei or Bifidobacterium adolescentis), single pathogen cultures (Escherichia coli or Listeria monocytogenes) or mixed bacterial cultures (from chicken breast extract). Although the growth of lactobacilli inhibited the growth of pathogens (single or mixed culture) the pathogens could not grow on the konjac hydrolysate as a sole carbon source. Microbial growth profiles using konjac hydrolysate or inulin in UHT milk were also investigated. The results showed that the numbers of colony forming units (cfu) obtained from milk containing the konjac hydrolysate were significantly (P = 0.01) higher than those containing inulin. It is suggested that the unique properties of konjac hydrolysate make it universally valuable as a prebiotic which can be applied to a wide range of foods, feeds and healthcare/pharmaceutical products. Copyright © 2007 Society of Chemical Industry
BACKGROUND: A host runs less risk of contracting a gastrointestinal infection when enteropathogenic bacteria adhere to dietary fibers instead of to epithelial cell receptors. The aim of this study was to test the binding capacity of food and feed components for intestinal bacteria from various hosts using a miniaturized in vitro assay. In total, 18 dietary components were tested with four strains of E. coli, seven strains of Salmonella enterica and two strains of Lactobacillus.
RESULTS: A comparison of the results obtained for all Salmonella strains tested revealed that konjac gum and sesame seed extract represented the most efficient binding matrices. Similarly, for all E. coli strains tested, sesame seed extract and artichoke performed well as binding matrices. Salmonella isolates from chickens adhered best to sesame seed extract. E. coli K88 and S. enterica sv. Typhimurium isolated from pigs effectively bound to BioMos®, pumpkin, sesame seed extract, and tomato. Sesame seed extract and tomato also had adhesive capacities for E. coli K 99, S. enterica sv. Dublin, and S. enterica sv. Typhimurium from calves. With human isolates, konjac gum showed a high binding potential for S. enterica and E. coli.
CONCLUSION: The adhesion screening of different food and feed components resulted in highly discriminating product rankings. Copyright
A novel macromolecular surface modifier, polypropylene-grafted-poly(ethylene glycol) copolymer (PP-g-PEG), was synthesized by coupling polypropylene containing maleic anhydride with monohydroxyl-terminated poly(ethylene glycol).
The effects of the reaction condition on the graft reactions were studied. The copolymers were characterized by IR, 1H NMR, thermogravimetry (TG) and differential scanning calorimetry (DSC). The results indicated that the graft reactions were
hindered by increasing the molecular weight of PP or PEG. The graft copolymer was found to have a higher initial thermal degradation
temperature and lower crystallization capacity as compared with pure PP, and the side chain of PEG hindered the PP chain from
forming a perfect β crystal. The thermal stability of PP-g-PEG decreased with the increasing content or molecular weight of PEG. The copolymers were blended with polypropylene to modify
the surface hydrophilicity of the products. The results of attenuated total reflectance FTIR spectroscopy (ATR-FTIR) showed
that PP-g-PEG could diffuse preferably onto the surface of the blends and be suitable as an effectual macromolecular surface modifier
for PP.
Inflammatory bowel diseases (IBDs), Crohn's disease (CD), and ulcerative colitis (UC) are chronic inflammatory conditions, which are increasing in incidence, prevalence, and severity, in many countries. While there is genetic susceptibility to IBD, the probability of disease development is modified by diet, lifestyle, and endogenous factors, including the gut microbiota. For example, high intakes of mono- and disaccharides, and total fats consistently increases the risk developing both forms of IBD. High vegetable intake reduces the risk of UC, whereas increased fruit and/or dietary fiber intake appears protective against CD. Low levels of certain micronutrients, especially vitamin D, may increase the risk of both diseases. Dietary patterns may be even more important to disease susceptibility than the levels of individual foods or nutrients. Various dietary regimes may modify disease symptoms, in part through their actions on the host microbiota. Both probiotics and prebiotics may modulate the microflora, and reduce the likelihood of IBD regression. However, other dietary factors affect the microbiota in different ways. Distinguishing cause from effect, and characterizing the relative roles of human and microbial genes, diet, age of onset, gender, life style, smoking history, ethnic background, environmental exposures, and medications, will require innovative and internationally integrated approaches.
This review highlights the occurrence and functions of mannans in plant materials, as well as enzymatic hydrolysis and microbial biodegradation thereof. Fungal 1,4-β-d-mannan mannohydrolases (β-mannanases) are discussed with regards to their mode of action with reference to auxiliary enzymes involved in the hydrolysis of mannans such as α-galactosidases, β-mannosidases, β-glucosidases and acetyl mannan esterases. The diversity and production of β-mannanases by various species of the phyla Basidiomycota and Ascomycota are also highlighted. Cloning and heterologous expression of both fungal and bacterial β-mannanases in fungal expression systems are reviewed, indicating production of enzymes at levels up to grams per litre and with high purity, making these production systems ideal for industrial enzyme production. Application of fungal β-mannanases in the production of nutraceuticals, food and feed, and commodity products is discussed.
The aim of this study was to evaluate how konjac glucomannan hydrolysates (GMH) could support the healthy re-colonisation of vaginal microflora post infections. A total of 26 female patients (12 controls and 14 treatments) aged 18 to 25 suffering from vaginal infection were recruited for this study. Patients were assigned randomly into two groups to receive a standard antifungal treatment or a standard antifungal treatment plus pessary capsules containing 200 mg GMH (twice a week for thirty days). Patients were assessed on day zero, sixteen and thirty of the trial. Several parameters were determined including yeast and bacterial counts, the KOH test, pH, Gram staining and wet mount microscopic observations. The results showed that the counts of Candida were diminished completely with antifungal treatment for both groups. However, the total bacterial counts increased with time in the GMH pessary group unlike the control. The normalised average KOH scores were reduced sharply with time in both groups although in the control group scores started to increase after sixteen days. The normalised average white blood cell scores also decreased with time for both groups. Epithelial cell scores decreased only for the GMH pessary group while clue cells and yeast-like fungi decreased with time for both control and GMH pessary groups. These results indicate the improvement of vaginal health recovery (post antifungal treatment for Candida infection) and especially the presence of healthy microflora due to the introduction of GMH in the vagina. The data indicate that it would be worth examining further the health benefits of GMH in a vaginal health format with a view to employing the material as a prophylactic or therapeutic agent. It provides an alternative approach to reducing vaginal infections and promoting consumer health.
Konjac glucomannan (KGM) is a dietary fiber found in Amophophallus konjac. This fiber is fermentable based on human and animal trials, but short-chain fatty acid (SCFA) production profiles are unknown. The aim of this study is to characterize the digestibility and fermentability in vitro of two preparations of KGM, to better understand how KGM improves human health. Konnyaku (yam cake made of A. konjac), isolated KGM, inulin, and guar gum were subjected to in vitro digestion and in vitro fermentation. Fermentation samples were removed at 0, 4, 8, 12, and 24 hours for gas volume, pH, and SCFA measurements. Acetate, propionate, and butyrate were measured with gas chromatography. Results of the in vitro digestion confirm that KGM and konnyaku are resistant to degradation by digestive enzymes. Gas production in fermentation vessels containing konnyaku and KGM was lower than for inulin from 8 to 24 hours. Both samples produced SCFA concentrations similar to guar gum, which favored acetate and propionate over butyrate production. This study is the first to characterize SCFA production by KGM in its isolated form and in food form. Fermentation patterns presented in this study may provide a mechanism for the previously published health benefit of konnyaku and KGM.
Prebiotics are nondigestible fermentable fibers that are reported to have health benefits for the host. Older as well as more recent studies show beneficial effects in experimental colitis and lately also in human inflammatory bowel diseases (IBD), such as Crohn's disease, ulcerative colitis, and chronic pouchitis. In this review we give an overview of the benefits of prebiotics in rodent IBD models and in IBD patients and discuss their possible protective mechanisms. Commensal intestinal bacteria induce and perpetuate chronic intestinal inflammation, whereas others are protective. However, most of the current medications are directed against the exaggerated proinflammatory immune response of the host, some of them toxic and costly. Feeding prebiotics changes the composition of the intestinal microflora toward more protective intestinal bacteria and alters systemic and mucosal immune responses of the host. Therapy for IBD targeting intestinal bacteria and their function is just emerging. Prebiotics have the promise to be relatively safe, inexpensive, and easy to administer. Unraveling their protective mechanisms will help to develop rational applications of prebiotics. However, the initial promising results with dietary prebiotics in preclinical trials as well as small studies in human IBD will need to be confirmed in large randomized controlled clinical trials.
Nutritional therapy for active Crohn's disease (CD) is an underutilised form of treatment in adult patients, though its use is common in the paediatric population. There is evidence that nutritional therapy can effectively induce remission of CD in adult patients. Enteral nutrition therapy is safe and generally well tolerated. Meta-analysis data suggest that corticosteroids are superior to nutritional treatment for induction of remission in active CD. However, the potential side effects of such pharmacotherapy must be taken into consideration. This review examines the evidence for the efficacy of elemental and polymeric diets, and the use of total parenteral nutrition in active CD.
The efficiency of ispaghula husk in relieving gastrointestinal symptoms in patients with ulcerative colitis in remission was studied in a placebo-controlled trial running for 4 months. Twenty-nine patients (81%) completed the trial; four withdrew after colitis relapse (three while receiving placebo). Grading of symptoms judged ispaghula to be consistently superior to placebo (p less than 0.001) and associated with a significantly higher rate of improvement (69%) than placebo (24%) (p less than 0.001). The results show that ispaghula can be helpful in the management of gastrointestinal symptoms in quiescent ulcerative colitis.
The value of dietary alteration and the nutritional management of Crohn's disease is assessed in this review.
Lactose restriction, low-fat diets and low-residue diets may be of value in specifically indicated clinical situations. A fibre-rich, unrefined carbohydrate diet has not been shown to alter the course of the disease, and the value of ‘exclusion diets’remains to be confirmed in controlled, prospective studies.
Nutritional insufficiency of varying degrees is common in Crohn's disease and can be corrected by the efficient use of enteral diets (usually with polymeric preparations) or intravenous nutritional support. Growth retardation in adolescents with Crohn's disease can usually be improved by enteral nutrition.
Nutritional support of various kinds may be of value in the management of local complications of Crohn's disease; sub-acute obstruction, anal, perianal and rectal lesions, fistulas and ileostomy complications, and the management of bile acid-induced diarrhoea.
The use of nutrition as ‘primary therapy; in Crohn's disease is considered. Theoretical reasons why nutritional support and bowel rest may possibly induce remission of the disease are discussed. The evidence to date suggests that intravenous nutrition and bowel rest may not be effective in inducing a primary remission of the disease, and the possible value of elemental diets and polymeric diets in this respect are assessed. Further prospective controlled studies of elemental diets as primary therapy in Crohn's disease are required.
Complex polymers containing mannose (mannans) possess significant biological activity when administered to mammals. When given orally, they inhibit cholesterol absorption and induce hypocholesterolemia. If administered by other routes, they bind to mannose-binding proteins and induce macrophage activation and interleukin-1 release, inhibit viral replication, stimulate bone marrow activity, promote wound healing and inhibit tumor growth. This range of activities makes the mannans, potentially important biological-response modifiers and therapeutic agents.
The effects of the soluble fiber konjac glucomannan (GM) on serum cholesterol concentrations were investigated in 63 healthy men in a double-blind crossover, placebo-controlled study. After a 2-wk baseline period, the subjects were given 3.9 g GM or placebo daily for 4 wk. After a washout period of 2 wk, crossover took place, followed by another 4 wk of treatment. The subjects were encouraged not to change their ordinary diets or general lifestyle during the investigation. GM fibers reduced total cholesterol (TC) concentrations by 10% (P < 0.0001), low-density-lipoprotein cholesterol (LDL-C) concentrations by 7.2% (P < 0.007), triglycerides by 23% (P < 0.03), and systolic blood pressure by 2.5% (P < 0.02). High-density-lipoprotein cholesterol (HDL-C) and the ratio of LDL-C to HDL-C did not change significantly. No change in diastolic blood pressure or body weight was observed. No adverse effects were observed. The results of this study show that GM is an effective cholesterol-lowering dietary adjunct.
Inulin stimulates intracolonic generation of butyrate and growth of lactic acid bacteria. This study investigated whether inulin protects against colitis.
Rats with dextran sodium sulfate colitis received inulin either orally (1% in drinking water, or 400 mg/day) or by enema. Matched groups received vehicle. In addition, fecal water obtained from inulin-fed rats was administered by enema to rats with colitis and compared with fecal water from control rats. Finally, rats with colitis received daily enemas of either butyrate (at 40 or 80 mmol/L) or vehicle. Inflammation was assessed by eicosanoid asssay in rectal dialysates and MPO activity in colonic tissue. Mucosal lesions were blindly scored by microscopic examination. Luminal pH was measured from cecum to rectum by a surface microelectrode.
Oral inulin prevented inflammation, as evidenced by lower lesion scores (p < 0.05), decreased release of mediators (p < 0.05), and lower tissue MPO (p < 0.05) as compared with controls. Inulin induced acidic environment (pH <7.0) from cecum to left colon and increased counts of lactobacilli. Fecal water from inulin-fed rats also reduced scores (p < 0.05) and inflammation (p < 0.05). However, inulin or butyrate enemas had no effect.
Oral inulin reduces the severity of dextran sodium sulfate colitis. The effect seems to be mediated by modification of the intracolonic milieu.
Galacto-oligosaccharides potentially attenuate colonic inflammation by two mechanisms: through beneficial effects on intestinal microflora and by increasing the colonic short-chain fatty acid concentration. The purpose of this study was to investigate the effects of galacto-oligosaccharides on the development of inflammation and on the growth of bifidobacteria in trinitrobenzene sulphonic acid (TNBS)-induced colitis, a model that has been shown to benefit from short-chain fatty acid administration and to be associated with alterations in the colonic microflora.
Rats were given daily either whey-derived or lactose-derived galacto-oligosaccharides (4 g kg(-1) day(-1), p.o.); starting 10 days before colitis induction, or dexamethasone (2 mg kg(-1) day(-1), s.c., a positive control), starting at colitis induction. Colon wet weight, macroscopic damage and myeloperoxidase activity were assessed 72 h after the induction of colitis. Faecal bifidobacteria were counted at the beginning of the study, and immediately before and 72 h after colitis induction.
Galacto-oligosaccharides increased the colonic levels of bifidobacteria but also the levels of other bacterial species. Neither whey-derived nor lactose-derived galacto-oligosaccharides reduced the severity of inflammation.
Galacto-oligosaccharides are able to modify gut microflora in severe TNBS-induced colitis, but unable to attenuate the inflammation.
We examined the efficacy of cyclic long-term administration of rifaximin, a broad spectrum, poorly absorbable antibiotic, in obtaining symptom relief in a large series of patients with uncomplicated diverticular disease, and compared the incidence of episodes of diverticulitis in the group treated with rifaximin to that in a group receiving fiber supplementation only.
In a multicenter, prospective, open trial, 968 outpatients with uncomplicated symptomatic diverticular disease were randomized to either fiber supplementation with 4 g/day glucomannan plus 400 mg rifaximin twice daily for 7 days every month ( n=558) or 4 g/day glucomannan alone ( n=346). Clinical evaluation was performed on admission and at 4-month intervals for 12 months.
After 12 months the group treated with glucomannan + rifaximin showed fewer symptoms (abdominal pain/discomfort, bloating, tenesmus, diarrhea, abdominal tenderness) and a lower global symptomatic score. Overall 56.5% of the patients treated with glucomannan + rifaximin and 29.2% of those treated with glucomannan alone were asymptomatic at 12 months ( P<0.001). The rate of complications (diverticulitis and rectal bleeding) was 1.34% in the rifaximin + glucomannan group and 3.22% in the glucomannan alone group ( P<0.05).
Cyclic administration of rifaximin is effective in obtaining symptom relief in uncomplicated diverticular disease of the colon. The incidence of episodes of diverticulitis in the group treated with rifaximin was lower than that in the group treated with glucomannan alone.
This review discusses the role of bacterial adjuvants and antigens in induction and reactivation of chronic intestinal inflammation in susceptible hosts; discusses the results of recent therapeutic trials of antibiotics, probiotics, and prebiotics; and suggests future treatment strategies.
Bacterial adjuvants, including peptidoglycan, lipopolysaccharide, and DNA (CpG) bind to membrane-bound toll-like receptors (TLR-2, 4, and 9. respectively) or cytoplasmic (NOD1 and NOD2) receptors (pattern recognition receptors) that activate nuclear factor-kappaB and transcription of many proinflammatory cytokines and adhesion, costimulatory, and major histocompatibility complex class II molecules. Experimental enterocolitis does not occur in a sterile (germ-free) environment and is prevented and treated by broad-spectrum antibiotics. Individual nonpathogenic intestinal bacterial species selectively induce experimental colitis, with host specificity. Crohn disease and ulcerative colitis patients exhibit pathogenic immune responses (loss of immunologic tolerance) to multiple normal enteric bacterial species and serologic responses to Mycobacterium paratuberculosis. Metronidazole and ciprofloxacin selectively treat colonic Crohn disease, but not ulcerative colitis or ileal Crohn disease, and may prevent recurrence of postoperative Crohn disease. Certain probiotic species decrease relapse of ulcerative colitis and chronic pouchitis and delay onset of pouchitis.
Normal, nonpathogenic enteric bacteria induce and perpetuate chronic intestinal inflammation in genetically susceptible hosts with defective immunoregulation, bacterial clearance, or mucosal barrier function. Altering the composition and decreasing mucosal adherence/invasion of commensal bacteria with antibiotics, probiotics, and prebiotics can potentially prevent and treat Crohn disease, pouchitis, and possibly ulcerative colitis, but optimal treatments have not yet been identified.
The prebiotic role of intact konjac glucomannan (KGM) is contradictory. Short-chain glucomannan may cause a greater or faster effect on colonic microflora compared with KGM. Therefore, time-course and dose-dependent studies were conducted to examine and compare effects of unhydrolyzed KGM with those of acid-hydrolyzed glucomannan (KH) on cecal and fecal microflora. Short-chain fatty acid concentrations in cecal content were also determined.
Seven-week-old male Balb/c mice were fed 5% (w/w) cellulose and KGM or KH diets for 2 or 4 wk in a time-course study. Cecal total anaerobes, bifidobacteria, Clostridium perfringens and Escherichia coli counts, and short-chain fatty acid concentrations were determined. In a subsequent dose-dependent study, Balb/c mice were fed AIN-93 fiber-free diets supplemented with 2.5%, 5%, or 7.5% of KGM or KH for 4 wk. Anaerobes, bifidobacteria, C. perfringens, and E. coli were enumerated in the cecal content and feces.
KGM and KH significantly increased cecal anaerobes and bifidobacteria counts at weeks 2 and 4, respectively, compared with cellulose. In contrast, KGM and KH significantly decreased cecal C. perfringens counts only at week 4. Acetate and propionate concentrations in cecal contents were increased by KGM and KH diets at weeks 2 and 4, respectively. In the dose-dependent study, KH increased cecal bifidobacteria counts only at the 2.5% level but increased fecal bifidobacteria count and suppressed C. perfringens counts at each dose level as compared with KGM.
Hydrolyzed glucomannan exerts a greater prebiotic effect than does KGM in Balb/c mice.
HLA-B27 transgenic rats develop spontaneous colitis under specific pathogen-free conditions (SPF) but germ-free rats remain disease-free, emphasizing a role for intestinal bacteria in the pathogenesis of chronic intestinal inflammation. Prebiotics are dietary substances that affect the host by stimulating growth and/or activity of potentially health promoting bacteria. The aims of this study were to investigate whether prebiotics can prevent colitis in SPF HLA-B27 rats, and secondly, to explore mechanisms of protection. SPF HLA-B27 transgenic rats received orally the prebiotic combination long-chain inulin and oligofructose (Synergy 1), or not, prior to the development of clinically detectable colitis. After seven weeks, cecal and colonic tissues were collected for gross cecal scores (GCS), histologic inflammatory scores (scale 0-4), and mucosal cytokine measurement. Cecal and colonic contents were collected for analysis of the gut microbiota by PCR-denaturing gradient gel electrophoresis (PCR-DGGE) and fluorescent in-situ hybridization (FISH), and analysis of short-chain fatty acid composition. Prebiotic treatment significantly decreased GCS and inflammatory histologic scores in the cecum and colon. Prebiotic treatment also decreased cecal IL-1beta, but increased cecal TGF-beta concentrations. Inulin/oligofructose altered the cecal and colonic PCR-DGGE profiles, and FISH analysis showed significant increases in cecal Lactobacillus and Bifidobacterium populations after prebiotic treatment compared with water-treated rats. In conclusion, the prebiotic combination Synergy 1 reduced colitis in HLA-B27 transgenic rats, which effect was associated with alterations to the gut microbiota, decreased tissue proinflammatory cytokines and increased immunomodulatory molecules. These results show promise for prebiotics as primary or adjuvant maintenance therapy for chronic inflammatory bowel diseases.
Glucomannan (GM) is a soluble, fermentable, and highly viscous dietary fiber derived from the root of the elephant yam or konjac plant, which is native to Asia. Preliminary evidence suggests that GM may promote weight loss. This review summarizes studies using GM for weight loss as well as studies investigating its mechanisms of action. At doses of 2-4 g per day, GM was well-tolerated and resulted in significant weight loss in overweight and obese individuals. There is some evidence that GM exerts its beneficial effects by promoting satiety and fecal energy loss. Additionally, GM has been shown to improve lipid and lipoprotein parameters and glycemic status. Further investigation of safety, efficacy, and mechanisms of action is needed to determine whether GM can help to decrease the high prevalence of overweight and obesity in the United States.
Diverticular disease of the colon is a complex syndrome that includes several clinical conditions, each needing different therapeutic strategies. In patients with asymptomatic diverticulosis, only a fiber-rich diet can be recommended in an attempt to reduce intraluminal pressure and slow down the worsening of the disease. Fiber supplementation is also indicated in symptomatic diverticulosis in order to get symptom relief and prevent acute diverticulitis. In this regard, the best results have been obtained by combination of soluble fiber, like glucomannan, and poorly absorbed antibiotics, like rifaximin, given 7-10 days every month. For uncomplicated diverticulitis the standard therapy is liquid diet and oral antimicrobials, usually ciprofloxacin and metronidazole. Hospitalization, bowel rest, and intravenous antibacterial agents are mandatory for complicated diverticulitis. Haemorrhage is usually a self-limited event but may require endoscopic or surgical treatment. Once in remission, continuous fiber intake and intermittent course of rifaximin may improve symptoms and reduce diverticulitis recurrence. These preventive strategies will likely improve patients' quality of life and reduce management costs. A surgical approach in diverticular disease is needed in 15-30% of cases and consists of removing the intestinal segment affected by diverticula. It is indicated in diffuse peritonitis, abscesses, fistulas, stenosis and after the second to fourth attack of uncomplicated diverticulitis. Young people and immunocompromised patients are more likely to be operated.
Diverticular disease of the colon is the fifth most important gastrointestinal disease in terms of direct and indirect healthcare costs in western countries. Uncomplicated diverticular disease is defined as the presence of diverticula in the absence of complications such as perforation, fistula, obstruction and/or bleeding. The distribution of diverticula along the colon varies worldwide being almost always left-sided and directly related to age in western countries and right-sided where diet is rich in fibre.
The pathophysiology of diverticular disease is complex and relates to abnormal colonic motility, changes in the colonic wall, chronic mucosal low-grade inflammation, imbalance in colonic microflora and visceral hypersensitivity. Moreover, there can be genetic factors involved in the development of colonic diverticula.
The use of non-absorbable antibiotics is the mainstay of therapy in patients with mild to moderate symptoms, and the effect of fibre-supplementation alone does not appear to be significantly different from placebo, although no definite data are available.
More recently, alternative treatments have been reported. Mesalazine acts as a local mucosal immunomodulator and has been shown to improve symptoms and prevent recurrence of diverticulitis. In addition, probiotics have also been shown to be beneficial by re-establishing a normal gut microflora. In this study, the current literature on uncomplicated diverticular disease of the colon is reviewed.
Konjac glucomannan (KGM) has been shown to relieve constipation, which could be associated with increased stool bulk and improved colonic ecology.
This placebo-controlled study consisted of a 21-d placebo period, a 7-d adaptation period when volunteers consumed KGM progressively, and a 21-d KGM-supplemented period (1.5 g/meal, 4.5 g/d). Eight healthy adults consumed 7-d cycle menus of typical low-fiber Chinese food throughout the study. The gastrointestinal response was monitored daily. Stools were fully collected on days 15 to 21 of placebo and KGM periods to determine the fecal mass, components, microflora, and short-chain fatty acid contents.
The KGM supplement significantly increased the mean defecation frequency (number/day), wet stool weight, and dry stool weight (g/d) by approximately 27.0% (P < 0.05), 30.2% (P < 0.05), and 21.7% (P < 0.05), respectively. The dry fecal mass increased mainly in the plant and soluble material, whereas bacterial mass tended to increase from 12.9 +/- 1.6 to 13.6 +/- 2.7 g/d (P > 0.05). However, KGM significantly promoted the fecal concentrations (log counts/g wet feces) of lactobacilli (P < 0.05) and total bacteria (P < 0.05), and promoted the daily output (log counts per day) of bifidobacteria (P < 0.05), lactobacilli (P < 0.05), and total bacteria (P < 0.05) as evaluated by the fluorescence in situ hybridization method. KGM supplement also promoted colonic fermentation as shown in the decreased fecal pH (P < 0.05) and increased fecal short-chain fatty acid concentrations (P < 0.05).
Supplementation of KGM into a low-fiber diet promoted the defecation frequency in healthy adults, possibly by increasing the stool bulk, thus promoting the growth of lactic acid bacteria and colonic fermentation.
To systematically evaluate the efficacy of antibacterial therapy in ulcerative colitis, we carried out a meta-analysis of controlled clinical trials. Within the time period 1966 through September 2006, PUBMED, EMBASE, and SCOPUS were searched for clinical trial studies that investigated the efficacy of antibiotics in ulcerative colitis. We considered clinical remission as our key outcome of interest. Of 122 studies, 10 randomized placebo-controlled clinical trials matched our criteria and were included in the analysis (530 patients). All the studies used antibiotics as an adjunct therapy to conventional treatment of ulcerative colitis (i.e., corticosteroids and 5-aminosalycilic acid). Pooling of these trials yielded odds ratio (OR) of 2.14 (95% confidence interval [CI], 1.48-3.09; P<0.0001) in favor of antimicrobial therapy. Meta-analysis of short-term trials (5-14 days) showed a higher rate of clinical remission in patients treated with antibiotics (OR, 2.02; 95% CI, 1.36-3). These results suggest that adjunctive antibacterial therapy is effective for induction of clinical remission in ulcerative colitis.
Inulin and oligofructose promote selective growth of saccharolytic bacteria with low inflammatory potential.
To test the effect of oligofructose-enriched inulin in patients with active ulcerative colitis.
Prospective, randomized, placebo controlled pilot trial. Eligible patients had been previously in remission with mesalazine as maintenance therapy or no drug, and presented with a relapse of mild to moderate activity. They were treated with mesalazine (3 g/day) and randomly allocated to receive either oligofructose-enriched inulin (12 g/day, p.o., n = 10) or placebo (12 g/day of maltodextrin, p.o., n = 9) for 2 week. Primary endpoint was the anti-inflammatory effect as determined by reduction of calprotectin and human DNA in faeces.
Rachmilewitz score decreased in both groups, reaching statistical significance at day 14 (P < 0.05). Oligofructose-enriched inulin was well-tolerated and dyspeptic symptoms scale decreased significantly with active treatment but not with placebo. At day 7, an early significant reduction of calprotectin was observed in the group receiving oligofructose-enriched inulin (day 0: 4377 +/- 659 microg/g; day 7: 1033 +/- 393 microg/g, P < 0.05) but not in the placebo group (day 0: 5834 +/- 1563 microg/g; day 7: 4084 +/- 1395 microg/g, n.s.). Changes in faecal concentration of human DNA were not significant.
In active ulcerative colitis, dietary supplementation with oligofructose-enriched inulin is well tolerated and is associated with early reduction in faecal calprotectin.