Clinical Evidence: Sedoaspis

Butyric acid in functional constipation

Aleksandra Pituch et al

Butyric acid, a short-chain fatty acid, is a major energy source for colonocytes. It occurs in small quantities in some foods, and in the human body, it is produced in the large intestine by intestinal bacteria. This production can be reduced in some cases, for which butyric acid supplementation may be useful.

So far, the use of butyric acid in the treatment of gastrointestinal disorders has been limited because of its specific characteristics such as its rancid smell and rapid absorption in the upper gastrointestinal tract. In the Polish market, sodium butyrate has been recently made available, produced by the modern technology of microencapsulation, which allows the active substance to reach the small and large intestines, where butyrate easily dissociates into butyric acid.

This article presents the potential beneficial mechanisms of action of butyric acid in defecation disorders, which are primarily associated with reductions in pain during defecation and inflammation in the gut, among others.

Prz Gastroenterol 2013; 8 (5): 295–298 DOI: 10.5114/pg.2013.38731

The effectiveness of microencapsulated sodium butyrate at reducing symptoms in patients with irritable bowel syndrome

Konrad Lewandowski et al

Abstract

Aim: The aim of the study was to assess the effectiveness of a patented preparation of sodium butyrate in the triglyceride matrix at reducing clinical symptoms and improving quality of life in patients with irritable bowel syndrome (IBS).

Material and methods: In this prospective multicenter clinical trial, we observed a total of 3000 non-hospitalized patients with confirmed IBS who were treated with sodium butyrate in a triglyceride matrix at a dosage of 150 mg twice a day for 12 weeks. The primary outcome was to evaluate the efficacy of sodium butyrate at reducing the severity of clinical symptoms and improving quality of life in patients with IBS.

Results: A total of 2990 complete surveys were collected. A statistically significant improvement in severity of abdominal pain was noticed (p < 0.001). Moreover, flatulence, diarrhea, constipation, urgent pressure for bowel movements, nausea, and vomiting decreased significantly (p < 0.001). Most of the respondents (93.90%) declared that they would continue the therapy and 88.9% would recommend using sodium butyrate to other IBS patients.

Conclusions: Sodium butyrate in the triglyceride matrix, as a postbiotic substance, may be effective in relieving the symptoms of IBS by modifying the intestinal microbiota.

Gastroenterology Rev 2022; 17 (1): 28–34 DOI: https://doi.org/10.5114/pg.2021.112681

Relationships of gut microbiota, short-chain fatty acids, inflammation, and the gut barrier in Parkinson’s disease

Velma T. E. Aho et al

Background: Previous studies have reported that gut microbiota, permeability, short-chain fatty acids (SCFAs), and inflammation are altered in Parkinson’s disease (PD), but how these factors are linked and how they contribute to disease processes and symptoms remains uncertain. This study sought to compare and identify associations among these factors in PD patients and controls to elucidate their interrelations and links to clinical manifestations of PD.

Methods: Stool and plasma samples and clinical data were collected from 55 PD patients and 56 controls. Levels ofstool SCFAs and stool and plasma inflammatory and permeability markers were compared between patients and controls and related to one another and to the gut microbiota.

Results: Calprotectin was increased and SCFAs decreased in stool in PD in a sex-dependent manner. Inflammatory markers in plasma and stool were neither intercorrelated nor strongly associated with SCFA levels. Age at PD onset was positively correlated with SCFAs and negatively correlated with CXCL8 and IL-1β in stool. Fecal zonulin correlated positively with fecal NGAL and negatively with PD motor and non-motor symptoms. Microbiota diversity and composition were linked to levels of SCFAs, inflammatory factors, and zonulin in stool. Certain relationships differed between patients and controls and by sex.

Conclusions: Intestinal inflammatory responses and reductions in fecal SCFAs occur in PD, are related to the microbiota and to disease onset, and are not reflected in plasma inflammatory profiles. Some of these relationships are distinct in PD and are sex-dependent. This study revealed potential alterations in microbiota-host interactions and links between earlier PD onset and intestinal inflammatory responses and reduced SCFA levels, highlighting candidate molecules and pathways which may contribute to PD pathogenesis and clinical presentation and which warrant further investigation.

Aho et al. Molecular Neurodegeneration (2021) 16:6  https://doi.org/10.1186/s13024-021-00427-6

Effects of Saffron Extract Supplementation on Mood, Well-Being, and Response to a Psychosocial Stressor in Healthy Adults: A Randomized, Double-Blind, Parallel Group, Clinical Trial

 Philippa A. Jackson et al

Anxiety, stress, and low mood are closely related and may contribute to depressive symptoms. Among non-pharmacological solutions to improve subclinical mood symptoms and resilience to stress, natural products such as saffron—identified as promising following preliminary beneficial effects in major depressive disorder—represent a relevant strategy. This study aimed to assess the efficacy of 8 weeks’ supplementation with 30 mg standardized saffron extract on emotional well-being in healthy adults with subclinical feelings of low mood and anxiety and/or stress and evaluate the acute effect of saffron in response to a lab-based psychosocial stressor. The study adopted a double-blind, randomized, parallel groups design in which 56 healthy male and female individuals (18–54 years) received either a saffron extract or a placebo for 8 weeks. Chronic effects of saffron on subjective anxiety, stress, and depressive feelings were assessed using a questionnaire battery [including Profile of Mood State-2, (POMS)] and acute effects in response to a lab-based psychosocial stressor were measured through psychological and physiological parameters. Urinary crocetin levels were quantified. Participants who received the saffron extract reported reduced depression scores and improved social relationships at the end of the study. Urinary crocetin levels increased significantly with saffron supplementation and were correlated with change in depression scores. The typical stress-induced decrease in heart rate variability (HRV) during exposure to the stressor was attenuated following acute saffron intake. Saffron extract appears to improve subclinical depressive symptoms in healthy individuals and may contribute to increased resilience against the development of stress-related psychiatric disorder

Front. Nutr. 7:606124. doi: 10.3389/fnut.2020.606124

A randomized, double-blind, clinical trial comparing the efficacy and safety of Crocus sativus L. with fluoxetine for improving mild to moderate depression in post percutaneous coronary intervention patients

 Nazila Shahmansouri et al

Objective: A significant correlation exists between coronary artery diseases and depression. The aim of this trial was to compare the efficacy and safety of saffron versus fluoxetine in improving depressive symptoms of patients who were suffering from depression after performing percutaneous coronary intervention (PCI).

 Methods: In this randomized double-blind parallel-group study, 40 patients with a diagnosis of mild to moderate depression who had undergone PCI in the last six months were randomized to receive either fluoexetine (40 mg/day) or saffron (30 mg/day) capsule for six weeks. Participants were evaluated by Hamilton depression rating scale (HDRS) at weeks 3 and 6 and the adverse events were systemically recorded.

Results: By the study endpoint, no significant difference was detected between two groups in reduction of HDRS scores (P¼0.62). Remission and response rates were not significantly different as well (P¼1.00 and P¼0.67; respectively). There was no significant difference between two groups in the frequency of adverse events during this trial. Limitations: Relatively small sample size and short observational period were the major limitations of this study.

Conclusion: Short-term therapy with saffron capsules showed the same antidepressant efficacy compared with fluoxetine in patients with a prior history of PCI who were suffering from depression.

Journal of Affective Disorders (2013), http://dx.doi.org/10.1016/j.jad.2013.11.003

A Review of the Relationship Between Vitamin D and Parkinson Disease Symptoms

Michelle E. Fullard et al

Vitamin D is a fat-soluble secosteroid that exerts its effects by binding to the vitamin D receptor (VDR), through which it directly and indirectly modulates the expression of hundreds to thousands of genes. While originally known for its role in regulating calcium homeostasis and metabolism, vitamin D is now associated with many other health conditions, including Parkinson’s disease (PD).  high prevalence of vitamin D deficiency has been noted in PD for at least the past two decades. These findings, along with the discovery that the DR and 1α-hydroxylase, the enzyme that converts vitamin D to its active form, are highly expressed in the substantia nigra, led to the hypothesis that inadequate levels of circulating vitamin D may lead to dysfunction or cell death within the substantia nigra. Studies investigating the relationship between vitamin D status and PD, however, have been inconsistent. wo prospective studies examined the association between mid-life vitamin D levels and risk of PD and produced conflicting results—one demonstrated an increased risk for PD with lower mid-life vitamin D levels, and the other showed no association between vitamin D and PD risk. One of the most consistent findings in the literature is the inverse association between serum vitamin D level and motor symptom severity in cross-sectional studies. While these data suggest that vitamin D may modify the disease, another likely explanation is confounding due to limited mobility. Fall risk has been associated with vitamin D in PD, but more study is needed to determine if supplementation decreases falls, which has been demonstrated in the general population. he association between vitamin D and non-motor symptoms is less clear. here is some evidence that vitamin D is associated with verbal fluency and verbal memory in PD. Studies in PD have also shown associations between vitamin D status and mood, orthostatic hypotension and olfactory impairment in PD. While more research is needed, given the numerous potential benefits and limited risks, vitamin D level assessment in PD patients and supplementation for those with deficiency and insufficiency seems justified.

Front. Neurol. 11:454. doi: 10.3389/fneur.2020.00454

The Role of Vitamin D in Inflammatory Bowel Disease: Mechanism to Management

 Jane Fletcher et al

Abstract: Vitamin D has been linked to human health benefits that extend far beyond its established actions on calcium homeostasis and bone metabolism. One of the most well studied facets of extra-skeletal vitamin D is its activity as an immuno-modulator, in particular its potent anti-inflammatory effects. As a consequence, vitamin D deficiency has been associated with inflammatory diseases including inflammatory bowel disease (IBD). Low serum levels of the major circulating form of vitamin D, 25-hydroxyvitamin D (25-OH-D) are significantly more prevalent in patients with IBD, particularly in the winter and spring months when UV-induced synthesis of vitamin D is lower. Dietary malabsorption of vitamin D may also contribute to low serum 25(OH)D in IBD. The benefits of supplementation with vitamin D for IBD patients are still unclear, and improved vitamin D status may help to prevent the onset of IBD as well as ameliorating disease severity. Beneficial effects of vitamin D in IBD are supported by pre-clinical studies, notably with mouse models, where the active form of vitamin D, 1,25-dihydroxyvitamin D (1,25-(OH)2D) has been shown to regulate gastrointestinal microbiota function, and promote anti-inflammatory, tolerogenic immune responses. The current narrative review aims to summarize the different strands of data linking vitamin D and IBD, whilst also outlining the possible beneficial effects of vitamin D supplementation in managing IBD in humans.

Nutrients 2019, 11, 1019; doi:10.3390/nu11051019