Characterizing gut microbial dysbiosis and exploring the effect of prebiotic fiber supplementation in patients with COPD.

PURPOSE: Chronic Obstructive Pulmonary Disease (COPD) is associated with poor dietary quality that may lead to gut microbiota imbalances. A healthy gut microbiome contributes to metabolic health and immune function through production of metabolites like short-chain fatty acids. Prebiotic fibers positively influence microbiota by promoting the production of beneficial metabolites. This study aimed to assess altered gut microbiota composition in patients with COPD and to explore the effects of targeted multi-nutrient supplementation including prebiotic fibers on these outcomes.

METHODS

An exploratory analysis was performed within the double-blinded placebo-controlled NUTRECOVER-trial to gain preliminary insights into the effects of the nutritional intervention. The cross-sectional baseline comparison included 32 patients with COPD and 32 age-matched healthy references. Subsequently, patients were randomly assigned to a multi-nutrient supplement including prebiotic fibers, vitamin D, tryptophan, and N-3 long-chain poly unsaturated fatty acids (n = 16) or placebo (n = 16) for three months. Stool samples, blood samples and food diaries were obtained before and after the intervention.

RESULTS

Higher relative abundance of Bacteroidota (0.50 ± 0.13 vs. 0.41 ± 0.14, p = 0.010), and lower Firmicutes (0.40 ± 0.14 vs. 0.49 ± 0.12, p = 0.007) were found in patients compared with healthy controls. Patients also showed lower alpha diversity (5.80 ± 0.32 vs. 5.99 ± 0.30, p = 0.017) and higher inter-individual variability (0.51 ± 0.16 vs. 0.48 ± 0.10, p < 0.001). No effects of the nutritional intervention on gut microbiome and systemic inflammation were shown at 3 months.

CONCLUSION

Patients with COPD exhibit differences in gut microbiota composition compared with healthy controls. Three months of multi-nutrient supplementation is insufficient to show changes in microbiome composition. The ongoing NUTRECOVER-trial will show the potential of long-term prebiotic fiber supplementation in this susceptible patient population.

TRIAL REGISTRATION NUMBER: clinicaltrials.gov: NCT03807310.