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BACKGROUND: Pectin is a water-soluble dietary fiber that has been widely used in hospitalized patients. However, there is insufficient high-quality evidence to support its use in critically ill patients. Therefore, we aimed to conduct a systematic review and meta-analysis to evaluate the efficacy and safety of pectin-supplemented enteral nutrition (PSEN) on diarrhea and other important outcomes in this patient population. METHODS: We searched PubMed, Embase, China National Knowledge Infrastructure, Wanfang, and the Cochrane database for relevant articles from inception to Oct 15, 2023. Studies were included if they focused on adult ICU patients receiving PSEN compared to controls. The primary outcome was diarrhea. We assessed study quality and performed subgroup analysis, sensitivity analysis, GRADE system and trial sequential analysis (TSA) to explore potential heterogeneity among the included studies. RESULTS: Twelve trials with 1,405 patients were included. Overall, PSEN significantly reduced the risk of diarrhea (odds ratio [OR] = 0.40; 95 % CI, 0.30-0.54; P < 0.00001). This finding was confirmed in further subgroup and sensitivity analyses. Of note, PSEN significantly reduced the risk of diarrhea in patients who did not use PPIs but not in those who did. PSEN also significantly reduced infectious complications (OR = 0.43; 95 % CI, 0.26-0.70; P = 0.0007), ICU length of stay (MD = -3.59 days; 95 % CI, -7.13 to -0.05; P = 0.05), and hospital length of stay (MD = -6.79 days; 95 % CI, -10.24 to -3.34; P = 0.0001). In addition, PSEN significantly reduced intestinal intolerance symptoms (vomiting [OR = 0.27; 95 % CI, 0.15-0.48], feeding intolerance [OR = 0.39; 95 % CI, 0.22-0.68], abdominal distension [OR = 0.22; 95 % CI, 0.22-0.46] and severe constipation [OR = 0.20; 95 % CI, 0.12-0.35]) and nutrition status (shorter time to target EN amount [MD = -1.81 days; 95 % CI, -2.18 to -1.44] and prealbumin changes [MD = -1.81 days; 95 % CI, -2.18 to -1.44]) but did not affect mortality (OR = 0.86; 95 % CI, 0.56-1.33) in this patient population. TSA and sensitivity analyses confirmed the primary findings. CONCLUSIONS: PSEN significantly had better feeding intolerance, and

The legume tree known as carob (Ceratonia siliqua L.) is indigenous to the Mediterranean area and over the centuries its pods had been traditionally used mostly as animal feed. However, it has gained great attention in human nutrition due to the molecular compounds it contains, which could offer many potential health benefits: for example, carob is renowned for its high content of fiber, vitamins, and minerals. Moreover, in traditional medicine it is credited with the ability to control glucose metabolism and gut microbiome. Modern science has also extensively acknowledged the numerous health advantages deriving from its consumption, including its anti-diabetic, anti-inflammatory, and antioxidant properties. Due to its abundant contents of pectin, gums, and polyphenols (such as pinitol), carob has garnered significant attention as a well-researched plant with remarkable therapeutic properties. Notably, carob is extensively used in the production of semi-finished pastry products, particularly in ice cream and other creams (especially as a substitute for cocoa/chocolate): these applications indeed facilitate the exploration of its positive effects on glucose metabolism. Our study aimed at examining the effects of carob extract on intestinal microbiota and glucose metabolism. In this review, we conducted a thorough examination, comprising in vitro, in vivo, and clinical trials to appraise the consequences on human health of polyphenols and pectin from different carob species, including recently discovered ones with high polyphenol contents. Our goal was to learn more about the mechanisms through which carob extract can support a balanced gut flora and improve one's glucose metabolism. These results could influence the creation of novel functional foods and dietary supplements, to help with the management and prevention of chronic illnesses like diabetes and obesity.

BACKGROUND: Chronic constipation is a prevalent disorder that remains challenging to treat. Studies suggest increasing fiber intake may improve symptoms, although recommendations on the fiber type, dose, and treatment duration are unclear. OBJECTIVES: We investigated the effects of fiber supplementation on stool output, gut transit time, symptoms, and quality of life in adults with chronic constipation via a systematic review and meta-analysis of randomized controlled trials (RCTs). METHODS: Studies were identified using electronic databases, backward citation, and hand searches of abstracts. RCTs reporting administration of fiber supplementation in adults with chronic constipation were included. Risks of bias (RoB) was assessed with the Cochrane RoB 2.0 tool. Results were synthesized using risk ratios (RRs), mean differences, or standardized mean differences (SMDs) and 95% CIs using a random-effects model. RESULTS: Sixteen RCTs with 1251 participants were included. Overall, 311 of 473 (66%) participants responded to fiber treatment and 134 of 329 (41%) responded to control treatment [RR: 1.48 (95% CI: 1.17, 1.88; P = 0.001); I2 = 57% (P = 0.007)], with psyllium and pectin having significant effects. A higher response to treatment was apparent in fiber groups compared to control groups irrespective of the treatment duration, but only with higher fiber doses (>10 g/d). Fiber increased stool frequency [SMD: 0.72 (95% CI: 0.36, 1.08; P = 0.0001); I2 = 86% (P < 0.00001)]; psyllium and pectin had significant effects, and improvement was apparent only with higher fiber doses and greater treatment durations (≥4 weeks). Fiber improved stool consistency (SMD: 0.32; 95% CI: 0.18, 0.46; P < 0.0001), particularly with higher fiber doses. Flatulence was higher in fiber groups compared to control groups(SMD: 0.80; 95% CI: 0.47, 1.13; P < 0.00001). CONCLUSIONS: Fiber supplementation is effective at improving constipation. Particularly, psyllium, doses >10 g/d and treatment durations of at least 4 weeks appear optimal, though caution is needed when interpreting the results due to considerable heterogeneity. These findings provide promising evidence on the optimal type and regim

BACKGROUND: Many interventions have shown effectiveness in reducing the duration of acute diarrhea and gastroenteritis (ADG) in children. Yet, there is lack of comparative efficacy of interventions that seem to be better than placebo among which, the clinicians must choose. Our aim was to determine the comparative effectiveness and safety of the pharmacological and nutritional interventions for reducing the duration of ADG in children. METHODS: Data sources included Medline, Embase, CENTRAL, CINAHL, LILACS, and Global-Health up to May 2017. Eligible trials compared zinc (ZN), vitamin A, micronutrients (MN), probiotics, prebiotics, symbiotics, racecadotril, smectite(SM), loperamide, diluted milk, lactose-free formula(LCF), or their combinations, to placebo or standard treatment (STND), or among them. Two reviewers independently performed screening, review, study selection and extraction. The primary outcome was diarrhea duration. Secondary outcomes were stool frequency at day 2, diarrhea at day 3, vomiting and side effects. We performed a random effects Bayesian network meta-analysis to combine the direct and indirect evidence for each outcome. Mean differences and odds ratio with their credible intervals(CrI) were calculated. Coherence and transitivity assumptions were assessed. Meta-regression, subgroups and sensitivity analyses were conducted to explore the impact of effect modifiers. Summary under the cumulative curve (SUCRA) values with their CrI were calculated. We assessed the evidence quality and classified the best interventions using the Grading of Recommendations, Assessment, Development & Evaluation (GRADE) approach for each paired comparison. RESULTS: A total of 174 studies (32,430 children) proved eligible. Studies were conducted in 42 countries of which most were low-and middle-income countries (LMIC). Interventions were grouped in 27 categories. Most interventions were better than STND. Reduction of diarrhea varied from 12.5 to 51.1 hours. The combinations Saccharomyces boulardii (SB)+ZN, and SM+ZN were considered the best interventions (i.e., GRADE quality of evidence: moderate to high, substantial superiority to STND, reduction in duration of 35

AIMS: Dietary fiber intake, especially viscous soluble fiber, has been established as a means to reduce cardiometabolic risk factors. Whether this is true for blood pressure remains controversial. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to investigate the effects of viscous soluble fiber supplementation on blood pressure and quantify the effect of individual fibers. DATA SYNTHESIS: MEDLINE, Embase, and Cochrane databases were searched. We included RCTs of ≥4-weeks in duration assessing viscous fiber supplementation from five types: β-glucan from oats and barley, guar gum, konjac, pectin and psyllium, on systolic blood pressure (SBP) and diastolic blood pressure (DBP). Study data were pooled using the generic inverse variance method with random effects models and expressed as mean differences (MD) with 95% confidence intervals (CIs). Twenty-two (N = 1430) and twenty-one RCTs (N = 1343) were included in the final analysis for SBP and DBP, respectively. Viscous fiber reduced SBP (MD = -1.59 mmHg [95% CI: -2.72,-0.46]) and DBP (MD = -0.39 mmHg [95% CI: -0.76,-0.01]) at a median dose of 8.7 g/day (1.45-30 g/day) over a median follow-up of 7-weeks. Substantial heterogeneity in SBP (I2 = 72%, P < 0.01) and DBP (I2 = 67%, P < 0.01) analysis occurred. Within the five fiber types, SBP reductions were observed only for supplementation using psyllium fiber (MD = -2.39 mmHg [95% CI: -4.62,-0.17]). CONCLUSION: Viscous soluble fiber has an overall lowering effect on SBP and DBP. Inclusion of viscous fiber to habitual diets may have additional value in reducing CVD risk via improvement in blood pressure. PROTOCOL REGISTRATION: ClinicalTrials.gov identifier-NCT02670967.

Comment in J Pain Symptom Manage. 2014 Jul;48(1):e2-3. doi: 10.1016/j.jpainsymman.2014.03.003. J Pain Symptom Manage. 2014 Jul;48(1):e3-4. doi: 10.1016/j.jpainsymman.2014.04.002. CONTEXT: Breakthrough cancer pain (BTcP) is widely recognized as a clinically significant complication of chronic cancer pain. With most BTcP episodes peaking in intensity within a few minutes and lasting for approximately 30 minutes, speed of onset is crucial for effective pain management. Although the last decade has seen the development of a number of rapid-onset fentanyl preparations, BTcP is still typically managed by supplemental or rescue doses of the patient's around-the-clock medication, such as oral morphine. Importantly, although the fentanyl preparations, such as fentanyl buccal tablet (FBT), sublingual fentanyl citrate orally disintegrating tablet (ODT), and oral transmucosal fentanyl citrate lozenge (OTFC), have all been proven to be efficacious in clinical studies, oral morphine has never been specifically tested in BTcP, other than as a comparator in studies of OTFC and fentanyl pectin nasal spray. OBJECTIVES: To determine the relative contributions to pain relief from oral morphine and the fentanyl preparations using placebo as a common comparator. METHODS: Relevant studies were identified by review of the literature and used in a mixed-treatment meta-analysis to indirectly compare fentanyl preparations, morphine, and placebo for the treatment of BTcP. RESULTS: Analysis incorporating the five relevant studies identified revealed that although the fentanyl preparations provide superior pain relief vs. placebo in the first 30 minutes after dosing (FBT provided an 83% probability of superior pain relief, ODT 66%, and OTFC 73% vs. placebo), oral morphine performed little better than placebo (56% probability). CONCLUSION: This mixed-treatment analysis suggests that FBT, ODT, and OTFC might provide more efficacious treatment options than oral morphine for BTcP.

BACKGROUND: Diet plays a critical role in colorectal cancer (CRC) prevention. Pesco-vegetarians, who consume both high fiber and fish containing n-3 (ω-3) polyunsaturated fatty acid (PUFA), have the lowest CRC risk. Ferroptosis is a form of regulated cell death characterized by the accumulation of lipid hydroperoxides that has emerged as a target for anticancer therapies. OBJECTIVES: This study aimed to assess the broad utility of diet modulation as a promising avenue to modulate ferroptosis in the colon. METHODS: 1) Immortalized young adult mouse colonic epithelial cells (YAMC) were treated with control linoleic acid or docosahexaenoic acid (DHA) ± butyrate (But), followed by cell viability and lipid peroxidation measurements, 2) mice were fed diets containing fish oil and highly fermentable pectin (FP) compared with control corn oil and poorly fermentable cellulose (CC). Colons were isolated and used for bulk and single-cell ribonucleic acid-sequencing (RNA)-seq analysis, 3) a crossover pilot study was conducted by supplementing 30 healthy adults with soluble corn fiber (33 g/d) + fish oil (7.7 g/d n-3 PUFA) (SCF+FO) or maltodextrin + corn oil (MD+CO) for 30 d followed by a 60 d wash period and then 30 d of MD+CO or SCF+FO. Exfoliated colonocyte mRNA was isolated from stool and RNA-seq was performed for transcriptomic analysis. RESULTS: In vitro treatment of DHA and But reduced YAMC cell viability (P < 0.05), increased lipid peroxidation, a key biomarker of ferroptosis, compared with the counterpart group. In vivo FP-fed mice promoted lipid peroxidation in colonocytes relative to the control CC-fed mice (P < 0.05), and the induction of ferroptosis transcriptional networks exclusively in colonic epithelial cells. Furthermore, human subjects supplemented with SCF+FO exhibited an upregulation in intestinal ferroptosis-related gene expression, as compared with similar doses of MD+CO. CONCLUSIONS: Our findings demonstrate that dietary fish oil and fermentable fiber combination induces ferroptosis exclusively in colonocytes. The human pilot study was registered at clinicaltrials.gov as NCT04211766. Published by Elsevier Inc.

The gut microbiota ferments dietary fibers, producing short-chain fatty acids (SCFA). Enhanced SCFA production in the distal colon has been linked to improved cardiometabolic health. However, most fibers are fermented proximally, resulting in increased protein fermentation distally, producing metabolites putatively harmful to metabolic health. This 12-week randomized, placebo-controlled trial aimed to improve metabolic health through increasing distal SCFA production while inhibiting proteolytic fermentation using a fiber supplement that increased distal SCFA production in vitro. We assessed the effects of daily potato fiber/sugar beet pectin supplementation (fiber, n = 19) versus maltodextrin (placebo, n = 21), both added to a high-protein diet (25E% protein, ±45% plant-based), on peripheral insulin sensitivity (IS) in adults with overweight/obesity. Secondary outcomes included tissue-specific IS, body composition, microbial composition and functionality, substrate metabolism, and gut permeability. Peripheral IS tended to decrease after fiber supplementation compared to placebo (p = 0.081), while whole-body IS significantly decreased (p = 0.034). Fiber mitigated the increase in insulin-mediated carbohydrate oxidation (p = 0.027) and decrease in fat oxidation (p = 0.006) that occurred in the placebo group. Additionally, fiber prevented an increase in protein oxidation (p = 0.048), while increasing colonic gut permeability (p = 0.046) and plasma interleukin-6 (p = 0.025). Body composition, microbial composition, and fecal and circulating metabolites remained unchanged. In conclusion, fibers combined with a high-protein diet reduced (peripheral) IS and decreased metabolic flexibility compared to placebo. Reduced protein oxidation after fiber may reflect diminished amino acid bioavailability. Additionally, coadministration of fiber and protein may compromise gut barrier function and inflammatory responses. More research investigating the interplay between dietary fibers and proteins is needed.

Currently, there is great interest in the use of pectins for prebiotic treatment of food allergy. Hence, the effects of two different esterified pectins - low methoxyl citrus-derived pectin (CP-DElow) and high methoxyl apple-derived pectin (AP-DEhigh) - were evaluated in peach allergic patients due to sensitization to lipid transfer proteins (LTPs). This study analyzed the systemic immune response, the gut microbiota composition (using 16S rRNA gene sequencing), and microbial-derived metabolome, including short-chain fatty acids (SCFAs) and bile acids (BAs). Prebiotic treatment with both pectins was safe and induced a significant clinical increase in allergen tolerance in more than 50 % of patients. Additionally, CP-DElow and AP-DEhigh groups exhibited a distinctive systemic proteomic profile characterized by a decrease in various inflammatory cytokines compared to Placebo. Regarding microbiota, CP-DElow induced an increase in Bacteroides_H genus and Roseburia intestinalis species, whereas AP-DEhigh was associated with an increase in Bifidobacterium and Succinivibrio genera, and Faecalibacterium prausnitzii species. Reduced concentrations of branched SCFAs were observed after both treatments compared to Placebo. Likewise, fecal levels of microbial-derived secondary BAs were modified by pectin supplementation. Multi-omics integration revealed distinctive signatures in pectin- and placebo-treated patients. This study suggests that pectin treatment is a promising and safe option for LTP allergy.

Type 2 diabetes and obesity have become major public health concerns. Growing evidence suggests that increased dietary fiber intake, through its interaction with the gut microbiota, may help prevent these diseases. Here, we demonstrate in a 12-week randomized, placebo-controlled trial in individuals at risk for type 2 diabetes that intake of an intrinsic fiber product, consisting of entire plant cells, tended to improve peripheral insulin sensitivity (p = 0.085), increased whole-body insulin sensitivity (p = 0.032), reduced circulating triglycerides (p = 0.049), and tended to reduce intrahepatic lipid content (p = 0.063), along with an increased proportion of small adipocytes (p = 0.008). Phylogenetic and metagenomic analysis revealed that these outcomes coincided with increased levels of fiber-degrading Bifidobacterium spp. and butyrate-producing Anaerostipes spp. and a functional shift toward a distal butyrogenic trophic chain while the best responding individuals had increased levels of pectin degraders that may produce propionate. Our findings demonstrate the pivotal role of slowly fermented, intrinsic plant cell fibers in improving cardiometabolic health. This study was registered at ClinicalTrials.gov (NCT04714944).

Curcuminoid absorption can be influenced by the presence of additional compounds, but there has been no study investigating this in a robust manner. The aim of this clinical trial was to assess the effect of the type of food matrix on the absorption of curcuminoids from a highly bioavailable turmeric formulation. Participants consumed the turmeric formulation in the form of capsules, a ready-to-drink fruit nectar, a sports nutrition bar, a dairy analogue (oat milk), pectin gummies, and a probiotic drink in a randomized, crossover study. Plasma samples were collected over a 24-hour period to assess the pharmacokinetics of curcuminoids. The relative bioavailability of total curcuminoids was increased in all the food matrices compared to that in the capsule formulation. The dairy analogue showed the highest increase in dose-normalized AUC24 h (+76%, p < 0.0001) and Cmax (+105%, p < 0.0001). The sports nutrition bar resulted in increased dose-normalized AUC24 h (+40%, p = 0.0112) and Cmax (+74%, p < 0.0001). The probiotic drink showed increased dose-normalized AUC24 h (+35%, p = 0.0318) and Cmax (+52%, p < 0.0001). The ready-to-drink and gummy formulations were bioequivalent to the capsules. The distribution of curcuminoid metabolites was similar in all the matrices. In conclusion, there was no negative food matrix effect; on the contrary, the bioavailability of curcuminoids can be improved when administered via food matrices, particularly those containing lipids in a suspended form or polar lipids.

Background/Objective: Although low-methoxy (LM) pectin (polysaccharides extracted from citrus peels) can reduce inflammation by binding to and inhibiting the TLR-2 pathway in animal models and in vitro studies, the anti-inflammatory effects of LM pectin in humans and mood have not been explored to date. The purpose of this study is to assess the role of dietary supplementation with LM pectin in healthy volunteers on inflammatory markers and on mood, specifically anxiety and depression. Methods: We carried out a 4-week dietary intervention with LM citrus pectin on healthy volunteers (N = 14, age 40 ± 16 y, BMI 24.7 ± 3.0 kg/m2, sex F 57%) comparing the effects of daily supplementation with 20 g of LM citrus pectin versus 10 g of maltodextrin as the control (N = 15 age 43.2 ± 11 y, BMI 25.18 ± 2.0 kg/m2, sex F 66%). The effects on mood and inflammation were also tested with LM pectin at 5 g, 10 g and 15 g (2 weeks each) in an independent cohort of n = 15 healthy volunteers (age 36 ± 21 y, BMI 23.5 ± 2.4 kg/m2, sex F 80%). We assessed serum levels of TNF-alpha (downstream from TLR-2 activation), IL-1 beta, IL-6, IL-10, INF-gamma, CRP, zonulin and TLR-2 concentration which were measured using ELISA in blood samples collected at both the baseline and follow-up visits. Validated measures of anxiety and depression were collected at baseline and follow-up. Results: Supplementation with 20 g of LM pectin resulted in decreases in the pro-inflammatory markers TNF-alpha, IL-1 beta, IL-6 and INF-gamma (all p < 0.05) and an increase in anti-inflammatory marker IL-10 (p = 0.01) at the end of the 4 weeks. No such effects were observed in the control group. In addition, a significant drop in anxiety scores (from 8.38 to 4.46, p < 0.006) was found with the 20 g/day intervention but not in the control arm. In the dose-response study, anti-inflammatory effects were seen only at 15 g for TNFα (p < 0.003) and a suggestive increase in IL-10 (p = 0.08), alongside a drop in TLR-2 (p < 0.027). No significant anti-inflammatory effects were observed at 5 g and 10 g doses of LM pectin supplementation. Significant dose-dependent drops in both anxiety and depression scores were found with 10

OBJECTIVE: Aim: To investigate the effectiveness of rifaximin and probiotics for the correction of intestinal permeability in patients with metabolic-associated fatty liver disease (MAFLD) in combination with type 2 diabetes mellitus. PATIENTS AND METHODS: Materials and Methods: The prospective interventional randomized investigation included 68 patients with MAFLD in combination with type 2 diabetes, who were examined and divided into the 2 groups of treatment. RESULTS: Results: The serum levels of interleukin (IL) - 6, IL-10 and zonulin, indicators of liver functional activity, liver attenuation coefficient between treatment group vs. control group after 2 weeks, 1 month, 3 and 6 months of therapy were significant differed. The serum levels of IL-6 and zonulin significantly decreasing and increasing of IL-10 in the treatment group after 2 weeks, 1, 3 and 6 months of combined therapy. When comparing of stool short-chain fatty acids concentration between treatment group vs. control group after 2 weeks, 1 month, 3 and 6 months of therapy the levels of acetic, butyric and propionic acids significantly differences and increase in their levels were established. CONCLUSION: Conclusions: The results of the study in dynamics during 6 months show that the additional appointment of rifaximin, multispecies probiotic and prebiotic to metformin in patients with MAFLD and type 2 diabetes led to the elimination of subclinical inflammation, modulation of the permeability of the intestinal barrier and lowering increased intestinal permeability, as well as to the lower serum activity of liver aminotransferases and decrease the stage of steatosis.

Dry mouth is a multifaceted condition which is caused by reduced salivary secretion. This study aimed to evaluate and compare the effects of different lozenge surface textures, tastes and acidity levels on stimulated salivary secretion for increased oral moistening in participants without hyposalivation. This randomized, double-blind, clinical crossover trial with before and after comparison involved 33 healthy volunteers. Five lozenges, including a baseline control (C), apple (A), sour (S), sour apple (SA) and granular pectin (P) were tested on five different days with all the subjects. Salivary flow, pH value, and subjective feeling (visual analog scale) were measured before and after consuming the lozenge each day. Throughout all trial days the unstimulated whole salivary flow (UWSF) averaged 0.65 ± 0.26 ml/min. Lozenges S, SA, and P showed higher stimulated whole salivary flow (SWSF) than C (P < 0.001) by more than 0.5 ml/min. Lozenge P, with a rough surface, demonstrated the highest difference between UWSF and SWSF, 2.41 ± 0.69 ml/min. The stimulated saliva with the lozenges containing acidifiers (S, SA and P) was more than 1.4 pH units lower compared to lozenges C and A (P < 0.001). Subjects reported the strongest subjective feeling of increased saliva with lozenges SA and P. Overall lozenges SA and P provided the best objective results in enhancing salivary flow rate and subjective feeling of increased salivary flow. Copyright 2024 SWISS DENTAL JOURNAL SSO – Science and Clinical Topics. License: This work is licensed under a Creative Commons Attribution 4.0 International License.

Pectin and its derivatives have been shown to modulate immune signaling as well as gut microbiota in preclinical studies, which may constitute the mechanisms by which supplementation of specific pectic polysaccharides confers protection against viral respiratory infections. In a double-blind, placebo-controlled rhinovirus (RV16) challenge study, healthy volunteers were randomized to consume placebo (0.0 g/day) (N = 46), low-dose (0.3 g/day) (N = 49) or high-dose (1.5 g/day) (N = 51) of carrot derived rhamnogalacturonan-I (cRG-I) for eight weeks and they were subsequently challenged with RV-16. Here, the effect of 8-week cRG-I supplementation on the gut microbiota was studied. While the overall gut microbiota composition in the population was generally unaltered by this very low dose of fibre, the relative abundance of Bifidobacterium spp. (mainly B. adolescentis and B. longum) was significantly increased by both doses of cRG-1. Moreover, daily supplementation of cRG-I led to a dose-dependent reduction in inter- and intra-individual microbiota heterogeneity, suggesting a stabilizing effect on the gut microbiota. The severity of respiratory symptoms did not directly correlate with the cRG-I-induced microbial changes, but several dominant groups of the Ruminococcaceae family and microbiota richness were positively associated with a reduced and hence desired post-infection response. Thus, the present results on the modulation of the gut microbiota composition support the previously demonstrated immunomodulatory and protective effect of cRG-I during a common cold infection.

BACKGROUND: Dietary fiber plays a potential role in regulating energy intake and stabilizing postprandial blood glucose levels. Soluble dietary fiber has become an important entry point for nutritional research on the regulation of satiety. METHODS: this was a double-blind, randomized cross-over trial enrolling 12 healthy subjects to compare the effects of RPG (R+PolyGly) dietary fiber products (bread, powder, and capsule) and pectin administered with a standard meal on satiety, blood glucose, and serum insulin level. RESULTS: Adding 3.8% RPG dietary fiber to bread significantly increased the volume, water content, hardness, and chewiness of bread compared to 3.8% pectin bread and white bread and significantly improved the sensory quality of bread. RPG bread had better appetite suppression effects at some time points than the other two groups and the best postprandial blood glucose lowering effects among the three groups. Administration of RPG capsules containing 5.6 g of RPG dietary fiber with meals improved satiety and reduced hunger compared to 6 g of RPG powder and 6 g of pectin, which had the greatest effect on suppressing appetite and reducing prospective food consumption. The peak level of serum glucagon-like peptide-1 (GLP-1) in the RPG capsule group (578.17 ± 19.93 pg/mL) was significantly higher than that in other groups at 0 min and 30 min after eating. RPG powder had the best effect in reducing postprandial blood glucose and increasing serum insulin levels; the total area under the curve (AUC) of serum insulin with RPG powder was higher than other groups (5960 ± 252.46 μU min/mL). CONCLUSION: RPG dietary fiber products can improve the sensory properties of food, reduce postprandial blood glucose, and enhance satiety, especially in capsule and powder forms. Further research on the physiological effects of RPG dietary fiber is required to facilitate its use as a functional ingredient in food products.

In recent years, polysaccharides with potential anticancer activity have attracted widespread attention. In this study, a homogeneous polysaccharide fraction, PEP-3 (102.35 kDa), was extracted and purified from the fruit of Phyllanthus emblica L. Structural analysis revealed that its backbone consists of methylated and unmethylated α-1,4-GalpA residues at the C-6 position. O-2 at α-2,4-Rhap-1→ participates in backbone extension, while O-4 serves as a branch point for the Galp and Araf side chains. Through machine learning-based target screening, HSP90 was identified as the core therapeutic target of PEP-3 for stomach adenocarcinoma (STAD) treatment and an important biomarker for diagnosis and prognosis. Mechanistic studies showed that PEP-3 inhibits HSP90 activity, leading to AKT degradation and activation of the Caspase cascade. In vitro experiments showed that the combination of PEP-3 and 5-fluorouracil (5-Fu) (PEP-3 concentration 400 μg/mL, 5-Fu concentration 3.13 μg/mL) exhibited a considerable synergistic effect, markedly enhancing apoptosis, inducing cell cycle arrest, promoting ROS and Ca2+ overload, and aggravating mitochondrial damage. These results indicate that PEP-3 enhances the chemosensitivity of 5-Fu by targeting HSP90 and inducing apoptosis through multiple pathways, while simultaneously reducing the toxic side effects of 5-Fu. This highlights its potential as a natural sensitizer for the treatment of STAD.

Polyphenols-rich plant extracts such as green tea catechins and turmeric curcuminoids are extensively studied for their antioxidant and anti-cancer properties. However, their poor stability, low bioavailability and strong undesirable flavors limit their application in functional foods. This study investigates the synergistic anti-cancer activity combinations of green tea and turmeric extracts against Huh7 liver cancer cells and evaluates the effect of encapsulation on their stability, bioavailability, sensory properties and consumer acceptance. A combination extract (COE) in a 2:1 ratio (12.5,6.25 μg/mL) significantly reduced Huh7 cell viability, with a combination index of 0.15 ± 0.05 indicating strong synergy. To overcome limitations in bioaccessibility and palatability, COE was encapsulated using pectin, maltodextrin, and inulin via freeze-drying, resulting in the encapsulated combination extract (ECOE) with high encapsulation efficiencies (79.52 ± 3.01 % for catechins and 82.14 ± 1.99 % for curcuminoids). Simulated in vitro digestion showed greater retention of bioactives in ECOE compared to COE. GC-E-Nose analysis and sensory evaluation confirmed significant reductions in pungent volatile compounds, bitterness, and astringency, with significantly higher consumer liking scores for ECOE across all attributes. These findings highlight a dual-functional strategy, synergistic extract design with optimized encapsulation that enhances both biological efficacy and sensory acceptability, supporting scalable applications in functional foods and nutraceuticals.

INTRODUCTION: Prebiotics are widely used in nutritional supplements, with water-soluble dietary fibers used as thickeners for patients with swallowing difficulties. Interactions between thickeners and medications have been reported; however, the effects of thickeners on warfarin remain unclear. Here, we examined the interaction between warfarin and thickeners through clinical and basic research studies. METHODS: The clinical research study evaluated the effects of combining warfarin and thickeners on blood coagulation, while the basic research study measured the impact of different prebiotics and mixing with gastric and intestinal fluids on warfarin concentration. RESULTS: The clinical research study showed no significant differences in the patients' prothrombin time-international normalized ratio and Warfarin Sensitivity Index (WSI) before and after the combination. However, the WSI decreased postcombination in half of the patients. Meanwhile, in the basic research study, a concentration-dependent decrease in the residual rate of warfarin was observed with xanthan gum, guar gum, and pectin. When mixed with artificial gastric and intestinal fluids, the residual rate decreased with xanthan and guar gum in gastric fluid and with pectin in intestinal fluid. CONCLUSION: Thickeners primarily composed of xanthan gum, guar gum, and pectin may reduce the effectiveness of warfarin due to drug-food interactions. © 2025 The Author(s). Published by S. Karger AG, Basel.

AIMS: This study aims to investigate the role of SOD3 in gastric cancer (GC) progression and its impact on chemotherapy efficacy and toxicity. It further seeks to evaluate the therapeutic potential of MCP in enhancing SOD3 activity to improve treatment outcomes and reduce chemotherapy-induced peripheral neurotoxicity (CIPN). MATERIALS AND METHODS: We used overexpression plasmids and small interfering RNAs (siRNAs) to modulate the expression of SOD3 and Desmocollin2 (DSC2) in gastric cancer cells. Molecular biology experiments were performed to analyze pathway-related protein expression and molecular interactions. In vitro and in vivo experiments were conducted to evaluate the effects of modified citrus pectin (MCP) and oxaliplatin (OXA), individually and in combination, on gastric cancer progression and CIPN. KEY FINDINGS: SOD3 inhibited the proliferation, migration, and invasion of GC cells via SOD3/EGFR/PKP3/DSC2 axis. MCP selectively increased SOD3 levels and enhanced its anti-tumor effects. Combined treatment with MCP and OXA synergistically inhibited GC progression in vitro and in vivo, while MCP alleviated CIPN, enabling OXA dose reduction without compromising efficacy. SIGNIFICANCE: The findings revealed that SOD3 played a critical tumor-suppressive role in gastric cancer by modulating the SOD3/EGFR/PKP3/DSC2 axis. MCP, a natural compound that selectively boosted SOD3 levels, enhanced chemotherapy efficacy while reducing peripheral neurotoxicity, providing a promising strategy to improve gastric cancer treatment and mitigate chemotherapy-related side effects.

Three polysaccharides from Vinegar-baked Radix Bupleuri (VR) and their combined effects were studied. VRP3-3 was a branched polysaccharide with a molecular weight (Mw) of 16.05 kDa characterized by 1,5 linked-α-Araf, 1,2,4 linked-α-Rhap and 1,4 linked-α-GalpA as main chain with a small amount of esterification and acetylation groups. And side chains were connected to the O-3 of Araf, O-4 of Rhap. VRP2-3 had a Mw of 95.35 kDa, its backbone comprised of 1,2 linked-α-Galp, 1,4 linked-β-GalpA(O-Ac), 1,2,4 linked-α-Rhap and 1,5 linked α-Araf. The residues of 1,4 linked-β-Galp,1,3 linked-β-Galp and 1,6 linked-β-D-Galp were connected at O-4 of α-L-Rhap and O-3 of α-L-Araf as its side chain. VRP2-4 was a pectin polysaccharide with a Mw of 57.90 kDa. Its main chain was constituted of 1,4 linked-α-Galp, 1,4 linked-α-GalpA(OMe), 1,4 linked-α-GalpA and 1,2,4 linked-α-Rhap, with some acetylation. As the major side chain, 1,5 linked-α-Araf was connected to O-4 of α-Rhap, a small amount of t-α-Galp and t-α-Manp were also included. VRP3-3 showed superior synergistic effect in combination with paclitaxel, methotrexate and cisplatin than the other two polysaccharides. The VR polysaccharide with a ~16 kDa molecular weight, a larger polymerization degree of arabinan in the backbone and the triple helix structure are the key structures for activity. Together, our findings clarify the pharmacodynamic basis of VR and provide promising adjuvants for Hepatocellular Carcinoma (HCC) chemotherapy.

We previously found that modified citrus pectin (MCP), an inhibitor of pro-inflammatory factor Galectin-3 (Gal-3), has significant anti-inflammatory and chondroprotective effects. In this study, a hyaluronate (HA) gel-based sustained release system of MCP (MCP-HA) was developed as an anti-inflammatory agent for chronic inflammation for osteoarthritis (OA) treatment. The MCP-HA gel was injected into the knee joint cavities of OA rabbit models induced by anterior cruciate ligament transection (ACLT) or modified Hulth method once a week for five weeks. We found that MCP-HA could improve the symptoms and signs of OA, protect articular cartilage from degeneration, suppress synovial inflammation, and therefore alleviate OA progression. Proteomic analysis of the synovial fluid obtained from the knee joints of OA rabbits revealed that MCP-HA synergistically regulated the levels of multiple inflammatory mediators and proteins involved in metabolic pathways. Taken together, our results demonstrate that the MCP-HA shows a synergistic effect of HA and MCP by modulating both inflammation and metabolic processes, thereby alleviating OA progression. The MCP-HA sustained release system has promising potential for long-term use in OA treatment.

The interactions between polysaccharides and phenolics in foods affect their physicochemical properties and bioactivity. Pectin and catechin/procyanidin present in plants ubiquitously and attracting more attentions for the potential health benefits. This work investigates the interactions between high methoxyl pectin and catechin/procyanidin in a simulative juice model using multiple microscopic and spectroscopic approaches and their influences on the antioxidant activity of phenolics were evaluated in the Caco-2 cells model. The results showed that pectin with either of phenolic compunds exhibited lower transmittance, zeta potential, viscosity, and larger particle size than it alone. The morphology of pectin complexes with either of phenolics under experimental conditions (pH = 3.5) was observed. The ΔH° (-6.821 kJ mol-1 ) and ΔS° (6.357×10-2 kJ mol-1 ) indicated that pectin interacts with procyanidin via electrostatic interaction, whereas hydrophobic interaction was the dominant drive force between pectin and catechin (ΔH° = 1.422 kJ mol-1 ; ΔS° = 13.048 × 10-2 kJ mol-1 ). The antioxidant activities of catechin/procyanidin decreased while binding with pectin based on indexes of glutathione peroxidase, total superoxide dismutase, total antioxidant capacity, and malondialdehyde. PRACTICAL APPLICATION: The findings of this work indicated that the physicochemical property of pectin and the antioxidant activity of catechin/procyanidin were influenced by the interactions between pectin and catechin/procyanidin in a simulative food system. This study provides insights into the molecular interactions between pectin and phenolics in a simulative food system. © 2021 Institute of Food Technologists®.

Here we sought to determine the relationship between STAT3 activity and Galectin-3 (Gal-3) and to investigate the cytotoxic effect of PectaSol-C Modified Citrus Pectin (Pect-MCP) as a specific competitive inhibitor of Galectin-3 (Gal-3) in combination with Paclitaxel (PTX) to kill the ovarian cancer cell SKOV-3 multicellular tumor spheroid (MCTS). To this order, SKOV-3 cells in 2D and 3D cultures were treated with exogenous Gal-3 for the assessment of STAT3 activity. Two-way ANOVA main effect and IC50 of each drug Paclitaxel (PTX) and Pect-MCP or in combination were obtained from MTT assay results. The phosphorylated STAT3 levels, migration, invasion, integrin mRNA and p-AKTser473 levels were assessed in the absence or presence of each drug alone or in combination. Gal-3 expression levels were assessed in human serous ovarian cancer (SOC) specimens and its correlation with different integrin mRNA levels was further assessed. Our results showed that Gal-3 expression level was significantly increased in MCTS compared to monolayer SKOV-3 cells which triggered STAT3 phosphorylation. Moreover, Pect-MCP synergized with PTX to kill SKOV3 MCTS through abrogation of STAT3 activity and reduced expression of its downstream target HIF-1α, reduced integrin mRNA levels, and subsequently decreased AKT activity. There were higher expression levels of Gal-3 in human high-grade SOC specimens compared to the normal ovary and borderline SOC which positively and significantly correlated with α5, β2 and β6 integrin mRNA levels. Together, these results revealed for the first time that Pect-MCP could be considered as a potential drug to enhance the PTX effect on ovarian cancer cells MCTS through inhibition of STAT3 activity. © 2019 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

Our previous paper reported the structure of ginseng pectic polysaccharides related to the cell migration inhibitory effects, but the underlying mechanisms are poorly understood. In this manuscript, rhamnogalacturonan I (RGI)-rich pectins prepared from ginseng pectin were investigated for their effect on cell migration. The results indicated that the combination of homogalacturonan (HG) and RGI-rich pectins exerted stronger effects than either HG- or RGI-rich pectin alone. Further studies revealed that the effects of HG- and RGI-rich pectins were dependent on pretreatment, which caused alterations in cell morphologies such as cell size and shape, focal adhesion, and the organization of actin filaments, suggesting that HG and RGI pectins exert synergistic effects on cell migration, likely through different ways. Morphological data and quantitative cell adhesion and spreading assays showed that HG- and RGI-rich pectin treatment decreased cell adhesion and cell spreading on the substratum, suggesting that HG- and RGI-rich pectins may exert their effects on cell migration via decreasing cell adhesion and cell spreading. Additionally, we showed that L-929 cells expressed little galectin-3 (Gal-3) and that lactose, an inhibitor of Gal-3 did not block the activities of HG- and RGI-rich pectins, implicating that cell migration inhibited by pectin did not correlate to Gal-3.

The purpose of our study was to determine effects of green tea extracts on the Jurkat cells incubated under oxidative stress conditions. The research was conducted on leukemic human mature T cells (Jurkat cells). For the modelling of oxidative stress 30% hydrogen peroxide (H2O2) (Sigma) (10 μl, 25 μl 50 μl and 100 μl) was added to Jurkat cell suspension with subsequent incubation for 4, 6, 8 and 24 h. Control group was represented by intact Jurkat cells. The assessment of cells proliferation activity (viability) was performed by MTT test. The viability of Jurkat cells incubated for 24 hours under acquit oxidative stress conditions dose-depenently, monotonically decreased (irreversibly at 100 μM of H2O2 and reaches the 30% of intact Jurkat cells viability level at 50 μM of H2O2). Low doses of H2O2 (10 μl, 25 μl H2O2) revealed cytotoxicity only within short term (8 hours) of the incubation, afterward the viability of Jurkat cells monotonically increased and after 24 hours it reached 43% and 56% of control level, respectively. Vitamins C and E revealed cytotoxic effect on intact Jurkat cells, while the C+V vitamins complex induced 2-fold stimulation of Jurkat cells viability. Under a moderate oxidative stress condition (25 μl of H2O2) the complex of C + E vitamins revealed cytoprotective effect on Jurkat cells which may be related to ability of vitamin C to induce regeneration and to transform E vitamin tocopheroxyl free radicals into tocopherol. Green tea had no effect, green tea catechins revealed stimulatory effect, while green tea pectin - weak cytotoxic effect on intact Jurkat cells. Green tea and especially extracted catechins (but not pectin) revealed stimulatory effect on the viability of the Jurkat cells incubated under an oxidative stress condition. Our study results confirm the opinion that the natural compounds (green tea extracts) are harmless for normal cellular metabolism. Their differential effects on the "diseased", incubated under an oxidative stress cells are mediated via impact on signaling regulatory systems. On the basis of screening of green tea extracts it will be possible to select new high effective cytotoxic and cytoprotective compounds.

BACKGROUND & AIMS: Functional Bowel Disorders (FBD) are clinically diagnosable conditions impacting the mid to lower gastrointestinal tract. Fibre manipulation (through amount or type) is commonly employed as a first-line treatment for symptom management. This systematic review will investigate the impact of fibre manipulation on symptom management and quality of life in adults diagnosed with FBD. METHODS: Four electronic databases (PubMed, EMBASE, CINAHL, and Cochrane Central) were systematically searched from January 2013 to December 2024. Studies were included if they reported Randomised Controlled Trials (RCTs) examining the impact of fibre manipulation in adults (≥18 years) with FBD. The primary outcome was symptom management, and secondary outcome was Quality of Life (QoL). Study quality was assessed using the Cochrane risk of bias tool 2. Data were narratively synthesised. RESULTS: Searches identified 8864 records; 5167 were screened against the eligibility criteria, and 44 records were assessed at full-text review. Ten studies reporting eight parallel and two crossover RCTs evaluating differing fibre supplements and doses for people with various types of FBD were included. Intervention length ranged from one to eight weeks, and the number of participants ranged from 11 to 250. The reported results varied. Seven studies reported significant improvements in symptom severity, and one study reported significant worsening of symptoms when compared to controls. The results indicated that fibre supplementation with agave fructans improved constipation but worsened flatulence, acacia fibre improved stool frequency, psyllium improved stool consistency, nopal fibre improved symptom severity, vege-powder improved stool hardness and amount, incomplete evacuation, straining and evacuation frequency, pectin powder improved abdominal pain, bloating, stool consistency and symptom severity, and a combination of sugarcane bagasse and resistant starch improved flatulence. One study reported significant worsening in QoL in the intervention group when compared to the placebo control group. CONCLUSIONS: This review concluded that fibre supplementation may be an effective trea

OBJECTIVE: This study aimed to evaluate the effectiveness of various formulas and the ability of breastfeeding with the exclusion of cow milk protein to reduce the Scoring Atopic Dermatitis (SCORAD) index and promote growth in infants with cow milk protein allergy. METHODS: We conducted a systematic search of PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, China National Knowledge Infrastructure, WanFang Data, Weipu, and the China Biomedical Literature Database. The search period ranged from the inception of each database to December 2023 (with an update until January 15, 2025). We included randomized controlled trials (RCTs) comparing formulas and breastfeeding for cow's milk protein allergy in infants. Two independent reviewers extracted data via standardized methods and assessed the risk of bias via the revised Cochrane risk-of-bias 2.0 tool. We performed a network meta-analysis (NMA) via a Bayesian fixed-effects model in RStudio and assessed the certainty of the evidence via the Confidence in Network Meta-Analysis (CINeMA) online application. The protocol for this NMA was preregistered in PROSPERO (No. CRD42024504707). RESULTS: This analysis included 23 RCTs involving 1997 children and assessed 12 interventions. Compared with the regular formula, the pectin-thickened amino acid formula (TAAF) might reduce the SCORAD index (-12.49, 95% confidence interval [CI] -20.38 to -4.48, low certainty). At ≤6 months of follow-up, compared with rice-hydrolyzed formula (RHF), breastfeeding might improve the length-for-age Z score (LAZ) (0.47, 95% CI 0.13-0.81, moderate certainty), and breastfeeding (0.39, 95% CI 0.02-0.77, low certainty) and extensively hydrolyzed formula (EHF) with probiotics (0.38, 95% CI 0.00-0.77, low certainty) might respectively improve the weight-for-age Z score (WAZ) and weight-for-length Z score (WLZ). At the 12-month follow-up, EHF might improve the LAZ (0.41, 95% CI 0.11-0.71, low certainty) and WLZ (0.37, 95% CI 0.18-0.56, low certainty) compared with RHF, whereas the amino acid formula (AAF) may improve the WAZ (0.33, 95% CI 0.02-0.63, low certainty). CONCLUSIONS: Low-certainty

Certain dietary fibers exhibit prebiotic effects on gut microbiota, but their influence on oral health remains unclear. This study conducted a systematic review across four databases to examine the potential effects of dietary fibers on dental caries. Data selection and extraction were conducted independently and in duplicate. From 962 found titles, twenty studies were included, of which 13 were in vitro. The substances identified as prebiotics included fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS), inulin, pectin, raffinose, polydextrose, sialyllactose, and short-chain fatty acids. Outcomes were assessed at biofilm (n = 14), saliva (n = 5), and tooth (n = 1) levels, with only six studies evaluating pH changes. Fifteen studies (75%) reported potential benefits, primarily attributed to the capacity of prebiotic fibers to limit the growth or adhesion of bacteria. Only two studies (10%) reported an increase in pH. Overall, the quality of the evidence was judged as moderate. In conclusion, certain dietary fibers may help limit caries development by modulating biofilm and pH levels. However, further clinical studies are needed to confirm the protective role of dietary fibers in dental caries. © 2025 Society of Chemical Industry. © 2025 Society of Chemical Industry.

Vitamins are responsible for providing biological properties to the human body; however, their instability under certain environmental conditions limits their utilization in the food industry. The objective was to conduct a systematic review on the use of biopolymers and lipid bases in microencapsulation processes, assessing their impact on the stability, controlled release, and viability of fortified foods with microencapsulated vitamins. The literature search was conducted between the years 2013-2023, gathering information from databases such as Scopus, PubMed, Web of Science and publishers including Taylor & Francis, Elsevier, Springer and MDPI; a total of 49 articles were compiled The results were classified according to the microencapsulation method, considering the following information: core, coating material, solvent, formulation, process conditions, particle size, efficiency, yield, bioavailability, bioaccessibility, in vitro release, correlation coefficient and references. It has been evidenced that gums are the most frequently employed coatings in the protection of vitamins (14.04%), followed by alginate (10.53%), modified chitosan (9.65%), whey protein (8.77%), lipid bases (8.77%), chitosan (7.89%), modified starch (7.89%), starch (7.02%), gelatin (6.14%), maltodextrin (5.26%), zein (3.51%), pectin (2.63%) and other materials (7.89%). The factors influencing the release of vitamins include pH, modification of the coating material and crosslinking agents; additionally, it was determined that the most fitting mathematical model for release values is Weibull, followed by Zero Order, Higuchi and Korsmeyer-Peppas; finally, foods commonly fortified with microencapsulated vitamins were described, with yogurt, bakery products and gummy candies being notable examples.