期刊论文详细信息
Nutrition Journal
Improving lactose digestion and symptoms of lactose intolerance with a novel galacto-oligosaccharide (RP-G28): a randomized, double-blind clinical trial
Howard L Foyt5  W Allan Walker1  Justin R Chandler5  Amy T Longcore5  Gareth M James4  Todd R Klaenhammer2  Andrew J Ritter5  Dennis A Savaiano3 
[1] Massachusetts General Hospital for Children, Charlestown, MA, USA;Departments of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Raleigh, USA;Department of Nutrition Science, Purdue University, Stone Hall, Rm 213, 700 W. State Street, West Lafayette, IN 47907-2059, USA;Marshall School of Business, University of Southern California, Los Angeles, USA;Ritter Pharmaceuticals, Los Angeles, CA, USA
关键词: Microflora;    Microbiome;    RP-G28;    Hydrogen breath test;    GOS;    Galacto-oligosaccharides;    Colonic adaptation;    Lactose intolerance;   
Others  :  801966
DOI  :  10.1186/1475-2891-12-160
 received in 2013-08-15, accepted in 2013-12-09,  发布年份 2013
PDF
【 摘 要 】

Background

Lactose intolerance (LI) is a common medical problem with limited treatment options. The primary symptoms are abdominal pain, diarrhea, bloating, flatulence, and cramping. Limiting dairy foods to reduce symptoms contributes to low calcium intake and the risk for chronic disease. Adaptation of the colon bacteria to effectively metabolize lactose is a novel and potentially useful approach to improve lactose digestion and tolerance. RP-G28 is novel galacto-oligosaccharide (GOS) being investigated to improve lactose digestion and the symptoms of lactose intolerance in affected patients.

Methods

A randomized, double-blind, parallel group, placebo-controlled study was conducted at 2 sites in the United States. RP-G28 or placebo was administered to 85 patients with LI for 35 days. Post-treatment, subjects reintroduced dairy into their daily diets and were followed for 30 additional days to evaluate lactose digestion as measured by hydrogen production and symptom improvements via a patient-reported symptom assessment instrument.

Results

Lactose digestion and symptoms of LI trended toward improvement on RP-G28 at the end of treatment and 30 days post-treatment. A reduction in abdominal pain was also demonstrated in the study results. Fifty percent of RP-G28 subjects with abdominal pain at baseline reported no abdominal pain at the end of treatment and 30 days post treatment (p = 0.0190). RP-G28 subjects were also six times more likely to claim lactose tolerance post-treatment once dairy foods had been re-introduced into their diets (p = 0.0389).

Conclusions

Efficacy trends and favorable safety/tolerability findings suggest that RP-G28 appears to be a potentially useful approach for improving lactose digestion and LI symptoms. The concurrent reduction in abdominal pain and improved overall tolerance could be a meaningful benefit to lactose intolerant individuals.

Study registration

ClinicalTrials.gov NCT01113619.

【 授权许可】

   
2013 Savaiano et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20140708014209216.pdf 480KB PDF download
Figure 6. 33KB Image download
Figure 5. 25KB Image download
Figure 4. 27KB Image download
Figure 3. 47KB Image download
Figure 2. 51KB Image download
Figure 1. 20KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

【 参考文献 】
  • [1]Scrimshaw NS, Murray EB: The acceptability of milk and milk products in populations with a high prevalence of lactose intolerance. Am J Clin Nutr 1988, 48:1079-1159.
  • [2]Bond JH, Currier BE, Buchwald H, et al.: Colonic conservation of nonabsorbed carbohydrate. Gastroenterology 1980, 78:444-447.
  • [3]Savaiano D: Lactose intolerance: a self-fulfilling prophecy leading to osteoporosis? Nutr Rev 2003, 61:221-223.
  • [4]Di Stefano M, Veneto G, Malservici S, et al.: Lactose malabsorption and intolerance peak bone mass. Gastroenterology 2002, 122:1793-1799.
  • [5]Brannon PM, Carpenter TO, Fernandez JR, et al.: NIH consensus development conference statement: lactose intolerance and health. NIH Consens State Sci Statements 2010, 27(2):1-27.
  • [6]Briet F, Flourie B, Achour L, et al.: Bacterial adaptation in patients with short bowel and colon in continuity. Gastroenterology 1995, 109:1446-1453.
  • [7]Hertzler SR, Savaiano DA, Levitt MD: Fecal hydrogen production and consumption measurements: response to daily lactose ingestion by lactose maldigesters. Dig Dis Sci 1997, 42(2):348-353.
  • [8]Briet F, Pochart P, Marteau P, et al.: Improved clinical tolerance to chronic lactose ingestion in subjects with lactose intolerance: a placebo effect? Gut 1997, 41:632-635.
  • [9]Hertzler SR, Savaiano DA: Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance. Am J Clin Nutr 1996, 64:232-236.
  • [10]Gibson GR, Roberfroid M: Handbook of Prebiotics. Boca Raton: CRC Press; 2008.
  • [11]Pribila BA, Hertzler SR, Martin BR, et al.: Improved lactose digestion and intolerance among African-American adolescent girls fed a dairy-rich diet. J Am Diet Assoc 2000, 100:524-528.
  • [12]Szilagyi A, Rivard J, Fokeeff K: Improved parameters of lactose maldigestion using lactulose. Dig Dis Sci 2001, 46:1509-1519.
  • [13]Szilagyi A, Shrier I, Heilpern D, et al.: Differential impact of lactose/lactase phenotype on colonic microflora. Can J Gastroenterol 2010, 24:373-379.
  • [14]Thomas M, Wrzosek L, Ben-Yahia L, et al.: Carbohydrate metabolism is essential for the colonization of Streptococcus thermophilus in the digestive tract of gnotobiotic rats. PLoS One 2011, 6:e28789.
  • [15]Hertzler SR, Huynh BC, Savaiano DA: How much lactose is low lactose? J Am Diet Assoc 1996, 96:243-246.
  • [16]Landon C, Tran T, Connell D: A randomized trial of a pre-and probiotic formula to reduce symptoms of dairy products in patients with dairy tolerance. FASEB J 2006, 20:A1053.
  • [17]Obermayer-Pietsch BM, Bonelli CM, Walter DE, et al.: Genetic predisposition for adult lactose intolerance and relation to diet, bone density, and bone fractures. J Bone Miner Res 2004, 19:42-47.
  • [18]Ross AC, Manson JE, Abrams SA, et al.: The 2011 report on dietary reference intakes for calcium and vitamin D from the institute of medicine: what clinicians need to know. J Clin Endocrinol Metab 2011, 96:53-58.
  • [19]Andersen JM, Barrangou R, Abou Hachem M, et al.: Transcriptional and functional analysis of galactooligosaccharide uptake by lacS in Lactobacillus acidophilus. Proc Natl Acad Sci U S A 2011, 108(43):17785-17790.
  • [20]Drossman DA: The functional gastrointestinal disorders and the Rome III process. Gastroenterology 2006, 130:1377-1390.
  • [21]Vandenberghe J, Vos R, Persoons P, et al.: Dyspeptic patients with visceral hypersensitivity: sensitization of pain specific or multimodal pathways? Gut 2005, 54:914-919.
  文献评价指标  
  下载次数:45次 浏览次数:23次