Copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Effect of ancient Khorasan wheat on gut microbiota, inflammation, and short-chain fatty acid production in patients with fibromyalgia
Simone Baldi, Giuditta Pagliai, Monica Dinu, Leandro Di Gloria, Giulia Nannini, Lavinia Curini, Marco Pallecchi, Edda Russo, Elena Niccolai, Giovanna Danza, Stefano Benedettelli, Giovanna Ballerini, Barbara Colombini, Gianluca Bartolucci, Matteo Ramazzotti, Francesco Sofi, Amedeo Amedei
Simone Baldi, Giuditta Pagliai, Monica Dinu, Leandro Di Gloria, Giulia Nannini, Lavinia Curini, Edda Russo, Elena Niccolai, Barbara Colombini, Francesco Sofi, Amedeo Amedei, Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
Giuditta Pagliai, Monica Dinu, Francesco Sofi, Unit of Clinical Nutrition, Careggi University Hospital, Florence 50134, Italy
Marco Pallecchi, Gianluca Bartolucci, Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmaceutical and Nutraceutical Sciences, University of Florence, Sesto Fiorentino 50019, Italy
Giovanna Danza, Matteo Ramazzotti, Department of Biomedical, Experimental and Clinical Sciences “Mario Serio”, University of Florence, Florence 50134, Italy
Stefano Benedettelli, Department of Agriculture, Food, Environment and Forestry, University of Florence, Florence 50144, Italy
Giovanna Ballerini, Multidisciplinary Center for Pain Therapy, Reference Center for Fibromyalgia, Piero Palagi Hospital, USL Toscana Centro, Florence 50122, Italy
Amedeo Amedei, SOD of Interdisciplinary Internal Medicine, Careggi University Hospital, Florence 50134, Italy
Author contributions: Baldi S and Pagliai G contributed equally to writing the manuscript; Baldi S, Pagliai G, Dinu M, and Russo E contributed to paper conceptualization and design; Baldi S, Pagliai G, Dinu M, Ramazzotti M, Bartolucci G, Pallecchi M, Di Gloria L, Curini L, Nannini G, Niccolai E, and Russo E performed the research analysis; Amedei A, Sofi F, Ramazzotti M, Bartolucci G, Danza G, Ballerini G, Colombini B, and Benedettelli S critically revised the paper; Amedei A and Sofi F equally coordinated and supervised the research. All authors read and approved the final version of the manuscript.
Supported by a grant from Kamut Enterprises of Europe, Oudenaarde, Belgium.
Institutional review board statement: The study was approved by the local ethics committee “Comitato Etico Regionale per la Sperimentazione Clinica della Regione Toscana, Sezione AREA VASTA CENTRO” (SPE 12.630), and adhered to the principles of the Declaration of Helsinki and the Data Protection Act.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no competing interests for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Amedeo Amedei, BSc, Reader (Associate Professor), Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, Florence 50134, Italy.
aamedei@unifi.it
Received: November 26, 2021
Peer-review started: November 26, 2021
First decision: January 8, 2022
Revised: January 19, 2022
Accepted: March 27, 2022
Article in press: March 27, 2022
Published online: May 14, 2022
Processing time: 166 Days and 17.1 Hours
ARTICLE HIGHLIGHTS
Research background
Fibromyalgia (FM) is a syndrome characterized by widespread pain, sleeping disorders, fatigue, and cognitive dysfunction. Frequently, gastrointestinal distress is also reported, suggesting the potential pathogenic role of the gut microbiota (GM).
Research motivation
The GM is deeply influenced by several factors, including diet, and recent findings highlighted a significant symptom improvement in FM patients following various nutritional interventions such as vegetarian diet, low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols based diets, gluten-free diet, and an ancient grain supplementation. Therefore, a replacement diet with ancient Khorasan grain could improve FM symptomatology.
Research objectives
The main objective of our study was to examine the effects of ancient Khorasan wheat on GM composition, fecal molecular immune profile, and short-chain fatty acids (SCFAs) production in FM patients.
Research methods
In this randomized, double-blind crossover trial, 20 FM patients were randomly assigned to consume either Khorasan or control wheat products for 8 wk and then, after an 8-wk washout period, crossed. At the beginning and at the end of each intervention period, symptom questionnaires and stool samples were collected and GM characterization was performed by 16S rRNA sequencing, while the fecal molecular inflammatory response and the SCFAs were respectively determined with a Luminex MAGPIX detection system and a mass chromatography-mass spectrometry method.
Research results
The Khorasan wheat replacement diet exhibited positive effects on GM composition and on both the fecal immune and SCFAs profiles. Moreover, we documented the improvement of various FM symptoms along with the variation of some gut bacteria after the Khorasan wheat diet.
Research conclusions
An ancient Khorasan wheat diet represents a good strategy to result in positive GM compositional and functional modifications that positively correlate with an improvement of FM symptomatology.
Research perspectives
We demonstrated that a replacement diet based on ancient Khorasan wheat seems to represent a non-invasive successful strategy to ameliorate FM patient’s symptomatology. We believe that our data will be a starting point for future studies on FM, especially with a long-term administration of Khorasan wheat products in high numbers of FM patients.
