Synbiotic supplementation reduces intestinal permeability and inflammation in overweight or obese kidney transplant recipients: a randomized controlled trial

Abstract

Increased intestinal permeability resulting from gut dysbiosis, cardiovascular disease (CVD), and graft failure is common among kidney transplant (KT) recipients. This study was designed to investigate the effects of synbiotics on intestinal permeability, systemic and vascular inflammation markers, oxidative stress, and fibrosis in KT recipients. In this randomized controlled trial, 46 KT recipients were randomly assigned to either the synbiotic or the placebo group. Participants in the synbiotic group received two synbiotic capsules for 12 weeks, while the placebo group received a corresponding placebo. Serum lipopolysaccharide binding protein (LBP), interleukin-6 (IL-6), high-sensitivity C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1 (sICAM-1), malondial­dehyde (MDA), galectin-3, urea, and creatinine were measured. Serum LBP (p = 0.03), hs-CRP (p = 0.02), ICAM-1 (p = 0.04), and IL-6 (p = 0.02) showed significant reductions in the synbiotic group compared to the placebo group. Serum MDA, galectin-3, urea, and creatinine did not show significant changes within each group. This study indicates that synbiotics reduce LBP, a marker of intestinal permeability, as well as hs-CRP, IL-6, and sICAM-1, which are risk factors for CVD and graft failure, in KT recipients.