Treatment of ulcerative colitis with germinated barley foodstuff feeding: a pilot study

Abstract

Background Germinated barley foodstuff (GBF) has been shown to attenuate intestinal injury in animal models, largely by increasing luminal short‐chain fatty acid production. Aim To investigate the safety and efficacy of GBF in the treatment of ulcerative colitis (UC). Methods Ten patients with active UC received 30 g of GBF daily for 4 weeks in an open‐label treatment protocol while the baseline anti‐inflammatory therapy was continued. The response to treatment was evaluated clinically and endoscopically. Pre‐ and post‐treatment stool concentrations of short‐chain fatty acids were measured by gas‐liquid chromatography. Results Patients showed improvement in their clinical activity index scores, with a significant decrease in the score from 6.9 ± 1.4 to 2.8 ± 1.5 (mean ± S.E.M., P < 0.05). The endoscopic index score fell from 6.1 ± 2.3 to 3.8 ± 2.3 (P < 0.0001). Patients showed an increase in stool butyrate concentrations after GBF treatment (P < 0.05). No side‐effects were observed. Conclusions Oral GBF therapy may have a place in management of ulcerative colitis, but controlled studies are needed to demonstrate its efficacy in the treatment of this disorder.

Histochemical demonstration of a Na+-coupled transporter for short-chain fatty acids (Slc5a8) in the intestine and kidney of the mouse

“…The feeding of germinated barley foodstuff, rich in dietary fiber, could prevent ulcerative colitis in human clinical cases and animal models, in parallel to increased production of SCFAs in the lumen (10,11,14). When we fed mice such germinated barley foodstuff, the level of Slc5a8 mRNA in the large intestine was elevated (Takebe, unpublished data), suggesting that diet affects the intestinal expression of Slc5a8.…”

Cellular expression of monocarboxylate transporters (MCT) in the digestive tract of the mouse, rat, and humans, with special reference to slc5a8

“…Butyrate also functions as an energy source of epithelial cells in the large intestine and promotes differentiation of the cells (2, 21) while suppressing the proliferation of tumor cells by the induction of apoptosis (6). Thus, direct and indirect intraluminal supplementation of butyrate maintains and strengthens the epithelial integrity to suppress mucosal damage such as ulcerative colitis (15,16,19,27). At least 60% of the SCFA uptake in the large intestine occurs by simple diffusion of the unionized form across the cell membrane; the remainder occurs by the active cellular uptake of ionized SCFA involving co-transport of inorganic protons, such as Na + , K + , and H + (7).…”

Ulcerative colitis and diet

“…Soluble fibers are a different issue. There are studies suggesting that food products rich in soluble fibers, particularly germinated barley food stuff and seeds of the plantago ovata plant, might have positive effects in UC patients (20)(21)(22). It is known that short-chain fatty acids such as butyrate, which is a degradation product of soluble fibers, have positive effects on colonocytes.…”