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Riboflavin Supplementation in Patients with Crohn's Disease [the RISE-UP study]

von Martels, J. Z. H., Bourgonje, A. R., Klaassen, M. A. Y., Alkhalifah, H. A. A., Sadaghian Sadabad, M., Vich Vila, A., Gacesa, R., Gabriëls, R. Y., Steinert, R. E., Jansen, B. H., Bulthuis, M. L. C., van Dullemen, H. M., Visschedijk, M. C., Festen, E. A. M., Weersma, R. K., de Vos, P., van Goor, H., Faber, K. N., Harmsen, H. J. M. & Dijkstra, G., May-2020, In : Journal of Crohn's and Colitis. 14, 5, p. 595-607 13 p.

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Background and Aims: Crohn's disease [CD] is characterised by chronic intestinal inflammation and dysbiosis in the gut. Riboflavin [vitamin B-2] has anti-inflammatory, antioxidant and microbiome-modulatory properties. Here, we analysed the effect of riboflavin on oxidative stress, markers of inflammation, clinical symptoms, and faecal microbiome in patients with CD.

Methods: In this prospective clinical intervention study, patients received 100 mg riboflavin [DSM, Nutritional Products Ltd] daily for 3 weeks. Clinical disease activity [Harvey-Bradshaw Index: HBI], serum biomarkers of inflammation and redox status [plasma free thiols], and faecal microbiome taxonomical composition and functionality [fluorescent in situ hybridisation: FISH; and metagenomic shotgun sequencing: MGS], were analysed before and after riboflavin intervention.

Results: In total, 70 patients with CD with varying disease activity were included. Riboflavin supplementation significantly decreased serum levels of inflammatory markers. In patients with low faecal calprotectin [IC] levels, IL-2 decreased, and in patients with high FC levels, C-reactive protein [CRP] was reduced and free thiols significantly increased after supplementation. Moreover, HBI was significantly decreased by riboflavin supplementation. Riboflavin supplementation led to decreased Enterobacteriaceae in patients with low FC levels as determined by FISH; however, MGS analysis showed no effects on diversity, taxonomy, or metabolic pathways of the the faecal microbiome.

Conclusions: Three weeks of riboflavin supplementation resulted in a reduction in systemic oxidative stress, mixed anti-inflammatory effects, and a reduction in clinical symptoms [HBI]. FISH analysis showed decreased Enterobacteriaceae in patients with CD with low FC levels, though this was not observed in MGS analysis. Our data demonstrate that riboflavin supplementation has a number of anti-inflammatory and anti-oxidant effects in CD.

Original languageEnglish
Pages (from-to)595-607
Number of pages13
JournalJournal of Crohn's and Colitis
Volume14
Issue number5
Early online date25-Jan-2020
Publication statusPublished - May-2020

    Keywords

  • Crohn's disease, riboflavin [vitamin B2], clinical intervention study, INFLAMMATORY-BOWEL-DISEASE, FAECALIBACTERIUM-PRAUSNITZII, OXIDATIVE STRESS, ULCERATIVE-COLITIS, VITAMIN B-2, CYTOKINES, BACTERIA, THIOLS, GUT

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