Quantitative Alterations in Short-Chain Fatty Acids in Inflammatory Bowel Disease: A Systematic Review and...

Area of Science:

• Gastroenterology
• Microbiome Research
• Metabolomics

Background:

• Reduced levels of short-chain fatty acids (SCFAs) are linked to impaired gut barrier function and immune dysregulation in inflammatory bowel disease (IBD).
• SCFAs play a crucial role in maintaining gut health, and their depletion is associated with increased inflammation.
• Microbiome-targeted therapies show promise for IBD treatment due to the role of SCFAs.

Purpose of the Study:

• To systematically analyze changes in SCFA levels in patients with IBD.
• To investigate the association between SCFA levels and the occurrence and progression of IBD.
• To evaluate the impact of dietary interventions on SCFA levels in IBD.

Main Methods:

• A comprehensive literature search was conducted from 2014 to July 2024.
• A random-effects model was used to calculate the standardized mean difference (SMD) and 95% confidence intervals.
• Subgroup analyses were performed to compare SCFA levels across different IBD types and disease activity.

Main Results:

• Fecal SCFA levels, including butyrate, acetate, and propionate, were significantly lower in all IBD subgroups compared to healthy controls.
• Active IBD showed a more pronounced reduction in butyrate (p=0.004), while ulcerative colitis (UC) exhibited a notable decrease in propionate (p=0.03).
• Dietary interventions in IBD patients led to increased SCFA levels, particularly butyrate (SMD=1.03), indicating therapeutic potential.

Conclusions:

• This meta-analysis confirms a significant reduction in fecal SCFA levels in IBD patients.
• SCFA depletion is particularly evident during active disease phases and is most pronounced in Crohn's disease (CD).
• Dietary modulation represents a promising therapeutic strategy for restoring SCFA levels and managing IBD.