Multi-omics analysis of a prebiotic intervention with pectin in lipid transfer proteins (LTPs) allergic patients

Currently, there is great interest in the use of pectins for prebiotic treatment of food allergy. Hence, the effects of two different esterified pectins - low methoxyl citrus-derived pectin (CP-DE_low) and high methoxyl apple-derived pectin (AP-DE^high) - were evaluated in peach allergic patients due to sensitization to lipid transfer proteins (LTPs). This study analyzed the systemic immune response, the gut microbiota composition (using 16S rRNA gene sequencing), and microbial-derived metabolome, including short-chain fatty acids (SCFAs) and bile acids (BAs). Prebiotic treatment with both pectins was safe and induced a significant clinical increase in allergen tolerance in more than 50 % of patients. Additionally, CP-DE_low and AP-DE^high groups exhibited a distinctive systemic proteomic profile characterized by a decrease in various inflammatory cytokines compared to Placebo. Regarding microbiota, CP-DE_low induced an increase in Bacteroides_H genus and Roseburia intestinalis species, whereas AP-DE^high was associated with an increase in Bifidobacterium and Succinivibrio genera, and Faecalibacterium prausnitzii species. Reduced concentrations of branched SCFAs were observed after both treatments compared to Placebo. Likewise, fecal levels of microbial-derived secondary BAs were modified by pectin supplementation. Multi-omics integration revealed distinctive signatures in pectin- and placebo-treated patients. This study suggests that pectin treatment is a promising and safe option for LTP allergy.