Healthy
Conditions
Keywords
gut microbiota, methionine, diet intervention, inflammation
Brief summary
Pro-inflammatory immune cells play a pivotal role in multiple sclerosis, and the gut microbiota is increasingly recognized as a key factor shaping the immune system. This study aims to determine the impact of a dietary intervention (methionine-restricted diet-MR) on gut microbiota and inflammation in humans. A randomized interventional pilot study with cross-over intervention is conducted in 40 healthy participants. For all participants, the first two weeks (week 1+week 2) consist of baseline assessment on their usual diet, and week 3+week 4 consist of MR diet only. For group A, the week 5+week 6 are MR+1,500 mg daily supplementation of methionine and for group B are MR+placebo, with a cross-over for week 7+week 8. Usual diet is resumed for all participants during week 9+week 10. Gut microbiota, blood levels of methionine and its metabolites, as well as immune and inflammatory markers will be evaluated every 2 weeks. It is hypothesized that MR could be used in humans to prevent and alleviate the course of multiple sclerosis by shaping the gut microbiota towards an anti-inflammatory profile, and that the gut microbiota is a biomarker associated with successful dietary interventions targeting inflammation in multiple sclerosis.
Interventions
BEHAVIORALMethionine-restricted diet
Methionine-restricted diet (plant-based diet) is a feasible and palatable way to achieve 50% reduction in methionine intake. Reduction to around 800 mg/day methionine will be achieved using participants' selection from low-methionine plant-based and ready to eat meals for 100% of their meals, for 6 weeks. Participants will be provided with education and a list of low methionine content food (green) and high methionine (red) for eating out, snacks and homemade meals.
Sponsors
Multiple Sclerosis Society of Canada
Centre hospitalier de l'Université de Montréal (CHUM)
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Intervention model description
Randomized interventional pilot study with cross-over intervention
Eligibility
Sex/Gender
ALL
Age
20 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
* Healthy adults * 20-50 years old * On omnivorous/western diet * Understanding French or English
Exclusion criteria
* B12 deficiency * Glomerular filtration rate \<75 ml/h * Liver dysfunction * Pregnant or lactating * Active inflammatory or infectious disease * Insulino-dependent diabetes * Active cancer * Eating disorder * BMI \< 18.5 kg/m2 * Severe food allergies or intestinal problems or active substance dependence that would prevent adherence to the experimental diet
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gut microbiota | At the end of week 2, 4, 6, 8, 10. | Lipocalin-2 will be measured in stools to assess for inflammation in the gut. Stool samples from a given participant (all timepoints) will be processed simultaneously for DNA extraction and sequencing. Amplification of hyper-variable regions V1-V3 of 16S with primers, 16S libraries preparation and sequencing (Génome Québec) will be performed. Microbiota diversity will be measured with Shannon and α-diversity indexes. To represent microbial communities' similarity/difference between groups, a principal coordinates analysis (PCoA) will be used. Data will be interpreted by using high dimensional class comparisons via linear discriminant analysis of effect size (LEfSe) and volcano plots to identify potential relationships between specific bacteria and immunological/metabolomics results and clinical data. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Immune and inflammatory profile | At the end of week 2 ,4, 6, 8, 10. | Established FACS panels will be used to characterize the complete immune profile including markers for B cells, T cells, myeloid cells, and CAMs implicated in gut and CNS homing. Validated multiplex immunoassays will be used on serum and supernatants to assess immune/inflammatory markers and metabolic markers (leptin, adiponectin, FGF21) in serum. In addition, sCD14, intestinal-type fatty acid-binding protein, and soluble suppression of tumorigenicity 2, which all correlated with gut damage in humans, will be measured. |
| Methionine level | At the end of week 2, 4, 6, 8, 10. | Levels of methionine and its metabolites (SAM and SAH) will be measured by LC-MS (serum and PBMCs). |
Countries
Canada
Contacts
Primary ContactCatherine Larochelle, MD, PhD
Outcome results
None listed