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Xiaole Yin, PhD

She/Her/Hers

Job Title

Postdoc

Academic Rank

Fellow or Postdoc

Department

Medicine

Authors

Xiaole Yin, Zheng Sun, Shanlin Ke, Shaikh Danish Mahmood, Gila Sasson, Demsina Babazadeh, Macie Andrews, Shelley Hurwitz, Maia Paul, Nadine Javier, Malav Dave, Alexandra Austin, Dan Pratt, Christopher Bowlus, Linda Gray, Francene Steinberg, Elaine Souza, Yang-Yu Liu, Joshua Korzenik

Principal Investigator

Joshua Korzenik and Yang-Yu Liu

Categories

Tags

The Impact of Dietary Interventions on Metabolomic Profile and Disease Progression in Primary Sclerosing Cholangitis Patients with Inflammatory Bowel Disease

Scientific Abstract

Background: Primary sclerosing cholangitis (PSC) is a chronic liver disease often associated with inflammatory bowel disease (IBD). Dietary impact on PSC progression remains underexplored.
Methods: A longitudinal study was conducted on 20 PSC patients, randomly assigned to an 8-week Low Protein Diet (LPD, n=10) or Specific Carbohydrate Diet (SCD, n=10). Stool samples underwent whole metagenomic sequencing and untargeted metabolomics.
Results: Among participants, 10 had ulcerative colitis (UC), 3 had Crohn’s disease (CD) and 7 had only PSC. Significant correlations emerged between LPD and reduced disease progression, with decreased Alkaline Phosphatase (ALP) values compared to baseline. 1428 detected metabolites were analyzed using linear multivariable models to identify responsible key metabolite features, revealing 27 elevated and 9 decreasing metabolites linked to IBD, but unreported in PSC before. Moreover, enrichment analysis highlighted ammonia recycling and methionine metabolism as key pathways influenced by LPD. A stratified analysis further found LPD to be especially beneficial for PSC patients with UC, aligning with the clinical response. Longitudinal observation illustrated a clear reduction in sulfur and nitrogen-related metabolites under LPD.
Conclusion: LPD can significantly influence disease progression in PSC patients. The unique metabolite pathways in response to dietary modifications were revealed. Further research is warranted.

Lay Abstract

Background: Primary sclerosing cholangitis (PSC) is a liver condition that sometimes goes hand-in-hand with a gut problem called inflammatory bowel disease (IBD). We wanted to see if diet changes could help manage this liver disease.
What We Did: We worked with 20 people who have PSC. Half of them were put on a low-protein diet (LPD) and the other half on a specific carbohydrate diet (SCD) for 8 weeks. We then checked the bacteria and other substances in their poop.
What We Found: Out of the 20 people, 10 had ulcerative colitis (a type of IBD), 3 had Crohn’s disease (another type), and 7 just had the liver condition. The low-protein diet seemed to help, as we noticed improvements in the liver health marker. We also identified some changes in the poop substances that connect to the gut problems. In particular, the low-protein diet was very helpful for those with ulcerative colitis. The substances we found in the poop of people on this diet were less harmful.
Conclusion: A low-protein diet might help people with PSC, especially those who also have ulcerative colitis. We’ve learned more about how diet changes the body’s internal environment, but more studies are needed.

Clinical Implications

Dietary interventions, particularly LPD, significantly influence disease progression in PSC patients with UC, offering potential as a supplementary therapeutic strategy. Further research is warranted to optimize dietary strategies for individual patient subgroups.