Fasting alters the gut microbiome reducing blood pressure and body weight in metabolic syndrome patients

András Maifeld, Hendrik Bartolomaeus, Ulrike Löber, Ellen G. Avery, Nico Steckhan, Lajos Markó, Nicola Wilck, Ibrahim Hamad, Urša Šušnjar, Anja Mähler, Christoph Hohmann, Chia-Yu Chen, Holger Cramer, Gustav Dobos, Till Robin Lesker, Till Strowig, Ralf Dechend, Danilo Bzdok, Markus Kleinewietfeld, Andreas Michalsen (), Dominik N. Müller () and Sofia K. Forslund ()
Additional contact information
András Maifeld: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Hendrik Bartolomaeus: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Ulrike Löber: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Ellen G. Avery: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Nico Steckhan: Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
Lajos Markó: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Nicola Wilck: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Ibrahim Hamad: VIB Laboratory of Translational Immunomodulation, VIB Center for Inflammation Research (IRC), UHasselt, Campus Diepenbeek
Urša Šušnjar: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Anja Mähler: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Christoph Hohmann: Immanuel Krankenhaus Berlin
Chia-Yu Chen: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Holger Cramer: University of Duisburg-Essen
Gustav Dobos: University of Duisburg-Essen
Till Robin Lesker: Helmholtz Centre for Infection Research
Till Strowig: Helmholtz Centre for Infection Research
Ralf Dechend: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Danilo Bzdok: McGill University
Markus Kleinewietfeld: VIB Laboratory of Translational Immunomodulation, VIB Center for Inflammation Research (IRC), UHasselt, Campus Diepenbeek
Andreas Michalsen: Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin
Dominik N. Müller: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin
Sofia K. Forslund: Experimental and Clinical Research Center, a joint cooperation of Max Delbruck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin

Nature Communications, 2021, vol. 12, issue 1, 1-20

Abstract: Abstract Periods of fasting and refeeding may reduce cardiometabolic risk elevated by Western diet. Here we show in the substudy of NCT02099968, investigating the clinical parameters, the immunome and gut microbiome exploratory endpoints, that in hypertensive metabolic syndrome patients, a 5-day fast followed by a modified Dietary Approach to Stop Hypertension diet reduces systolic blood pressure, need for antihypertensive medications, body-mass index at three months post intervention compared to a modified Dietary Approach to Stop Hypertension diet alone. Fasting alters the gut microbiome, impacting bacterial taxa and gene modules associated with short-chain fatty acid production. Cross-system analyses reveal a positive correlation of circulating mucosa-associated invariant T cells, non-classical monocytes and CD4+ effector T cells with systolic blood pressure. Furthermore, regulatory T cells positively correlate with body-mass index and weight. Machine learning analysis of baseline immunome or microbiome data predicts sustained systolic blood pressure response within the fasting group, identifying CD8+ effector T cells, Th17 cells and regulatory T cells or Desulfovibrionaceae, Hydrogenoanaerobacterium, Akkermansia, and Ruminococcaceae as important contributors to the model. Here we report that the high-resolution multi-omics data highlight fasting as a promising non-pharmacological intervention for the treatment of high blood pressure in metabolic syndrome patients.

Date: 2021
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DOI: 10.1038/s41467-021-22097-0

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