Meta-analysis Of Intestinal Short Chain Fatty Acid Content In Patients With Ulcerative Colitis And Clinical Validation Study

Objective:To study the composition and content of intestinal short-chain fatty acids in patients with ulcerative colitis and the effect of mesalazine on intestinal short-chain fatty acids in ulcerative colitis.Methods:1)According to the PRISMA guidelines of systematic review and meta-analysis,the research published by March 2022 was systematically searched in PUBMED,HowNet and Wanfang databases,using the following keywords:"ulcerative colitis"," ulcerative colitis ","UC "," short-chain fatty acid "," short chain fatty acids"," SCFAs","acetic acid ","propionic acid "," butyric acid","valeric acid "," isobutyric acid "and" isovaleric acid ".The 95%confidence interval(CI)standardized mean difference(SMD)was used to calculate the effect after data collection and analysis.2)Eight patients with mild or moderate chronic recurrent ulcerative colitis were recruited.Before and after 8 weeks of treatment with mesalazine,clinical data such as leukocyte count,erythrocyte sedimentation rate,endoscopic score,Mayo score,etc.were collected.Their fecal samples were processed and detected by ultra performance liquid chromatography-tandem mass spectrometry(UPLC-MS/MS).The composition and content changes of short-chain fatty acids including acetic acid,propionic acid,butyric acid,valeric acid,caproic acid,isobutyric acid and isovaleric acid in each sample were detected.Results:1)Meta-analysis showed that total SCFAs,acetic acid,propionic acid,butyric acid,isobutyric acid,valeric acid and isovaleric acid in UC patients were lower than those in healthy volunteers.2)After treatment with mesalazine,the stool frequency and blood symptoms of UC patients were significantly improved,the endoscopic score was significantly decreased,and the Mayo score was also significantly decreased.The number of white blood cells,the proportion of neutrophils and ESR in serum were slightly decreased compared with those before treatment.3)Acetic acid,propionic acid and butyric acid were the main types of short chain fatty acids in stool samples of UC patients.After treatment with mesalazine,the contents of short chain fatty acids in stool samples were significantly increased,especially valeric acid,butyric acid,isovaleric acid,isobutyric acid and propionic acid.Conclusion:1)The contents of total SCFAs,acetic acid,propionic acid,butyric acid,isobutyric acid,valeric acid and isovaleric acid in UC patients were lower than those in healthy volunteers.2)Mesalazine treatment can obviously improve the symptoms of diarrhea and mucinous purulent hematochezia in UC patients,and can effectively relieve the colonic mucosal erosion and ulcer in UC patients,reduce the endoscopic score,improve the quality of life and satisfaction of patients.At present,mesalazine is still the first choice for patients with mild and moderate ulcerative colitis.3)Mesalazine treatment can increase the content of short-chain fatty acids in the intestinal mucosa of patients,especially butyric acid,valeric acid,isovaleric acid,isobutyric acid and propionic acid,so as to further repair the damaged intestinal barrier of UC patients,which may be one of the pharmacological mechanisms of mesalazine treatment of ulcerative colitis.