Effect of ancient Khorasan wheat on gut microbiota, inflammation, and short-chain fatty acid production in patients with fibromyalgia

BACKGROUND Fibromyalgia (FM) syndrome is mainly characterized by widespread pain, sleeping disorders, fatigue and cognitive dysfunction. In many cases, gastrointestinal distress is also reported, suggesting the potential pathogenic role of gut microbiota (GM). GM is deeply influenced by several environmental factors, especially the diet, and recent findings highlighted significant symptoms’ improvement in FM patients following various nutritional interventions such as vegetarian diet, low-fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet, gluten-free diet. and especially an ancient grain supplementation. In particular, a recent study reported that a replacement diet with ancient Khorasan wheat led to an overall improvement in symptom severity of FM patients. AIM To examine the effects of ancient Khorasan wheat on gut microbiota, inflammation and short-chain fatty acids’ production in FM patients. METHODS After a two-week run-in period, 20 FM patients were enrolled in this randomized, double-blind crossover trial. In detail, they were assigned to consume either Khorasan or control wheat products for 8 wk and then, following an 8-wk washout period, crossed. Before and after treatments, intestinal microbiota characterization was performed with a 16S rRNA sequencing while the fecal molecular inflammatory response and the short-chain fatty acids (SCFAs) determination were respectively performed with Luminex MAGPIX detection system and a mass chromatography-mass spectrometry method. RESULTS The Khorasan-wheat replacement diet, in comparison with control-wheat diet, determined more positive effects on the intestinal microbiota composition and on both the fecal’ immune and SCFAs profiles such as the significant increase of butyric acid levels (P = 0.054), candidatus Saccharibacteria (P = 9.95e-06) and Actinobacteria and the reduction of Enterococcaceae (P = 4.97e-04). Moreover, the improvement of various FM symptoms along with the variation of some gut bacteria after the Khorasan wheat diet have been documented, in fact we reported reported positive correlations between Actinobacteria and both Tiredness Symptoms Scale (P < 0.001) and Functional Outcome of Sleep Questionnaire (P < 0.05), between Verrucomicrobiae and both Widespread Pain Index (WPI) + Symptom Severity scale (SS) (P < 0.05) and WPI (P < 0.05), among candidatus Saccharibacteria and SS (P < 0.05) and between Bacteroidales and Sleep-Related and Safety Behaviour Questionnaire (P < 0.05). CONCLUSION The replacement diet based on ancient Khorasan wheat determined beneficial GM compositional and functional modifications that positively correlates with an improvement of FM symptomatology