Gold kiwifruit compositions and methods of preparation and use therefor
Клучни зборови
Информации за патент
Број на патент | 10512663 |
Пополнети | 11/26/2015 |
Датум на патент | 12/23/2019 |
Апстракт
Тврдења
What is claimed is:
1. A method of: (i) maintaining or increasing beneficial bacteria in the digestive tract of a subject, wherein the beneficial bacteria comprise Faecalibacterium prausnitzii; (ii) maintaining or increasing Faecalibacterium prausnitzii in the digestive tract of a subject; or (iii) treating or preventing microbiota imbalance in the digestive tract of a subject, which imbalance includes inappropriate levels of Faecalibacterium prausnitzii; the method comprising administering a composition prepared from dried gold kiwifruit to a subject, wherein the dried gold kiwifruit is a Gold3 kiwifruit or a genetic derivative thereof, thereby maintaining or increasing the beneficial bacteria, maintaining or increasing the Faecalibacterium prausnitzii, or treating or preventing the microbiota imbalance in the subject.
2. The method according to claim 1, wherein the composition is administered by enteral, oral, or rectal administration.
3. The method according to claim 1, wherein the composition is administered as one or more of a tablet, capsule, liquid, jelly, or sachet.
4. The method according to claim 3, wherein the capsule is a gel capsule.
5. The method according to claim 1, wherein the composition is administered at a dosage of: (i) 2000 to 4000 mg of powder per day, or a liquid equivalent thereof; (ii) 250 to 2500 mg of powder per day, or a liquid equivalent thereof; (iii) approximately 2400 mg of powder per day, or a liquid equivalent thereof; or (iv) approximately 600 mg of powder per day, or a liquid equivalent thereof.
6. The method according to claim 1, wherein the composition is co-administered with one or more of: (i) a further digestive aid; (ii) probiotic, prebiotic, or synbiotic compositions; or (iii) fibre and/or a digestive enzyme.
7. The method according to claim 1, wherein the composition is further supplemented with polyphenols.
8. The method according to claim 1, wherein the beneficial bacteria are selected from: the group of Bacteroides-Prevotella-Porphyromonas, Bifidobacterium spp., Lactobacillus spp., and the Lachnospiraceae group.
9. The method according to claim 1, wherein the beneficial bacteria are selected from: Clostridium coccoides, Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides ovatus, Bacteroides cellulosilyticus, Roseburia intestinalis, Roseburia inulinovorans, Ruminococcus bromii, and Ruminococcus flavefaciens.
10. The method according to claim 1, wherein the subject has one or more symptoms of inflammation.
11. The method according to claim 1, wherein the subject has one or more symptoms of: bowel irregularity, Crohn's disease, ulcerative colitis, irritable bowel syndrome, inflammatory bowel disease, gastrointestinal cancer, allergy, atopy, or diabetes.
12. A method of increasing or ameliorating a decrease in Faecalibacterium prausnitzii levels in the digestive tract of a subject, and thereby: (i) treating or preventing constipation in the subject; (ii) maintaining or improving bowel regularity in the subject; or (iii) treating or preventing irritable bowel syndrome or inflammatory bowel disease in the subject; the method comprising administering a composition prepared from dried gold kiwifruit to a subject, wherein the dried gold kiwifruit is a Gold3 kiwifruit or a genetic derivative thereof, thereby treating or preventing the constipation, maintaining or improving the bowel regularity, or treating or preventing the irritable bowel syndrome or inflammatory bowel syndrome in the subject.
13. The method according to claim 12, wherein the composition is administered by enteral, oral, or rectal administration.
14. The method according to claim 12, wherein the composition is administered as one or more of a tablet, capsule, liquid, jelly, or sachet.
15. The method according to claim 12, wherein the capsule is a gel capsule.
16. The method according to claim 12, wherein the composition is administered at a dosage of: (i) 2000 to 4000 mg of powder per day, or a liquid equivalent thereof; (ii) 250 to 2500 mg of powder per day, or a liquid equivalent thereof; (iii) approximately 2400 mg of powder per day, or a liquid equivalent thereof; or (iv) approximately 600 mg of powder per day, or a liquid equivalent thereof.
17. The method according to claim 12, wherein the composition is co-administered with one or more of: (i) a further digestive aid; (ii) probiotic, prebiotic, or synbiotic compositions; or (iii) fibre and/or a digestive enzyme.
18. The method according to claim 12, wherein the composition is further supplemented with polyphenols.
Опис
RELATED APPLICATIONS
This application is a National Entry Application of PCT application No. PCT/NZ2015/050200, filed on Nov. 27, 2015, which claims the benefit of New Zealand patent application number 702454 filed 28 Nov. 2014, and New Zealand patent application number 706405 filed 27 Mar. 2015, the contents of which are incorporated by reference herein, in their entirety.
FIELD OF THE INVENTION
The present disclosure relates to compositions prepared from gold kiwifruit, Actinidia chinensis. Also related are methods of preparing such compositions, and methods of using such compositions, including methods of treating or preventing disorders of the gastrointestinal system.
BACKGROUND OF THE INVENTION
The gastrointestinal tract harbours approximately 10.sup.14 microbial cells, consisting of over 1000 species or phylotypes, the majority of which reside in the colon (Rajilic-Stojanovic and de Vosm 2014; Qin et al. 2010; Egert et al. 2006). The large intestine is a metabolically active site of fermentation, characterised by diverse and intricate microbial relationships that are integral to human health (Backhed et al. 2005). Experimental data have shown the extent to which the colonic microbiota and its human host exist in a delicate state of equilibrium. The microbiota has been shown to be associated with a wide range of health benefits including improved immune function and maturation, modified behaviour, regulation of satiety, inhibition of pathogens, augmentation of mineral absorption and maintenance of energy balance (Geurts et al. 2014; Parnell and Reimer 2012; Bravo et al. 2011; Buffie and Pamer 2013).
This host-microbiota interdependency has been illustrated in a study using mice and zebrafish, where the native microbiotas of each were transplanted into germ-free representatives of the other species. It was found that the composition would revert back to resemble that of the native host microbiota (Rawls et al. 2006). Imbalances in microbial community composition caused by diet, genetics, age, stress, or xenobiotics can induce a state of dysbiosis that may promote a more disease susceptible microbiota. Consumption of certain types of dietary components has a major influence on the communities of colonic microorganisms, with changes typically being observed within 24 hours of consumption (Wu et al. 2011; Parkar et al. 2012).
In the human gastrointestinal tract, Faecalibacterium prausnitzii is one of the most populous species, being typically observed at over 5% of the total proportion of the colonic microbiota of healthy adults (Miquel et al. 2013). Members of the Firmicutes phylum, F. prausnitzii are commensal inhabitants of the human large bowel, with demonstrated anti-inflammatory properties in vivo (Sokol et al. 2009; Furet et al. 2010). Low levels of F. prausnitzii have repeatedly been associated with a range of intestinal disorders including irritable bowel syndrome (IBS), atopy, diabetes and inflammatory bowel diseases (IBD) such as Crohn's disease (CD) and ulcerative colitis (UC) (Sokol et al. 2009; Furet et al. 2010; Rajilic-Stojanovic et al. 2011; Candela et al. 2012; Willing et al. 2010). These consistent observations show that a depleted concentration of F. prausnitzii is an undesirable endpoint and therefore any treatment that can selectively stimulate its proliferation is likely to be worthwhile.
The mechanisms by which F. prausnitzii facilitate their health promoting effects have been attributed to butyrate production and anti-inflammatory effects. A mouse study by Sokol and colleagues found that F. prausnitzii or F. prausnitzii supernatant reduced the severity of chemical-induced colitis, promoted the synthesis of anti-inflammatory cytokines, and mitigated proinflammatory cytokine production, suggesting that the anti-inflammatory effects are mediated by secreted metabolites (Sokol et al. 2008). In addition, F. prausnitzii generate large amounts of butyrate as well as some lactate and formate as the result of carbohydrate fermentation (Duncan et al. 2002; Duncan et al. 2004).
Constipation is a common condition which can significantly affect an individual's quality of life, with impairment being compared to that of serious chronic conditions such as diabetes and osteoarthritis. It is estimated that up to 20% of the world's population suffer from this condition, with women and individuals aged over 65 years being most frequently affected (Attaluri et al. 2011; Udani & Bloom 2013). Complications that can arise from constipation include anal fissures, rectal prolapse, and faecal impaction. Straining to pass stool may lead to hemorrhoids. In later stages of constipation, the abdomen may become distended, hard, and diffusely tender. Severe cases may exhibit symptoms of bowel obstruction, for example, vomiting and a painful abdomen, as well as encopresis, where soft stool from the small intestine bypasses the mass of impacted faecal matter in the colon.
It is well known that the disturbance of the microbiota balance in the digestive tract may change intestinal motility, resulting in constipation (Husebye et al, 2001; Rhee et al. 2001). In addition, patients with chronic intestinal constipation present imbalance in the microbiota, characterized by a relative decrease of beneficial bacteria and an increase of potentially pathogenic bacteria and fungi (Khalif et al. 2005). Such patients show a significant increase in the counts of E. coli, S. aureus and enterobacteria (Khalif et al. 2005).
Moreover, a longer disease progression of chronic constipation leads to higher scores for undesirable microorganisms, and the lower scores for desirable ones (Khalif et al. 2005). In a study with children diagnosed with chronic constipation, intestinal dysbiosis was found in the faeces, with a significant increase in the counts of Clostridium, Bacteroides, and E. coli (Zoppi et al. 1998). One particular study has found a significant decrease in the count of Bifidobacterium and Lactobacillus strains in faeces of constipated individuals; such decrease is up to ten times lower for the Bifidobacterium genus (Chassard et al. 2012).
The intervention options for constipation remain difficult and challenging, and many individuals are dissatisfied with current therapies and medications. These include lifestyle and dietary modifications such as increased consumption of fruit and vegetables, fibre supplementation (methylcellulose; Konjac glucomannan, psyllium), increased fluid intake and exercise, as well as pharmacological intervention with stool softeners, stimulant laxatives and osmotic laxatives (Attaluri et al. 2011; Leung et al. 2011; Liu 2011).
The routine use of laxatives is contraindicated, as patients may come to be dependent upon their use. Enemas can be used to provide a form of mechanical stimulation. On the other hand, enemas are typically useful only for stool in the rectum, not in the intestinal tract. An increasing range of herbal and other natural products (including aloe and rhubarb (Udani & Bloom 2013)) advertised for aiding laxation have been made available on the market. Yet, there is only anecdotal evidence regarding their efficacy and success in affording relief from constipation.
By contrast, fibre is well known to be important in digestion--soluble fibre attracts water helping to slow digestion, and insoluble fibre adds bulk to stool to assist laxation. Enzymes also aid digestion by breaking down the large dietary compounds into smaller manageable pieces. For example, amylase breaks down starch into simple sugars and proteases break down proteins into amino acids. However, fibre and enzyme supplementation alone are largely ineffective for slow-transit constipation (prolonged delay in the transit of stool through the colon) and defecatory disorders. In addition, such supplementation may have unwanted side-effects such as excessive gas production and uncomfortable bloating.
Green kiwifruit (e.g., Actinidia deliciosa var. Hayward) have been highlighted as an effective product in the area of digestion with several studies now demonstrating their efficacy (Stonehouse et al. 2012). The current consensus is that the laxation effect of green kiwifruit appears to be primarily due to its dietary fibre and actinidin (enzyme) content (Chang et al. 2010; Rush et al. 2002, Stonehouse et al. 2012, Drummond & Gearry 2013).
In contrast, gold kiwifruit (e.g., Actinidia chinensis var. Hort16A) are not traditionally associated with laxation (Ferguson 2003; Rush 2002). It has been noted that gold kiwifruit has little/no actinidin content and less dietary fibre than green kiwifruit. The Hort16A variety of kiwifruit has been investigated for its effect on immunity (Hunter et al 2012; Skinner 2012), with the contention that the reduced or lesser laxative effects of gold kiwifruit make it an ideal choice for naturally boosting immunity, particularly in children where increased laxation may not be desirable (Adaim 2010).
Given the occurrence of gastrointestinal disorders in the population, there is a need for new compositions, particularly compositions derived from natural sources, for restoring and maintaining digestive health.
SUMMARY OF THE INVENTION
In one aspect, the invention comprises a method of preparing a kiwifruit composition, comprising:
a) obtaining gold kiwifruit which is a Gold3 variety or a genetic derivative thereof;
b) removing the skins of the kiwifruit and pureeing to a sieve size of less than 1 mm; and
c) drying the puree and producing a powder.
In various aspects:
The method further comprises removing the seeds of the kiwifruit prior to pureeing.
The method further comprises pureeing the kiwifruit to obtain puree with a Brix value of 16 to 21.degree..
The method further comprises pureeing the kiwifruit to obtain puree with a viscosity of 11.0 to 13.0, or 10.0 to 14.0, measured at 12.5.degree. Brix, 20.degree. C.
The method further comprises lyophilising the puree and milling to produce the powder.
The method further comprises enriching the composition for polyphenols.
The method further comprises adding polyphenols to the composition.
The method further comprises drying the puree for 24 to 56 hours.
The method further comprises lyophilising the puree for 40 to 56 hours.
In one other aspect, the invention comprises a composition prepared from dried gold kiwifruit, wherein the dried gold kiwifruit is a Gold3 kiwifruit or a genetic derivative thereof. The powder may be produced by a method of any one of the preceding aspects.
In various aspects:
The composition is formulated for enteral administration.
The composition is formulated for oral administration.
The composition is formulated as a tablet or a capsule.
The capsule is a gel capsule.
The tablet or capsule is formulated to comprise 400 to 800 mg of the powder.
Alternatively, the capsule is formulated to comprise 100 to 1000 mg of the powder.
The composition is formulated as a liquid.
The liquid is formulated to comprise 400 to 800 mg of the powder per dosage unit.
The composition is formulated as a jelly or a sachet.
The composition is formulated in combination with a further digestive aid.
The composition is formulated in combination with one or more prebiotic, probiotic, or synbiotic compositions.
The composition is formulated in combination with fibre and/or a digestive enzyme.
The composition is supplemented with polyphenols.
In one other aspect, the invention comprises a method of treating or preventing constipation, or maintaining or improving bowel regularity, comprising: administering to a subject a composition of any one of the preceding aspects, thereby treating or preventing constipation, or maintaining or improving bowel regularity, in the subject.
In various aspects:
The composition is administered enterally.
The composition is administered orally or rectally.
The composition is administered as a tablet, capsule, or liquid.
The composition is administered as a jelly or a sachet.
The capsule is a gel capsule.
The composition is administered at a dosage of 2000 to 4000 mg of powder per day, or a liquid equivalent thereof.
Alternatively, the dosage is 250 to 2500 mg of powder per day, or a liquid equivalent thereof.
The composition is co-administered with further digestive aid.
The composition is co-administered with one or more probiotic, prebiotic, or synbiotic compositions.
The composition is co-administered with fibre and/or a digestive enzyme.
The composition is supplemented with polyphenols.
In one other aspect, the invention comprises a method of treating or preventing microbiota imbalance in the digestive tract, comprising: administering to a subject a composition of any one of the preceding aspects, thereby treating or preventing the microbiota imbalance in the subject.
In various aspects:
The composition is administered enterally.
The composition is administered orally or rectally.
The composition is administered as a tablet, capsule, or liquid.
The composition is administered as a jelly or a sachet.
The capsule is a gel capsule.
The composition is administered at a dosage of 2000 to 4000 mg of powder per day, or a liquid equivalent thereof.
Alternatively, the dosage is 250 to 2500 mg of powder per day, or a liquid equivalent thereof.
The composition is co-administered with further digestive aid.
The composition is co-administered with one or more probiotic, prebiotic, or synbiotic compositions.
The composition is co-administered with fibre and/or a digestive enzyme.
The composition is supplemented with polyphenols.
In yet one other aspect, the invention comprises a method of maintaining or increasing beneficial bacteria in the digestive tract, comprising: administering to a subject a composition of any one of the preceding aspects, thereby maintaining or increasing beneficial bacteria in the digestive tract in the subject.
In various aspects:
The composition is administered enterally.
The composition is administered orally or rectally.
The composition is administered as a tablet, capsule, or liquid.
The composition is administered as a jelly or a sachet.
The capsule is a gel capsule.
The composition is administered at a dosage of 2000 to 4000 mg of powder per day, or a liquid equivalent thereof.
Alternatively, the dosage is 250 to 2500 mg of powder per day, or a liquid equivalent thereof.
The composition is co-administered with further digestive aid.
The composition is co-administered with one or more probiotic, prebiotic, or synbiotic compositions.
The composition is co-administered with fibre and/or a digestive enzyme.
The composition is supplemented with polyphenols.
The beneficial bacteria are selected from: the group of Bacteroides-Prevotella-Porphyromonas, Bifidobacterium spp., Lactobacillus spp., and the Lachnospiraceae group.
The beneficial bacteria are selected from: Faecalibacterium prausnitzii, Clostridium coccoides, Bacteroides fragilis, Bacteroides thetaiotaomicron, Bacteroides ovatus, Bacteroides cellulosilyticus, Roseburia intestinalis, Roseburia inulinovorans, Ruminococcus bromii, and Ruminococcus flavefaciens.
In still one other aspect, the invention comprises a method of maintaining or increasing Faecalibacterium prausnitzii in the digestive tract, comprising:
administering to a subject a composition of any one of the preceding aspects, thereby maintaining or increasing the Faecalibacterium prausnitzii in the digestive tract in the subject.
In various aspects:
The composition is administered by enteral, oral, or rectal administration.
The composition is administered as one or more of a tablet, capsule, liquid, jelly, or sachet.
The capsule is a gel capsule.
The composition is administered at a dosage of 2000 to 4000 mg of powder per day, or a liquid equivalent thereof.
The composition is administered at a dosage of 250 to 2500 mg of powder per day, or a liquid equivalent thereof.
The composition is co-administered with further digestive aid.
The composition is co-administered with one or more probiotic, prebiotic, or synbiotic compositions.
The composition is co-administered with fibre and/or a digestive enzyme.
The composition is supplemented with polyphenols.
The subject has one or more symptoms of inflammation.
The subject has one or more symptoms of: Crohn's disease, ulcerative colitis, irritable bowel syndrome, inflammatory bowel disease, gastrointestinal cancer, allergy, atopy, or diabetes.
In even one other aspect, the invention comprises a method of treating or preventing irritable bowel syndrome or inflammatory bowel disease, comprising:
administering to a subject a composition of any one of the preceding aspects, thereby treating or preventing irritable bowel syndrome or inflammatory bowel disease in the subject.
In various aspects:
The composition is administered by enteral, oral, or rectal administration.
The composition is administered as one or more of a tablet, capsule, liquid, jelly, or sachet.
The capsule is a gel capsule.
The composition is administered at a dosage of 2000 to 4000 mg of powder per day, or a liquid equivalent thereof.
The composition is administered at a dosage of 250 to 2500 mg of powder per day, or a liquid equivalent thereof.
The composition is co-administered with further digestive aid.
The composition is co-administered with one or more probiotic, prebiotic, or synbiotic compositions.
The composition is co-administered with fibre and/or a digestive enzyme.
The composition is supplemented with polyphenols.
In still one further aspect, the invention comprises the use of the composition of any one of the preceding aspects for preparing a medicament for: (i) treating or preventing constipation, or maintaining or improving bowel regularity, in a subject; (ii) treating or preventing a microbiota imbalance in a subject; (iii) maintaining or increasing beneficial bacteria in the digestive tract of a subject; (iv) maintaining or increasing Faecalibacterium prausnitzii in the digestive tract of a subject; or (v) treating or preventing irritable bowel syndrome or inflammatory bowel disease in a subject.
The foregoing brief summary broadly describes the features and technical advantages of certain embodiments of the present invention. Further technical advantages will be described in the detailed description of the invention and examples that follows.
Novel features that are believed to be characteristic of the invention will be better understood from the detailed description of the invention when considered in connection with any accompanying figures and examples. However, the figures and examples provided herein are intended to help illustrate the invention or assist with developing an understanding of the invention, and are not intended to limit the invention's scope.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1: Polyphenol content of green (Hayward) and gold (Gold3) kiwifruit powder pre- and post-digestion.
FIG. 2: Change in growth of bacteria strains when exposed to water and DMSO extracts of digested gold (Gold3) kiwifruit powder.
FIG. 3: Effect of gold (Gold3) kiwifruit powder on short chain fatty acid production in vitro using a mixed fermentation model.
FIG. 4: Schematic of trial treatments, washouts, and sampling points.
FIG. 5A: Improvement in Digestive Health Index in functionally constipated participants after GOLD (Gold3) treatment.
FIG. 5B: Net difference in abundance of Faecalibacterium prausnitzii in functionally constipated participants after GOLD (Gold3) treatment
FIG. 5C: Quantitative PCR data (LOG transformed) showing net difference in Faecalibacterium prausnitzii levels in functionally constipated participants after GOLD (Gold3) treatment.
FIG. 6: LightCycler.RTM. 480 qPCR data displaying bacterial groups as the calculated average 16S rRNA gene copy number/gram faecal sample (top row LOG transformed, bottom row natural data) and standard error of the mean (SEM) as error bars before and after each treatment period in the healthy group.
FIG. 7: LightCycler.RTM. 480 qPCR data displaying bacterial groups as the calculated average 16S rRNA gene copy number/gram faecal sample (top row LOG transformed, bottom row natural data) and standard error of the mean (SEM) before and after each treatment period in the functionally constipated group.
DETAILED DESCRIPTION OF THE INVENTION
The following description sets forth numerous exemplary configurations, parameters, and the like. It should be recognised, however, that such description is not intended as a limitation on the scope of the present invention, but is instead provided as a description of exemplary embodiments.
All references, including patents and patent applications, cited in this specification are hereby incorporated by reference. No admission is made that any reference constitutes prior art. Nor does discussion of any reference constitute an admission that such reference forms part of the common general knowledge in the art, in New Zealand or in any other country.
Definitions
In each instance herein, in descriptions, embodiments, and examples of the present invention, the terms "comprising", "including", etc., are to be read expansively, without limitation. Thus, unless the context clearly requires otherwise, throughout the description and the claims, the words "comprise", "comprising", and the like are to be construed in an inclusive sense as to opposed to an exclusive sense, that is to say in the sense of "including but not limited to".
"Bowel regularity" means having regular bowel movements, e.g., on a daily or weekly basis. While regularity will differ from person to person, an expected number of bowel movements can range from at least four times per week to at least once per day. An "improvement" in regularity means an increase in at least one bowel movement per week.
The term "bowel irregularity" means that the regularity of bowel movements has been compromised. This can mean, for example, an increased time period between bowel movements, or a decrease in the expected number of bowel movements per day or per week. For example, a reduction in at least one bowel movement per week can indicate a bowel irregularity.
As used herein "constipation" means having one or more symptom of being constipated, e.g., one or more of: straining during a bowel movement; hard or lumpy stools; sensation of anorectal obstruction or blockage; sensation of incomplete evacuation; manual manoeuvres to facilitate defecation; or three or fewer bowel movements in a week.
A "dietary aid" is a composition that assists with digestion or other aspects of the digestive system, e.g., soluble and insoluble fibre, digestive enzymes, probiotics, prebiotics, and synbiotics. Included as digestive aids are compositions comprising one or more of psyllium, methylcellulose, glucomannan, magnesium, flaxseed, wheatgrass, ginger, aloe (e.g., aloe vera juice), and rhubarb.
A "digestive enzyme" is an enzyme that assists with the function of the gastrointestinal system. Included are actinidin, amylase, protease, lipase, lactase, maltase, sucrase, and cellulase.
"Digestive tract" and "gut" refer to the digestive system (i.e., gastrointestinal system) of a human and other animal. This includes the oesophagus, stomach, small intestine, including the duodenum, jejunum, and ileum, large intestine, including the cecum, ascending, transverse, descending, and sigmoid colon, and rectum. "Bowel" is a synonym for the intestinal tract.
A "disorder" of the digestive tract includes a disease or other condition affecting the digestive system (i.e., gastrointestinal system), which may be an acute or chronic condition, such as inflammation, constipation, bowel irregularity, microbiota imbalance (e.g., reduced levels of beneficial organisms, altered ratios of beneficial organisms, and/or increased levels of deleterious organisms). Particular disorders include inflammatory bowel disease and irritable bowel syndrome. Other disorders are described in detail herein.
"Gold3" refers to a particular variety of gold kiwifruit also known as `Zesy002`, and marketed as ZESPRI.RTM. SUNGOLD kiwifruit. A New Zealand plant variety right application was made on 25 Jun. 2009 for Gold3 under the application number KIW042. The botanical name for Gold3 gold kiwifruit is Actinidia chinensis Planch.
A "genetic derivative" of a gold kiwifruit variety (e.g., Gold3 variety) refers to offspring, sports, or other cultivars that are obtained from the gold kiwifruit parent stock. This includes offspring obtained from a genetic cross with the gold kiwifruit parent, e.g., F1 progeny or F2 progeny. The term "genetic derivative" may refer to the derived plant, itself, or to its fruit.
"Inflammation" refers to a condition characterised by one or more of: vasodilation, heat, redness, pain, swelling, edema, lesions, fissures, ulcerations, leukocyte extravasation, and loss of function. Included are both acute and chronic forms of inflammation, the latter of which includes inflammatory disorders, e.g., autoimmune diseases. Particularly included is inflammatory bowel disease. Other inflammatory disorders are described elsewhere in this document.
As noted herein, the terms "lyophilising" and "freeze drying" are used synonymously. It will be understood that the terms "freeze drying"/"lyophilising" do not exclude the use of higher temperatures (i.e., higher than freezing temperatures). For example, higher temperatures may be used for removing residual moisture during the secondary drying phase for lyophilisation/freeze drying procedures.
"Microbiota" as used herein refers to populations of microorganisms that live in the digestive tracts of humans and other animals. Synonymous terms are "microflora" and "microbiome".
A "microbiota imbalance" (also called "dysbiosis") is a condition whereby the number of beneficial organisms in the digestive system is reduced, one or more ratios of beneficial organisms are altered, and/or the number of deleterious organisms in the digestive system is increased. Beneficial organisms may include, for example, lactic acid producing bacteria and butyrate producing bacteria. Particular beneficial organisms include but are not limited to Bifidobacterium strains, Bacteroidaceae strains such as Bacteroides fiagilis, and also faecal bacteria, such as beneficial bacteria from the Clostridium leptum phylogenetic group, including Faecalibacterium prausnitzii, Included as well are Clostridium coccoides, Bacteroides thetaiotaomicron, Bacteroides ovatus, Bacteroides cellulosilyticus, Roseburia intestinalis, Roseburia inulinovorans, Ruminococcus bromii, and Ruminococcus flavefaciens. Also included are beneficial organisms from the groups of Bacteroides-Prevotella-Porphyromonas, Lachnospiraceae, and Lactobacilli. Deleterious organisms may include, as non-limiting examples, Staphylococcus and Salmonella strains, as well as members of the groups Enterobacteriaceae, Pasteurellacaea, Veillonellaceae, and Fusobacteriaceae.
A "prebiotic" is a composition that increases the number and/or activity of beneficial organisms in the digestive system. Typically, a prebiotic comprises fermentable components and produces positive changes (e.g., improved levels, activities, or ratios) in the populations of beneficial bacteria in the gastrointestinal microbiota. This includes, for example, lactic acid producing bacteria and/or butyrate producing bacteria. Specific examples of beneficial organisms include Bifidobacterium strains and Faecalibacterium strains, including Faecalibacterium prausnitzii, and also Bacteroidaceae strains such as Bacteroides fragilis. Included as well are Clostridium coccoides, Bacteroides thetaiotaomicron, Bacteroides ovatus, Bacteroides cellulosilyticus, Roseburia intestinalis, Roseburia inulinovorans, Ruminococcus bromii, and Ruminococcus flavefaciens. Also included are the groups of Bacteroides-Prevotella-Porphyromonas, Lachnospiraceae, and Lactobacilli, as well as other organisms described herein.
A "probiotic" is a composition comprising one or more beneficial organisms that colonise the digestive system, including the colon, for example, lactic acid producing bacteria and/or butyrate producing bacteria. Particular beneficial organisms include Bifidobacterium strains and Faecalibacterium strains, including Faecalibacterium prausnitzii, and also Bacteroidaceae strains such as Bacteroides fragilis, as well as other organisms described herein.
A "synbiotic" is a composition that combines one or more prebiotic agents and one or more probiotic organisms.
As used herein, a "subject" may be a human or non-human animal, particularly a mammal, including cattle, sheep, goats, pigs, horses, and other livestock, including, as well, dogs, cats, and other domesticated pets.
"Treating" as used herein is meant as reducing, ameliorating, or resolving a disorder, for example a gastrointestinal disorder, such as a disease or other condition of the gastrointestinal system. A treatment will result in the reduction, amelioration, or elimination of one or more symptoms of the disorder.
"Preventing" as used herein is meant as stopping or delaying the onset of a disorder, for example a gastrointestinal disorder, such as a disease or other condition of the gastrointestinal system. A preventative measure will result in the stoppage or delay of one or more symptoms of the disorder, or a lessening of symptoms if such do arise.
Gold Kiwifruit and Associated Bioactivity
Gold3 is a new variety of gold kiwifruit developed by Zespri.RTM., which has been found to have a tolerance to Pseudomonas syringae pv actinidiae (Psa; a bacterial kiwifruit vine disease) and is replacing the Hort16A variety as the new commercial gold variety of choice in New Zealand. The Gold3 variety of kiwifruit is similar in nutritional composition to its predecessor, having less actinidin and dietary fibre content than green kiwifruit (Table 1).
TABLE-US-00001 TABLE 1 Nutritional content of whole kiwifruit Average nutritional properties of samples harvested 2009/10.sup.1 Green kiwifruit Gold kiwifruit (Actinidia (Actinidia chinensis) deliciosa) Component Units Gold3 Hort16A Hayward Vitamin C mg/100 g 133 92 89 Vitamin E IU/100 g 1.4 2.1 1.4 Fibre dietary soluble g/100 g 2.1 2.2 3.6 Fibre dietary g/100 g <1 1.1 2.1 insoluble Beta carotene mg/100 g 0.016 0.025 0.023 Alpha carotene mg/100 g <0.005 <0.005 <0.005 Sugars total g/100 g 12.7 12.4 9.5 Folic acid mg/100 g 21.4 24.6 29.9 Oxalate Raphides/g 585 1267 965 Actinidin FU/100 g 88 3.4 334 Nitrogen mg/100 g 164 148 135 Phosphorous mg/100 g 25.3 23.8 26.8 Potassium mg/100 g 327.5 305 335 Calcium mg/100 g 23 31.8 35.3 Magnesium mg/100 g 12.7 15.4 15.3 Sulphur mg/100 g 15.2 15.3 14.8 Iron mg/100 g 0.265 0.267 0.323 Boron mg/100 g 0.333 0.385 0.33 Copper mg/100 g 0.106 0.131 0.095 Manganese mg/100 g 0.055 0.087 0.139 Zinc mg/100 g 0.073 0.106 0.104 Sodium mg/100 g <1 1.78 1.61 .sup.1Zespri .RTM. 2010 New varieties information guide.
Given that gold kiwifruit varieties contain lower levels of fibre and actinidin, the components considered to be primarily responsible for the laxation effects of green kiwifruit, it would be expected that a gold kiwifruit-derived product would have a lesser laxation effect than one derived from green Hayward kiwifruit.
Surprisingly, the inventors have found that Gold3 kiwifruit-derived powder (GOLD) improved laxation to the same degree as the green Hayward kiwifruit-derived powder (ACTAZIN.TM.) in healthy individuals (see Examples 5 and 6, herein below). These results suggest that other kiwifruit bioactive components present in the Gold3 powder may be having a greater impact on the observed laxation effect than current convention dictates. The compositions are therefore useful for maintaining or improving bowel regularity and/or treating or preventing constipation.
Although not wishing to be bound by theory, it is postulated that the polyphenols may be key active ingredients in gold kiwifruit varieties, in particular in the Gold3 variety of kiwifruit. It is postulated that the observed effectiveness for laxation may be attributable to the combination of the fibre, enzymes, prebiotic carbohydrates, and polyphenols in the fruit.
Polyphenols are naturally occurring compounds in plants, characterised by the presence of one or more phenol unit. It is believed that at least some of the health benefits of polyphenols arise through encouraging the growth of beneficial bacteria and by the bacteria converting the polyphenols into other bioactive compounds which are absorbed into the bloodstream and exert effects both in the gut and elsewhere in the body (Seeram 2014; Cardona et al. 2013).
It is estimated that 90 to 95% of total polyphenol intake accumulates in the colon where the phenolics are subjected to metabolism by gut microbes into low molecular weight metabolites. These metabolites are absorbable and may be attributable for the observed health effects of polyphenols (Cardona et al. 2013).
Based on the results shown herein, the inventors believe that the polyphenols of gold kiwifruit varieties, e.g., Gold3 or its derivatives, may have the ability to act as prebiotics. Researchers in the field have described prebiotics as "selectively fermented ingredients that result in specific changes in the composition and/or activity of the gastrointestinal microflora, thus conferring benefit(s) upon host health" (Gibson et al. 2010).
Notably, gold kiwifruit have higher levels of polyphenols than green kiwifruit (see, e.g., Drummond 2013; see also Table 5, herein). Moreover, the inventors' in vitro studies have shown that digested (simulated upper gastrointestinal digestion) Gold3 gold kiwifruit powder has an altered polyphenol profile compared to pre-digestion (see Example 2); however, the overall phenolic content is retained. Although green kiwifruit powder also has an altered polyphenol profile post-digestion, the overall content is reduced by digestion (see Example 2).
From this, the inventors conclude that the polyphenols present in the Gold3 gold kiwifruit powder are surviving digestion in the stomach, better than those in the green kiwifruit powder. This means that the polyphenols from gold kiwifruit such as the Gold3 variety of kiwifruit are available for biotransformation into different phenolics.
Without wishing to be bound by theory, it is believed that the Gold3 gold kiwifruit has a unique profile rich in chlorogenic acid, E-caffeoyl-3-glucoside, phlorizin, procyanidin B2, and quercetin. It is believed that these phenolics remain `undigested` and therefore transit into the colon where they are metabolised by the gut microbiota into metabolites (phenolic derivatives). These derivatives can then be absorbed and go on to interact in other metabolic pathways and support health benefits, including facilitated laxation.
It is known that the phenylpropanoid pathway produces the majority of phenolic compounds found in plants. Phenylpropanoids control plants' repair, growth and defense systems (immune systems), and their interaction with beneficial microbes and beneficial predators (trophic systems). Thus, it is feasible that phenolic compounds in the Gold3 variety may be responsible for both the pest-resistance of the plant and the digestive benefits of the Gold3-derived powder, as disclosed herein.
The inventors have also found that Gold3 gold kiwifruit powder contains digestion-resistant components, which are known to have prebiotic properties (see Example 4). These components assist in modulating the gut microbiota, and stimulating the production of metabolites such as short chain fatty acids (SCFAs; see Example 4), which are attributed with various health benefits.
Additionally, the inventors have discovered that Gold3 gold kiwifruit powder influences the growth pattern of gut microflora, stimulating an increase in beneficial bacteria relative to harmful bacteria (see Example 3). Notably, the inventors have also observed a significant increase in the relative abundance of Faecalibacterium prausnitzii in faecal samples of constipated patients treated with Gold3 gold kiwifruit powder (Examples 7 and 8). This increase in beneficial bacteria, including F. prausnitzii, has been confirmed by quantitative PCR analysis (Examples 9 and 10).
This is a significant finding as depleted concentrations of F. prausnitzii are associated with gastrointestinal disorders, and in particular, inflammatory conditions of the gastrointestinal tract. It is noted that reduced levels of F. prausnitzii have been associated, specifically, with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), as well as other health conditions. See, e.g., Sokol et al. 2008; Sartor 2011. See also, further below.
Therefore, it is evident that Gold3 gold kiwifruit and its genetic derivatives may be used in compositions for: treating or preventing constipation, maintaining or improving bowel regularity, treating or preventing microbiota imbalance, maintaining or increasing beneficial bacteria in the digestive tract, maintaining or increasing F. prausnitzii in the digestive tract, and/or treating or preventing irritable bowel syndrome or inflammatory bowel disease. Further uses for the composition are described in detail herein.
Methods of Producing Kiwifruit Compositions
The present invention relates generally to a composition prepared from gold kiwifruit. In one particular aspect, the composition is prepared from Actinidia chinensis. Preferably, the Gold3 (also known as G3) variety of gold kiwifruit is used. In other aspects, one or more genetic derivatives from the gold kiwifruit variety may be used. For example, it may be desirable to use F1 or F2 progeny from a genetic cross that includes the parent stock of the gold kiwifruit variety. Alternatively, any sports or other cultivars obtained from the parent may be used.
The composition may be prepared in powdered form, for example, a lyophilised powder, or in any other suitable dosage form. In certain aspects, it may be desirable to formulate the powder into tablets (including rapid dissolve tablets) or capsules (including extended release capsules). The tablets may be scored tablets, chewable tablets, effervescent tablets, orally disintegrating tablets, or tablets for forming a suspension. The capsules may be gel capsules, including gel capsules made by single piece gel encapsulation and two piece gel encapsulation. Non-gelatine capsules are also included, as well as caplets. The powder may be provided in free flowing form or as a solid cake. The composition may be provided as a powder for forming a suspension, powder for forming a solution, bulk oral granules, or bulk oral powder. Alternatively, composition may formulated as a tonic, elixir, linctus, concentrate, syrup, solution, suspension, emulsion, draught, puree, paste, or as drops. In other aspects, the composition may be formulated as a gel or jelly. The composition may be provided in sachet form, for example, a powder sachet, or a gel or jelly sachet. Included also are formulations comprising thin strips, or comprising solids in a capsule to mix with food or drink. Other formulas are also possible, as described herein below.
The compositions of the invention may be prepared from a gold kiwifruit puree obtained from one or more commercial sources. Preferably, the gold kiwifruit puree has had both seeds and skin removed. It is also preferred that the puree has been prepared with a sieve size of about 1 mm or less. It is further preferred that the puree has a viscosity (measured at 12.5.degree. Brix, 20.degree. C.) of about 12.0; or may range from 10.0 to 14.0; or 11.0 to 13.0; or 11.75 to 12.25; or 11.8 to 12.2; or 11.9 to 12.1; or may be about 11.0, about 11.25, about 11.7, about 11.8, about 11.9, about 12.1, about 12.2, about 12.3, or about 12.5.
The pH of the puree may range from 3.2 to 3.8; or 3.0 to 4.0; or 3.1 to 3.9; or may be about 3.1, about 3.2, about 3.3, about 3.4, about 3.5, about 3.6, about 3.7, about 3.8, about 3.9, or about 4.0. In some circumstances, it may be desirable to adjust the pH of the puree or that of the final composition to approximate physiological levels. In particular, it may be useful to obtain a pH range from 6.0 to 8.0; or 6.5 to 7.5; or 6.8 to 7.2; or a pH of about 6.5, about 6.7, about 6.8, about 6.9, about 7.0, about 7.1, about 7.2, about 7.3, about 7.4, or about 7.5.
In certain aspects, the compositions of the invention may be prepared by "soft pulping" technology referred to in New Zealand Patent No. 235972 (which is hereby incorporated by reference), which can be adapted to produce a pulpy gold kiwifruit juice.
In initial preparatory stages, the gold kiwifruit may undergo a pre-treatment process which may include the well known steps of ripening, inspecting, grading, and/or sorting of the kiwifruit. With regard to ripening, it is preferable to use ripe or mature gold kiwifruit when producing the compositions of the invention; however, rotted or decaying material is preferably avoided.
Ripeness can be assessed using widely known and used methods in the art. Ripeness can be measured prior to picking or processing the gold kiwifruit. In particular, ripeness may be measured using the Brix system. Gold kiwifruit with a sugar level ranging from 16 to 21.degree. Brix; or 14.degree. to 23.degree. Brix; or 15.degree. to 22.degree. Brix; or about 14.degree., about 15.degree., about 16.degree., about 17.degree., about 18.degree., about 19.degree., about 20.degree., about 21.degree., about 22.degree., or about 23.degree. Brix, may be indicative of ripeness.
Gold kiwifruit exceeding this Brix level may be overly mature or fermenting and may not produce an ideal composition. Kiwifruit with a Brix level below the ideal may be artificially ripened before use. Time left in storage may be sufficient to achieve ripening. For example, gold kiwifruit picked at about 5.degree. Brix can rise to above 10.degree. Brix in 4-6 weeks in cool storage at 0.degree. C. This fruit will ripen to reach 12.degree. Brix or higher upon removal from cool storage. Other changes in chemistry also occur during ripening so that the kiwifruit is within the ideal range of maturation to provide an optimised product.
As part of the processing, the gold kiwifruit may be sterilised. The fruit may be passed through an assembly having one or more roller brushes for removing any adhering foreign matter. Conventional washing techniques may then be employed. For example, it is possible to use a series of spray nozzles to wash the kiwifruit. Wash additives aiding cleansing or reducing the bacteria count on the kiwifruit may be employed according to local regulations and requirements. For example, the fruit may be washed by a chlorine wash and/or an ozone impregnated water wash followed by a fresh water rinse.
The sterilized gold kiwifruit may then be conveyed into a hopper. This can be tapered to form a funnel to direct the kiwifruit one by one to a cutting assembly. The cutting assembly can include a cutting device such as a water laser or similar, which has the advantage of preventing damage to the seed so the seed of the fruit does not contaminate the pulp. Other suitable cutting devices include rotating circular blades, reciprocating blades, fluid jet cutting devices, swing blades, etc.
The cutting device may cut the gold kiwifruit substantially in half, for example, across its length. Alternately, the cutting device may be replaced with a soft crushing device able to break the skin of the kiwifruit. Preferably this is done without causing significant cellular damage to the kiwifruit. For instance, the gold kiwifruit may be directed between rollers to result in the breakage of the skin of the kiwifruit. In particular, the kiwifruit may be burst by passing the fruit through spaced rollers biased towards each other. This method can be used to squeeze the fruit so the skin is split. The burst kiwifruit remains substantially intact but readily separable into large fragments. Other bursting methods may be employed.
After cutting, the gold kiwifruit segments may be passed through a pressing assembly designed to separate the skin from the pulp. The pressing assembly may be adapted to perform a pulping or comminution process. Such process can be relatively mild and gentle ("soft pulping") compared to conventional fruit pulping techniques. With soft pulping, no significant disintegration or lysis of fruit cells or components. Preferably, only a minor proportion (generally less than 5-10%) of seeds is fragmented by this process. Excluded from soft pulping processes are chemical and/or enzyme lysis methods, thermal techniques, techniques directed to the breaking down of cells, and mechanical techniques which involve excessive pulverization of fruit material.
In one embodiment, the pressing assembly performs the soft pulping of the gold kiwifruit by pressing the kiwifruit segments between a twin converging belt press. The press belts may be multiple loops rotated about a series of pulleys. The distance separating the press belts may decrease in the direction of travel of the kiwifruit. In this way, increased force may be exerted upon the kiwifruit as it travels along the length of the pressing assembly. This can produce pulping of the kiwifruit without significant damage to the seeds. This in turn prevents seeds from contaminating the pulp.
The pulp generated from the pressing assembly may be directed to a screening process, in order to separate the seeds from the pulp. In particular, the pulp may be separated from the seed using a soft mechanical screening technique. For example, a pulp finisher may be used. This includes a rotating flexible impeller which is rotated within a cone shaped screen having apertures of a predetermined size. In particular aspects, the size of the apertures is selected to permit the pulp and juice of the kiwifruit to pass through the screen while retaining a substantial portion, if not all, of the seeds within the interior cavity defined by the screen.
In certain aspects, it may be preferable to use a paste rather than a puree from the gold kiwifruit. A kiwifruit paste may be made as a concentrate. For example, the fruit may be heated for several hours, strained, and reduced to a thick, concentrated form. The fruit may be heated after removing the skins, or after the pulping or pureeing process. The fruit can be heated gradually, and then kept heated at a moderate temperature, with mixing. Upon thickening, the paste can be spread on a flat sheet, or transferred to a packaging, for example, a bag, tube, jar, bottle, or other container. The paste may be transferred aseptically, such that it is suitable for human consumption. Preferably, the kiwifruit paste is produced from mature gold kiwifruit. Preferably, the paste is prepared from pulped fruit. The paste may be a smooth preparation, and may comprise a concentrate of about 40.degree. Brix; or from 30.degree. to 50.degree. Brix; or from 35.degree. to 45.degree. Brix; or about 35.degree., about 36.degree., about 370, about 380, about 390, about 41.degree., about 42.degree., about 430, about 44.degree., or about 45.degree. Brix.
The pulp (e.g., in paste or puree form) may then be processed by a freezing step. This may be followed by or used in conjunction with a drying step. In an alternative embodiment, the pulp is dried and processed to a powder without an intervening freezing step. For example, methods involving drum drying may be used. In the drum-drying process, a puree or paste may be dried at relatively low temperatures over rotating, high-capacity drums that produce sheets of drum-dried product. In certain aspects, an additive may be used to accelerate or otherwise assist the drying process. For example, pea starch or other drying aids may be utilised. The dried product may then be milled to a finished flake or powder form. Advantageously, drum drying techniques may be used to produce a dried composition that retains its key components, e.g., phenolic compounds, and can be easily reconstituted using liquid. For example, drum dried products may be made to be cold water soluble. As further alternatives, belt drying or convection drying may be used. Such drying methods are widely known and used in the field.
If freezing is used, it is preferable to freeze the pulp as soon as possible after it is produced to maintain freshness. However, freezing may be carried out within 24 or 48 hours, as needed. Freezing methodologies are well known and need not be described in significant detail herein, Blast freezing is particularly preferred for use with the invention. The pulp may be frozen in standard sized pales, which are used to collect the fresh pulp after processing. The pulp can be stored frozen (e.g., at -18.degree. C.) until it is required to make the composition.
The frozen pulp may be freeze dried, i.e., lyophilised. Freeze drying techniques are widely known and commonly used. The freeze drying cycle may be about 48 hours; or ranging from 40 to 56 hours; or 12 to 36 hours; or 36 to 60 hours; or about 40 hours, about 42 hours, about 44 hours, about 46 hours, about 48 hours, about 50 hours, about 52 hours, or about 54 hours. A longer freeze drying cycle, e.g., at least 48 hours ("gentle freeze drying"), may be used to retain maximal activity. In particular aspects, the process may be carried out to such that water formation is avoided, and the moisture content is minimised during processing.
It may be desirable to use a particular lyophilisation process for obtaining the dried product. For example, a lyophilisation drying program may be used as part of an automated drying system. The lyophilisation process may include multiple drying steps, e.g., with step-wise increases and reductions in temperature. Preferably, a primary drying setting is used for sublimation, followed by one or more secondary drying settings that are used to remove residual moisture. In particular aspects, the top temperature of the lyophilisation process does not exceed 70.degree. C. In other aspects, the temperature of the lyophilisation process ranges between -10.degree. C. to 70.degree. C. In one other aspect, up to 48 hours of lyophilisation is utilised.
The resulting dried product may then be milled into a powder which can then be utilised as appropriate. Milling methods are well known and widely used in the art. Standard mesh sizes may be used to produce the powder, for example, US 20, US 23, US 30, US 35, US 40, US 45, or US 50 mesh sizes may be used. The sieve size for the powder may range from 1.0 to 0.3 mm; or 0.84 to 0.4 mm; or 0.71 to 0.5 mm; or may be about 1.0 mm, about 0.84 mm, about 0.71 mm, about 0.59 mm, about 0.5 mm, about 0.47 mm, about 0.465 mm, about 0.437 mm, about 0.4 mm, about 0.355 mm, or about 0.3 mm.
To ensure minimal degradation of kiwifruit ingredients, the preparation process may be performed at a temperature of less than 40.degree. C. In various embodiments, the process is performed at a temperature ranging from -4.degree. C. to 40.degree. C.; or from -1.degree. C. to 10.degree. C.; or from 1.degree. C. to 6.degree. C.; or at approximately 0.degree. C., approximately 1.degree. C., approximately 2.degree. C., approximately 3.degree. C., approximately 4.degree. C., approximately 5.degree. C., or approximately 6.degree. C. These temperatures may be kept during the entire preparation process, including the storage of the whole fruit, prior to it being broken open, and during the pulping/pureeing process. For optimal results, these temperatures are kept at least from the point that the fruit has been broken open. Use of such temperatures avoids oxidation of the fruit and the use of reducing agents. In certain circumstances, it may be possible to obtain organic certification.
The processing method is preferably performed so as to prevent or at least minimise any damage or effects on the active material in the gold kiwifruit. To ensure optimal production methods, the resulting compositions can be monitored for activity, for example, for polyphenol content. The composition may be expected to contain at least the following polyphenol compounds: chlorogenic acid, E-caffeoyl-3-glucoside, neochlorogenic acid, phlorizin, procyanidin B2, and quercetin rhamnoside. Also present may be: catechin, epicatechin, E-caffeoyl-4-glucoside, and quercetin rutinoside. The levels for these polyphenols are noted herein below. Assays for polyphenols are well known in the art and are also described below. In particular, it is possible to measure gallic acid equivalents (GAE) to determine total polyphenol content. For example, the Folin-Ciocalteu method (employing the Folin-Ciocalteu reagent, also called Folin's phenol reagent or Folin-Denis reagent) may be used for colorimetric in vitro assays of phenolic compounds (Singleton et al. 1999).
Alternatively or additionally, the compositions can be tested for the stimulation of growth of beneficial organisms, e.g., Lactobacillus and/or Bifidobacterium, or for increased levels of short chain fatty acids, e.g., acetate, butyrate, and/or propionate. These growth levels and organic acid levels are noted herein below. The corresponding assays are widely known and also described in detail herein. Preferably, the noted activities in stimulating bacterial growth and organic acid levels, and the noted polyphenol content are still present upon digestion of the composition, e.g., as assayed by in vitro digestion. In particular aspects, in vitro digestion assays may be utilised as described by the inventors, herein. Other in vitro assays are known and used in the art (see, e.g., Kaur et al. 2010).
In some circumstances, it may be possible to use genetic derivative of the gold kiwifruit stock (e.g., Gold3 stock) to obtain the compositions of the invention. It is expected that a composition obtained from such derivative would share one or more of the characteristics of the compositions obtained from gold kiwifruit stock. Exemplary features include: polyphenol levels and polyphenol profiles, actinidin levels, fibre levels, vitamin levels, stimulation of growth of beneficial organisms, and enhancement of levels of organic acids, as noted above and disclosed in detail herein.
Regarding the fruit itself, it is expected that the kiwifruit obtained from a genetic derivative would share a similar compositional makeup as the gold kiwifruit parent. For example, the vitamin C content of the fruit may be from 100 to 150 mg; or from 90 to 200 mg; or from 80 to 220 mg; or about 80 mg, about 90 mg, about 100 mg, about 115 mg, about 130 mg, about 140 mg, about 150 mg, about 160 mg, about 170 mg, or about 180 mg, per 100 g of fruit. The actinidin content of the fruit may be from 60 to 110 FU; or from 70 to 100 FU; or from 80 to 90 FU; or about 60 FU, about 70 FU, about 80 FU, about 90 FU, about 100 FU, about 110 FU, or about 120 FU, per 100 g of fruit. The total polyphenol content of the fruit may be from 250 to 450 mg GAE; or from 200 to 800 mg GAE; or from 300 to 600 mg GAE; or from 270 to 430 mg GAE; or from 280 to 420 mg GAE; or from 290 to 410 mg GAE; or from 300 to 400 mg GAE; or from 310 to 390 mg GAE; or from 320 to 380 mg GAE, per 100 g of fruit.
Compositions Comprising Gold Kiwifruit
The inventors have found that Gold3 gold kiwifruit powder includes beneficial ingredients that are useful for maintaining the health of the digestive system, as well as treating and preventing digestive problems and/or gastrointestinal disorders. The Gold3 gold kiwifruit powder was shown by the inventors to be particularly efficacious for improving bowel regularity. The Gold3 powder was also effective in stimulating the growth of beneficial bacteria relative to harmful bacteria, and generating increases in F. prausnitzii, specifically.
As such, the gold kiwifruit compositions of the invention can be used to support or improve overall gut health and/or to treat or prevent various diseases or other conditions of the digestive tract, including inflammation, constipation, microbiota imbalance, irritable bowel syndrome, and inflammatory bowel disease. In addition, the compositions may be used to maintain or improve bowel regularity, and maintain or increase beneficial bacteria in the digestive tract, including F. prausnitzii.
The gold kiwifruit powder may be encapsulated, tableted, or added to or incorporated in other products. Particularly encompassed are delayed release formulas, extended release formulas, as well as formulas for rapid disintegration. Gel capsules are specifically encompassed, as well as sachets and chewable tablets. Additionally included are combination formulas, which include the powder of the invention mixed with other beneficial agents, e.g., one or more probiotics, prebiotics, synbiotics, or other digestive aids. In alternate embodiments, the powder may be reconstituted as a liquid, for example, a concentrate, syrup, suspension, or tonic for oral administration, or as an enema or cluster composition for rectal administration. Rectal suppositories are also encompassed.
In preferred aspects, the resulting dried gold kiwifruit powder is encapsulated, and each capsule contains approximately 500 mg or approximately 600 mg of the dried powder; or ranging from 50 to 650 mg; 150 to 850 mg; or 200 to 800 mg; 300 to 700 mg; or 550 to 750 mg; or approximately 50 mg, approximately 100 mg, approximately 150 mg, approximately 200 mg, approximately 250 mg, approximately 300 mg, approximately 350 mg, approximately 400 mg, approximately 450 mg, approximately 500 mg, approximately 550 mg, approximately 575 mg, approximately 590 mg, approximately 610 mg, approximately 625 mg, approximately 650 mg, approximately 675 mg, approximately 700 mg, approximately 750 mg, approximately 800 mg, or approximately 850 mg, of the dried powder.
In certain circumstances, it may be desirable to isolate or enrich the polyphenols from the gold kiwifruit. In particular, it may be advantageous to use the gold kiwifruit to obtain polyphenol enriched compositions, phenolic concentrates, or compositions comprising isolated phenolics. For example, the compositions of the invention may be enriched for polyphenols such that their concentration is increased relative to the other components of the gold kiwifruit, e.g., fibre, sugars, and/or proteins. In particular aspects, the compositions of the invention may include polyphenols that have been isolated away from (e.g., purified from) the other components of the gold kiwifruit.
Methods of enriching and extracting polyphenols are widely known in the art (see, e.g., Sun-Waterhouse et al. 2009; Eidenberger et al. 2014). Preferably, the resulting composition has at least 2 times, at least 3 times, at least 4 times, at least 5 times, or at least 10 times the amount of polyphenols compared to the composition prepared without polyphenol enrichment or isolation steps. The polyphenol enriched compositions, phenolic concentrates, and compositions comprising isolated phenolics may be dried as a powder, and used in accordance with the present invention. In particular aspects, such powder is encapsulated, and each capsule contains approximately 100 mg, approximately 150 mg, approximately 200 mg, approximately 250 mg, approximately 300 mg, or approximately 350 mg, or approximately 400 mg, of powder; or ranging from 100 mg to 200 mg; or from 100 to 300 mg; or from 200 to 400 mg of powder.
The dosage form may contain excipients, for example, one or more anti-adherents, binders, coatings, disintegrants, flavours, colours, sweeteners, lubricants, glidants, flow agents, anti-caking agents, sorbents, or preservatives. Useful excipients include but are not limited to: stearin, magnesium stearate, and stearic acid; saccharides and their derivatives, e.g., disaccharides: sucrose, lactose; polysaccharides and their derivatives, e.g., starches, cellulose or modified cellulose such as microcrystalline cellulose and cellulose ethers such as hydroxypropyl cellulose; sugar alcohols such as isomalt, xylitol, sorbitol and maltitol; proteins such as gelatin; synthetic polymers such as polyvinylpyrrolidone, polyethylene glycol; fatty acids, waxes, shellac, plastics, and plant fibers, e.g., corn protein zein; hydroxypropyl methylcellulose; crosslinked polymers, e.g., crosslinked polyvinylpyrrolidone (crospovidone), and crosslinked sodium carboxymethyl cellulose (croscarmellose sodium); sodium starch glycolate; silicon dioxide, fumed silica, talc, and magnesium carbonate.
It is expected that the gold kiwifruit compositions of the invention will include various components, for example, carbohydrates, dietary fibre, polyphenols, and actinidin. In various aspects, there may be from 10 to 20 mg carbohydrates; from 0.5 to 5.5 mg dietary fibre; from 0.1 to 0.5 mg GAE polyphenols; and from 100 to 500 AU actinidin, per 25 mg powder. In one particular aspect, there may be approximately 18 mg carbohydrates, approximately 3.0 mg dietary fibre, approximately 0.28 mg GAE polyphenols, and approximately 230 AU actinidin, per 25 mg powder.
The gold kiwifruit compositions of the invention may include particular polyphenols as active components. The polyphenols in the composition may still be present upon digestion of the composition, e.g., in vitro digestion, as described in detail herein. For example, following digestion, the chlorogenic acid content of the composition may be at least 40 .mu.g/g, at least 45 .mu.g/g, at least 50 .mu.g/g, or at least 55 .mu.g/g; or from 40 to 60 .mu.g/g; or from 45 to 55 .mu.g/g, based on dry weight. The E-caffeoyl-3-glucoside content of the composition may be at least 45 .mu.g/g, at least 50 .mu.g/g, at least 55 .mu.g/g, at least 60 .mu.g/g, at least 65, at least 70 .mu.g/g, or at least 75 .mu.g/g; or from 40 to 80 .mu.g/g; or from 50 to 70 .mu.g/g, based on dry weight. The epicatechin content of the composition may be at least 6 .mu.g/g, at least 7 .mu.g/g, at least 8 .mu.g/g, at least 9 .mu.g/g, at least 10 .mu.g/g, at least 11 .mu.g/g, at least 12 .mu.g/g, at least 13 .mu.g/g, or at least 14 .mu.g/g; or from 8 to 12 .mu.g/g; or from 9 to 11 .mu.g/g, based on dry weight. The neochlorogenic acid content of the composition may be at least 15 .mu.g/g, at least 18 .mu.g/g, at least 20 .mu.g/g, at least 22 .mu.g/g, at least 25, at least 30 gig/g, or at least 35 .mu.g/g; or from 10 to 30 .mu.g/g; or from 15 to 25 .mu.g/g, based on dry weight.
In further aspects, following digestion, the phlorizin content of the gold kiwifruit compositions may be at least at least 45 .mu.g/g, at least 50 .mu.g/g, at least 55 .mu.g/g, at least 60 .mu.g/g, at least 65, at least 70 .mu.g/g, or at least 75 .mu.g/g; or from 40 to 80 .mu.g/g; or from 50 to 70 .mu.g/g, based on dry weight. The procyanidin B2 content may be at least 15 .mu.g/g, at least 20 .mu.g/g, at least 25 .mu.g/g, at least 30, at least 35 .mu.g/g, at least 40 .mu.g/g, or at least 45 .mu.g/g; or from 20 to 40 .mu.g/g; or from 25 to 35 .mu.g/g, based on dry weight. The quercetin rhamnoside content of the composition may be at least at least 15 .mu.g/g, at least 18 .mu.g/g, at least 20 .mu.g/g, at least 22 .mu.g/g, at least 25, at least 30 .mu.g/g, or at least 35 .mu.g/g; or from 10 to .mu.g/g; or from 15 to 25 .mu.g/g, based on dry weight.
In still further aspects, following digestion, the catechin content of the gold kiwifruit compositions may be at least 0.5 .mu.g/g, at least 1 .mu.g/g, at least 2 .mu.g/g, or at least 3 .mu.g/g; or from 1 to 4 .mu.g/g; or from 2 to 3 .mu.g/g, based on dry weight. The E-caffeoyl-4-glucoside content of the composition may be at least 3 .mu.g/g, at least 4 .mu.g/g, at least 5 .mu.g/g, at least 6 .mu.g/g, at least 7 .mu.g/g, at least 8 .mu.g/g, or at least 9 .mu.g/g; or from 4 to 8 .mu.g/g; or from 5 to 7 .mu.g/g, based on dry weight. The quercetin rutinoside content of the composition may be at least 1 .mu.g/g, at least 2 .mu.g/g, at least 3 .mu.g/g, at least 4 .mu.g/g, or at least 5 .mu.g/g; or from 1 to 5 .mu.g/g; or from 2 to 4 .mu.g/g, based on dry weight.
In the absence of digestion, the gold kiwifruit compositions of the invention may include a total polyphenol content of from 1000 to 1200 mg GAE; or from 900 to 1300 mg GAE; or from 800 to 1400 mg GAE, per 100 g. The content of E-caffeoyl-3-glucoside may be from 60 to 120 .mu.g/g; or from 80 to 100 .mu.g/g; or from 90 to 110 .mu.g/g; or about 80 .mu.g/g, about 90 .mu.g/g, about 100 .mu.g/g, about 110 .mu.g/g, about 115 .mu.g/g, or about 120 .mu.g/g., based on dry weight. The content of epicatechin may be from 20 to 60 .mu.g/g; or from 30 to 50 .mu.g/g; or about 20 .mu.g/g, about 30 .mu.g/g, about 40 .mu.g/g, about 45 .mu.g/g, about 50 .mu.g/g, or about 60 .mu.g/g, based on dry weight. The content of neochlorogenic acid may be from 20 to 60 .mu.g/g; or from 30 to 50 .mu.g/g; or about 20 .mu.g/g, about 30 .mu.g/g, about 39 .mu.g/g, about 40 .mu.g/g, about 41 .mu.g/g, about 50 .mu.g/g, or about 60 .mu.g/g, based on dry weight. The content of procyanidin B2 may be from 40 to 120 .mu.g/g; or from 50 to 100 .mu.g/g; or from 65 to 90 .mu.g/g; or from 60 to 80 .mu.g/g; or about 40 .mu.g/g, or about 50 .mu.g/g, or about 60 .mu.g/g, or about 70 .mu.g/g, or about 75 .mu.g/g, or about 80 .mu.g/g, or about 90 .mu.g/g, or about 100 .mu.g/g, based on dry weight.
The gold kiwifruit compositions of the invention may also include fibre as an active component. In particular aspects, the total fibre content may be from 12.4 to 12.7%, based on dry weight; or from 12.0 to 13.0%; or from 10 to 15%; or about 10%, about 11%, about 12%, about 13%, about 14%, or about 15%, based on dry weight. In additional aspects, the soluble fibre content may be from 3.4 to 3.5% based on dry weight; or from 3.0 to 4.0%; or from 3.2 to 3.8%; or about 3.0%, about 3.1%, about 3.2%, about 3.3%, about 3.4%, about 3.5%, about 3.6%, about 3.7%, about 3.8%, about 3.9%, or about 4.0%, based on dry weight. In further aspects, the insoluble fibre content may be from 8.9 to 9.3%, based on dry weight; or from 8.0 to 10.0%; or from 8.5 to 9.5%; or about 8.0%, about 8.5%, about 9.0%, about 9.5%, or about 10.0%, based on dry weight.
The gold kiwifruit compositions of the invention may also include various sugars, including neutral sugars and uronic acids. Pectic polysaccharides are specifically included in the compositions of the invention, Regarding neutral sugars, the compositions in the invention may include one or more of: rhamnose, arabinose, galactose, and glucose.
The gold kiwifruit compositions of the invention may further include actinidin enzyme. In particular aspects, the actinidin levels may be from 8,000 to 11,000 AU; or from 6,000 to 16,000 AU; from or from 7,000 to 11,000 AU; or from 8,000 to 10,000 AU; or about 8,000 AU, about 9,000 AU, about 10,000 AU, about 11,000 AU, or about 15,000 AU, per gram. Methods for measuring actinidin level are widely known and used in the art. See, e.g., Drummond 2013 and Kaur et al. 2010. For example, it is possible to measure N-.alpha.-CBZ-lys-p-nitrophenol (Z-lys-pNp; Sigma Aldrich Pty Ltd) digestion, for example, at 25.degree. C. (i.e., 77.degree. F.), to determine actinidin levels/activity (Boland & Hardman 1972). Measurements can be expressed as AU/g or AU/mg for the composition. Alternatively, it is possible to measure actinidin levels using fluorescent assays to assess cysteine protease activity (Nieuwenhuizen et al. 2012; Maddumage 2013). In particular, fluorescent substrates Z-FRAMC (benzyloxycarbonyl-Phe-Arg-7-amino-4-methylcoumarin), H-D-Ala-Leu-Lys-AMC, or Bz-Arg-AMC (Feinchemikalien AG) may be used. These measurements can be expressed as FU/g or FU/mg for the composition.
The gold kiwifruit compositions of the invention are expected to be active in stimulating the growth of beneficial enteric organisms (e.g., beneficial bacteria) such as members of Lactobacillus or Bifidobacterium groups, as well as certain members of the Clostridiales group, including Faecalibacterium prausnitzii, as demonstrated herein. Other beneficial organisms may also show increased growth, for example, Erysipelotrichales and Bacteroidales strains. Included as well are beneficial organisms that include Clostridium coccoides, Bacteroides thetaiotaomicron, Bacteroides ovatus, Bacteroides cellulosilyticus, Roseburia intestinalis, Roseburia inulinovorans, Ruminococcus bromii, and Ruminococcus flavefaciens. Also included are beneficial organisms within the groups of Bacteroides-Prevotella-Porphyromonas, and Lachnospiraceae, as well as other organisms described herein.
In various aspects of the invention, the gold kiwifruit composition (e.g., 25 mg of powder, which can be diluted at 0.3 to 0.5 mg/ml powder) may increase the growth of one or more Lactobacillus and/or Bifidobacterium strains (e.g., starting with 1 billion cfu) by at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 100%, or at least 110%. In one particular aspect, 25 mg of powder added to 1 billion cfu of probiotic organism(s) may be used to obtain a growth rate of greater than 50%, relative to the control, which has been normalized to 0%. Such increases may still be observed upon digestion of the composition, e.g., in vitro digestion, as described in detail herein. Preferably, there are no concomitant increases in deleterious enteric organisms (e.g., harmful bacteria) such as Salmonella and/or Staphylococcus strains. In some cases it may be possible to achieve decreases in one or more deleterious organisms.
The gold kiwifruit compositions of the invention may also be active in stimulating the growth of faecal bacteria, including Clostridiales bacteria such as those from the Clostridium leptum phylogenetic group, and in particular Faecalibacterium strains, including Faecalibacterium prausnitzii. Increases in the relative abundance of Faecalibacterium prausnitzii may be at least 20%, at least 30%, at least 40%, at least 50%, at least 60%, at least 70%, at least 80%, at least 90%, at least 100%, at least 150%, or at least 200%; or 20% to 200%; or 50% to 150%; or 70% to 100%, in subjects, e.g., constipated subjects, upon treatment with the gold kiwifruit powder.
The gold kiwifruit compositions of the invention show activity in increasing levels of short chain fatty acids. In particular aspects of the invention, the composition (e.g., 10 mg of powder) may increase the levels of one or more of acetate, butyrate, and propionate by at least 10%, at least 15%, at least 18%, at least 20%, at least 22%, at least 25%, at least 28%, or at least 30%. Such increases may still be observed upon digestion of the composition, e.g., in vitro digestion, as described in detail herein.
Methods of Using Kiwifruit Compositions
As noted above, the gold kiwifruit compositions of the invention can be used to support or improve overall gut health and/or to treat or prevent various conditions of the digestive tract, including inflammation, constipation, microbiota imbalance, irritable bowel syndrome, and inflammatory bowel disease. In addition, the compositions may be used to maintain or improve bowel regularity, and to maintain or increase beneficial bacteria in the digestive tract, including F. prausnitzii.
Constipation may be caused by a disorder of bowel function or a structural problem, and may have one or more symptoms of: reduced bowel movements, incomplete and assisted bowel movements, straining, hard or lumpy stool forms, bloating, flatulence, abdominal pain, and reliance on laxatives, Common causes of constipation include: inadequate water intake; inadequate fibre in the diet; a disruption of regular diet or routine; inadequate activity or exercise; consumption of large amounts of dairy products; stress; avoidance of bowel movements (e.g., due to pain); overuse of laxatives or stool softeners; hypothyroidism; neurological conditions such as Parkinson's disease or multiple sclerosis; antacid medicines containing calcium or aluminium; medicines (especially pain medicines, such as narcotics, antidepressants, or iron supplements); depression; eating disorders; irritable bowel syndrome; pregnancy; colon cancer; and lack of nerve and muscle function in the bowel.
The etiology of microbiota imbalances (e.g., decreases in beneficial organisms, altered ratios of beneficial organisms, and/or increases in deleterious organisms) is complex and yet to be fully elucidated. Imbalances may be caused by certain medicines such as antibiotics, disorders of the digestive tract, or dietary insufficiencies. A gut microbiota imbalance may show up as one or more symptoms of: diarrhoea, particularly antibiotic-associated diarrhoea, runny stools, constipation, and/or bloating.
Microbiota imbalances are correlated with various disorders of the gastrointestinal system, as well as other disorders. In particular, an imbalance in the microbiota may be associated with inflammatory bowel disease, irritable bowel syndrome, coeliac disease, Crohn's disease, ulcerative colitis, necrotizing enterocolitis, intestinal inflammation, enteric infections, carcinogenesis including gastric carcinomas, colorectal carcinomas, cholelithiasis, endotoxemia, hepatic disease such as cirrhosis, and hepatic encephalopathy.
Microbial imbalances in the digestive tract are associated with a number of different health conditions, including:
TABLE-US-00002 System/organ Disorder Observations affected References Crohn's Diversity decrease - reduced F. prausnitzii GIT (Fujimoto et al. 2013; disease Willing et al. 2010) Ulcerative Diversity decrease - reduced A. GIT (Lepage et al. 2011; colitis muciniphila and F. prausnitzii Sokol et al. 2009) Irritable bowel Increased Clostridium cluster IX, decreased GIT (Jeffery et al. 2012; syndrome Bacteroides spp. Maccaferri et al. 2012) GIT cancer Diversity decrease, variation in Bacteroides GIT (Chen et al. 2012; spp., increased Fusobacteria spp., reduced Wang et al. 2012) F. prausnitzii Allergy/Atopy Diversity decrease, increased Systemic (Abrahamsson et al. Enterobacteriaceae, reduced A. muciniphila 2012; Candela et al. and F. prausnitzii 2012) Celiac disease Altered composition, esp in small intestine. GIT (de Sousa Moraes et Fewer lactobacilli and bifidobacteria al. 2014; Kalliomaki et al. 2012) Diabetes Reduced Bifidobacterium spp. and F. Systemic (Furet et al. 2010; Wu prausnitzii et al. 2010) Obesity Increase in ratio of Firmicutes to Systemic (Ley et al. 2006; Bacteroidetes Turnbaugh et al. 2008) Autism Increased Sutterella spp., decreased A. Brain (Wang et al. 2011; muciniphila and Bifidobacterium spp. Williams et al. 2012) Atherosclerosis .sup.1 Involvement of Veillonella spp., Arteries (Koeth et al. 2013; Streptococcus spp. and Prevotella Koren et al. 2011) enterotype Depression and Changes in gut microbiota as a whole and Brain (Desbonnet et al. anxiety .sup.1 decreased Bifidobacterium spp. 2008; Neufeld et al. 2011) Infant colic .sup.1 Increased Proteobacteria and reduced GIT (de Weerth et al. bifidobacteria and lactobacilli 2013; Savino et al. 2007) Multiple Changes in gut microbiota as a whole and Brain (Lee et al. 2011; sclerosis .sup.1 presence of Clostridium perfringens Type B Rumah et al. 2013) Parkinson's Decreased Prevotellaceae and increased Brain (Murata et al. 2013; disease .sup.1 Clostridium spp. Scheperjans et al. 2014) Rheumatoid Changes in gut microbiota as a whole and Systemic (Abdollahi-Roodsaz et arthritis .sup.1 decreased Bacteroides spp. al. 2008; Vaahtovuo et al. 2008) .sup.1 Preliminary evidence for link between colonic microbiota and these disorders. GIT, gastrointestinal tract. Table modified from de Vos & de Vos 2012.
Inflammation of the digestive tract may be associated with various conditions including atrophic glossitis, angular cheilitis, orofacial granulomatosis, esophagitis, gastritis, including atrophic gastritis, pyloric stenosis, colitis, ileitis, Crohn's disease, coeliac disease, inflammatory bowel disease, irritable bowel syndrome, lesions, fissures, and various ulcers, including ulcers of the mouth, esophagus, stomach, and intestines, and specifically including ulcerative colitis. Inflammation may also be associated with deleterious organisms, such as bacterial, protozoan, and/or viral organisms, including the groups/organisms of Enterobacteriaceae, Pasteurellaceae, Veillonellaceae, Fusobacteriaceae, Proteobacteria, Campylobacter, Shigella, Yersinia, Listeria, Salmonella, Escherichia coli, Staphylococcus aureus, Clostridium difficile, Helicobacter pylori, Mycobacterium avium, Enterococcus faecalis, Fusobacterium varium, Giardia, Entamoeba histolytica, rotavirus, norovirus, adenovirus, astrovirus, and measles virus. In certain circumstances, inflammation may result from injury, medication, or surgery.
The gold kiwifruit compositions of the invention find use for treating or preventing gastrointestinal inflammation, constipation, bowel irregularity, microbiota imbalance, irritable bowel syndrome, inflammatory bowel disease, or other conditions described herein. As exemplary dosages, the compositions may be administered from 250 to 2500 mg; 500 to 5000 mg; 1000 to 4000 mg; or from 1500 to 4500 mg; or from 2000 to 3000 mg; or at about 250 mg, about 500 mg, about 600 mg, about 800 mg, about 1000 mg, about 1200 mg, about 1500 mg, about 1700 mg, about 1800 mg, about 2000 mg, about 2200 mg, about 2300 mg, about 2400 mg, about 2500 mg, about 2600 mg, about 2700 mg, about 2800, about 2900, about 3000 mg, about 3200, about 3500, about 3600 mg, about 4000 mg, about 4200 mg, about 4800 mg, about 5000 mg, about 5400 mg, about 6000 mg, or about 6600 mg, of gold kiwifruit powder per day, or equivalent dosage if a liquid form is used. Administration may be carried out once daily, twice daily, or three times daily. Administration may be made with food, or before a meal. The appropriate dosage and dosage form will be readily determined by a person of skill in the art.
Various routes of administration may be used for the gold kiwifruit compositions of the invention, including enteral administration, oral administration, and rectal administration. Oral administration may be by tablet, capsule, sachet, drops, elixir, linctus, solution, emulsion, suspension, draught, puree, paste, syrup, gel, jelly, tonic, or other known means. Enteral administration may be by duodenal tubing or gastric tubing, including nasogastric tubing. Rectal administration may be by enema, suppository, or other suitable means. Different means of administration are known in the art and may be utilised by a skilled person. The compositions of the invention are not limited to a particular form for administration.
In particular aspects, the compositions of the invention may be co-administered with one or more probiotic organisms. For example, the gold kiwifruit composition may be formulated as a combined dosage form with one or more probiotics. Alternatively, the gold kiwifruit composition may be administered as a separate dosage form along with one or more probiotics. Exemplary probiotic organisms include but are not limited to: Bacillus coagulans, e.g., GBI-30 and 6086 strains; Bifidobacterium longum, e.g., subsp. infantis 35624; Lactobacillus acidophilus, e.g., NCFM and CL1285 strains; Lactobacillus paracasei, e.g., St11 and NCC2461 strains; Lactobacillus johnsonii, e.g., La1 and NCC533 strains; Lactobacillus LC1; Lactobacillus plantarum, e.g., 299v and HEAL 9 strains; Lactobacillus reuteri, e.g., ATCC 55730, SD2112, Protectis (DSM 17938, daughter strain of ATCC 55730), Prodentis (DSM 17938/ATCC 55730 and ATCC PTA 5289 in combination), and RC-14.RTM. strains; Saccharonmyces boulardii; Lactobacillus rhamnosus e.g., a GR-1.RTM. strain; Lactobacillus casei, e.g., a LBC80R strain; Lactobacillus bulgaricus; Streptococcus thermophilus; and Lactobacillus bifidus. Other organisms that may be useful as probiotics include Faecalibacterium strains, including Faecalibacterium prausnitzii, and also Bacteroidaceae strains such as Bacteriodes fragilis.
In other aspects, the gold kiwifruit compositions of the invention may be co-administered with one or more prebiotic agents, e.g., as a combined dosage form or as separate dosage forms. As have been previously identified, prebiotic agents are comprised of non-digestible fibre or fermentable compounds that pass through the upper part of the digestive tract and stimulate the growth and/or activity of beneficial organisms that colonise the large intestine by acting as substrate for them.
These agents may be short-chain, long-chain, or full-spectrum prebiotics. Short-chain prebiotics include 2 to 8 links per saccharide molecule. Long-chain prebiotics include 9 to more than 60 links per saccharide molecule. Full-spectrum prebiotics include a full range of molecular link-lengths from 2 to more than 60 links per saccharide molecule. Exemplary prebiotic agents include but are not limited to: oligofructose, inulin, oligofructose-enriched inulin, fructo-oligosaccharides, xylooligosaccharides, polydextrose, galacto-oligosaccharides, trans-galacto-oligosaccharides, mannan oligosaccharides, lactulose, tagatose, and starch.
Based on the results shown herein, it is believed that the polyphenols present in the disclosed compositions may be acting as prebiotic agents. Thus, it may be useful to add one or more phenolic compounds to the compositions of the invention, to supplement the prebiotic activity therein. Exemplary compounds include but are not limited to: phenolic derivatives such as phenolic acid, and flavonoids such as lignins, proanthocyanidins, anthocyanins, anthocyanidins, isoflavones, catechins, tannins, quercetin, naringenin, and hesperidin. Particularly encompassed are phenolic compounds extracted from one or more of: tea, cocoa, wine, soybeans, feijoa, citrus fruits, apples, grapes, berries, and kiwifruit, particularly gold kiwifruit, including Hort16 and Gold3. Specific phenolics from Gold3 gold kiwifruit include but are not limited to: catechin, chlorogenic acid, E-caffeoyl-3-glucoside, E-caffcoyl-4-glucoside, epicatechin, neochiorogenic acid, phlorizin, procyanidin B1 and B2, quercetin rhamnoside, and quercetin rutinoside.
In further aspects, the compositions of the invention may be co-administered with one or more synbiotic (combined prebiotic and probiotic) agents. For example, the gold kiwifruit powder may be formulated as a combined dosage form with one or more synbiotics. Alternatively, the gold kiwifruit may be administered as a separate dosage form along with one or more synbiotics. As examples, Bifidobacteria or Lactobacilli may be combined with fructo-oligosaccharides or insulins or galactooligosaccharides. Particular synbiotic combinations include but are not limited to: Bifidobacteria and fructo-oligosaccharides; Lactobacillus rhamnosus, e.g., a GG strain, and insulins.
As additional aspects, the compositions of the invention may be co-administered with fibre and/or digestive enzymes. For example, the gold kiwifruit powder may be formulated as a combined dosage form with one or more compositions comprising fibre and/or digestive enzymes. Alternatively, the gold kiwifruit powder may be formulated as administered as a separate dosage form with one or more compositions comprising fibre and/or digestive enzymes. Exemplary fibre compositions include soluble and/or insoluble fibre compositions, for example, compositions including one or more of wheat dextrin, calcium polycarbophil, psyllium, inulin, methylcellulose, glucomannan, flax, flaxseed, wheatgrass, acacia senegal, and rhubarb. Exemplary digestive enzymes include, but are not limited to: actinidin, protease, lipase, amylase, cellulose, pancreatin, pepsin, bromelain, papain, trypsin, and chymotrypsin. Combinations of digestive enzymes may also be used, for example, combinations of protease, lipase, and amylase, including those with or without added actinidin.
In further aspects, the gold kiwifruit compositions of the invention may be co-administered with one or more anti-inflammatory agents and/or anti-microbial agents. Of particular interest is use of the composition of the invention as a prebiotic supplement during and/or following antibiotic treatment. For example, the gold kiwifruit powder may be formulated as a combined dosage form with one or more anti-inflammatory/anti-microbial agents. Alternatively, the gold kiwifruit may be administered as a separate dosage form along with one or more anti-inflammatory/anti-microbial agents. Exemplary anti-inflammatory/anti-microbial agents include but are not limited to aminosalicylates, for example, mesalazine (e.g., Pentasa.RTM.) and sulphasalazine (e.g., Salazopyrin.RTM.), corticosteroids, for example, budesonide (e.g., Entocort.RTM.) and hydrocortisone acetate (e.g., Colifoam.RTM.), and include also azathioprine (e.g., Azasan.RTM., Imuran.RTM.), mercaptopurine (e.g., Purinethol.RTM., Purixan.TM.), cyclosporine (e.g., Gengraf.RTM., Neoral.RTM., Sandimmune.RTM.), infliximab (e.g., Remicade.RTM.), adalimumab (e.g., Humira.RTM.), golimumab (e.g., Simponi.RTM.), methotrexate (e.g., Rheumatrex.TM., Methoblastin.TM.), natalizumab (e.g., Tysabri.TM.), vedolizumab (e.g., Entyvio.TM.), ustekinumab (e.g., Stelara.RTM.), and antibiotics including metronidazole (e.g., Flagyl.RTM.) and ciprofloxacin (e.g., Cipro.RTM., Ciplox.TM.).
EXAMPLES
The examples described herein are provided for the purpose of illustrating specific embodiments of the invention and are not intended to limit the invention in any way.
Example 1
Preparation of Kiwifruit Powder
Frozen gold kiwifruit puree (Frozen Gold Kiwifruit Puree Single Strength (Seed Out)) was obtained from Kiwifruit Processing Company Ltd, Tauranga, New Zealand. The puree was made from 100% New Zealand gold kiwifruit (Actinidia chinensis G3) grown to Zespri.RTM. export standards, and hand graded. The puree was produced by manufacturing processes to remove the skin and seeds to leave a smooth and rich puree.
The product specification of the frozen gold kiwifruit puree follows:
The colour is kiwifruit gold, with some variation in colour being normal. The taste is typical of ripe gold kiwifruit. The texture is smooth and seedless. The puree has nil quantities of rotten or fermented fruit, or foreign bodies, and contains no detectable E coli. The Brix value is 16 to 21.degree.. The viscosity (at 12.5.degree. Brix, 20.degree. C.) is approximately 12.0, but can vary when fruit is held across a season. The pH is 3.2 to 3.8. The sieve size is <1 mm. The product is kept frozen at -18.degree. C. until use.
In addition, frozen green kiwifruit puree (Frozen Green Kiwifruit Puree Single Strength (Seed Out)) was obtained from Kiwifruit Processing Company Ltd, Tauranga, New Zealand. The puree was made from 100% New Zealand green (Actinidia deliciosa, Hayward variety) kiwifruit grown to Zespri.RTM. export standards, and hand graded. The puree was produced by manufacturing processes to remove the skin and seeds to leave a smooth and rich puree.
The product specification of the frozen green kiwifruit puree follows:
The colour is kiwifruit green, with some variation in colour being normal. The taste is typical of ripe green kiwifruit. The texture is smooth and seedless. The puree has nil quantities of rotten or fermented fruit, or foreign bodies, and contains no detectable E. coli. The Brix value is 13 to 18.degree.. The viscosity (at 12.5.degree. Brix, 20.degree. C.) is approximately 12.0, but can vary when fruit is held across a season. The pH is 3.2 to 3.8. The sieve size is <1 mm. The product is kept frozen at -18.degree. C. until use.
The process for obtaining kiwifruit powder was as follows:
1) Frozen Gold3 puree was purchased from Kiwifruit Processing Company Ltd, Tauranga, New Zealand.
2) The frozen puree was lyophilised (freeze-dried). The lyophilisation process was typically performed for up to about 48 hours, at temperatures not exceeding 70.degree. C. The resulting dried material was then milled through a US 20 mesh to produce a free-flowing powder. 3) The same method was used to obtain green kiwifruit powder.
Example 2
Polyphenol Measurement for Kiwifruit Powders
The polyphenol profiles of green and gold kiwifruit powders were tested. Lyophilised (freeze-dried) green (Hayward) and gold (Gold3) kiwifruit powders were prepared in accordance with Example 1.
The powders were digested using an in vitro upper gastro-intestinal model as described in Monro et al. 2010. Briefly, 20 mL of water and 5 mL 20% saline solution were added to 5 g of samples at pH 2.5 before vortexing. Then 1 mL of 1% pepsin in 0.05 M hydrochloric acid was added, followed by 30 minute incubation at 37.degree. C. with slow constant mixing (220 rpm), The samples were adjusted to pH 6.5, followed by the addition of 5 mL of 2.5% bile extract obtained from Sigma Aldrich.RTM., and 1 mL of 5% pancreatin in 3% sodium chloride (NaCl).
The samples were then vortexed and incubated at 37.degree. C. with slow constant mixing (220 rpm) for 2 hours. The digested samples were then transferred to dialysis bags (500 Da MWCO, obtained from Thermofisher Scientific) and dialysed in 10 mM NaCl at 4.degree. C. overnight, followed by a change in dialysis fluid and a further 2 hours at 2.degree. C., representing absorption in the small intestine. The samples were stored at -80.degree. C. then freeze dried.
Pre and post-digested samples of the freeze dried green and gold powders (100 mg) were extracted with 5 mL ethanol/water/formic acid (80:20:1). The extraction mixture was sonicated for 30 minutes then stored overnight. Samples were centrifuged at full speed to remove particulates and diluted 2.times. prior to liquid chromatography--mass spectrometry (LC-MS) analysis. Details are provided in Table 2, below.
TABLE-US-00003 TABLE 2 LC-MS analysts for pre- and post-digested kiwifruit powders LCMS Dionex Ultimate .RTM. 3000 Rapid Separation LC with micrOTOF QII mass spectrometer Column Zorbax .TM. SB-C18 2.1 m .times. 100 mm, 1.8 .mu.m Mobile phase flow 350 .mu.L/min Solvents A = 100% acetonitrile B = 0.2% formic acid Gradient 10% A, 90% B, 0-0.5 min Linear to 50% A, 50% B, 0.5-18 min Linear to 100% A, 18-30 min Held at 100% A for 30-40 min Linear to 10% A, 90% B, 40-40.2 min Injection volume 2 .mu.L MS parameters Drying N.sub.2 temperature: 200.degree. C. Drying N.sub.2 flow: 8 L/min Nebulizer N.sub.2: 1.5 bar Mass range: 100-1500 Da Acquisition rate: 2 scan/s
Compound concentrations were calculated using calibration curves from authentic standards.
As shown in FIG. 1, digested Gold3 powder (simulated upper gastrointestinal digestion) has an altered polyphenol profile compared to pre-digestion (FIG. 1); however, the overall phenolic content is retained. In particular, 269 .mu.g/g polyphenol content pre-digestion versus 264 .mu.g/g phenol content post-digestion was observed for the Gold3 powder (FIG. 1; combined total for phenolic compounds tested). Green kiwifruit powder also shows an altered polyphenol profile post-digestion, but the overall content is reduced by digestion (FIG. 1). For the green kiwifruit powder, the overall polyphenol content was 258 .mu.g/g pre-digestion versus 153 .mu.g/g post-digestion (FIG. 1; combined total for phenolic compounds tested).
Example 3
Microbial High-throughput Assays for Kiwifruit Powders
Gold3 gold kiwifruit powder was obtained from a paste formula (prepared by Cedenco Foods, New Zealand), which was drum-dried with pea starch (14.28:1 wet weight in). A sample (5 g) of the powder was digested in vitro using an upper gastro-intestinal model as described in Example 2.
The digested material was then solubilised in either water or dimethyl sulfoxide (DMSO) to a uniform concentration of 100 mg/mL. The samples were then diluted 100-fold with sterile deionised water to reduce the DMSO to a manageable concentration to prevent bacterial lysis. The water and DMSO `extracts` were added to microbial high-throughput assay wells to a final concentration of 1.0 mg/mL
The organisms used in the study included probiotic Escherichia coli Nissle 1917, Lactobacillus rhamnosus HN001 (DR20), Bifidobacterium lactis HN019 (DR10), and pathogenic Salmonella enterica serovar Typhimurium ATCC 1772 and Staphylococcus aureus ATCC 25932.
A ninety-six-well microplate growth bioassay measuring optical density (OD) as described in Rosendale et al. 2008, was used for this work. The change in growth (.DELTA.growth) was calculated and used to represent the magnitude of effect. This was calculated by converting the OD to a percentage of the control OD, then subtracting 100, effectively normalizing the control growth to a baseline value of zero.
One strain of bacterium per microplate was used and each extract was analysed in quadruplicate per microplate at a range of concentrations (0, 0.0124, 0.037, 0.111, 0.333, 1 mg/mL). The microplates were inoculated with an equal volume (50 .mu.L) of bacterial inoculum and the OD measured immediately at a wavelength of 595 nm with a plate reader (FLUOstar Optima.RTM.) to determine the blank/zero growth value. The microplates were incubated at 37.degree. C. for 24 hours, then the OD determined to measure the growth of the cultures.
The results showed that the Gold3 gold powder supported the growth of Bifidobacteria and Lactobacillus strains, whilst not affecting a significant change in the numbers of pathogenic bacteria, versus the control (FIG. 2).
Example 4
Mixed Fermentation Model for Testing Kiwifruit Powders
Gold3 gold kiwifruit powder was obtained from a paste formula (prepared by Cedenco Foods, New Zealand), which was drum-dried with pea starch (14.28:1 wet weight in). A sample (5 g) of powder was digested in accordance with Example 2. The digested sample was solubilised in water to a final concentration of 10 mg/mL.
Freshly voided faecal samples were collected from three healthy human volunteers. The digested gold powder was incubated in a test tube inoculated with mixed microbiota from a single faecal donor, repeated for each of the three donors. Hungate tubes containing pre-reduced fermentation media (9 mL) under carbon dioxide were supplemented with 1 mL of the sample or control and inoculated with 1 mL of a 10% (w/v) faecal slurry. The tubes were incubated at 37.degree. C. with gentle (150 rpm) orbital shaking. Subsamples were periodically (0, 5, 10, 24, 48 hrs) removed with a syringe and 22 gauge needle through the rubber septum to prevent exposure of the sample to the atmosphere.
The samples removed from the fermentation tubes were collected into 1.5 mL Eppendorf Tubes.RTM. and centrifuged immediately at 13,000.times.g for 5 minutes. The cell--and particle-free supernatants were collected into fresh Eppendorf Tubes.RTM. and frozen at -80.degree. C. until required.
The supernatant was defrosted and diluted 1:4 in 0.01 M phosphate buffered saline with 2-ethylbutyrate (5 mM final concentration) as an internal standard. The sample was then centrifuged at 3,000.times.g for 5 minutes at 4.degree. C. The supernatant (0.25 mL) was acidified with concentrated hydrochloric acid (0.125 mL), diethyl ether (0.5 mL) was added, then vortexed and centrifuged at 10,000.times.g for 5 minutes (4.degree. C.), The upper diethyl ether phase was collected, dried with magnesium sulphate, and derivatised with N-tert-butyldimethylsilyl-N-methyltrifluroroacetamide with 1% tert-butyldimethylchlorosilane by heating to 80.degree. C. for 20 minutes.
The concentrations of the microbial organic acid metabolites in the fermentation samples were quantified by gas chromatography (GC) as per Table 3 below.
TABLE-US-00004 TABLE 3 GC analysis of organic acid metabolites GC Shimazdu GC-17A with flame ionisation detector (FID) Column 10 m .times. 0.53 mm ID .times. 2.65 .mu.m Carrier gas Helium Flow rate 37 mL/min Pressure 7 kPa, increasing to 15 kPa at 0.8 kPa/hr Hold for 4 min Temperature programme 70.degree. C. increasing to 80.degree. C. at 10.degree. C./min Increase to 255.degree. C. at 20.degree. C./min Hold for 5 min Injector and detector 260.degree. C. temperature Injection volume 1 .mu.L, splitless
Organic acid standard mixtures of known concentration were analysed alongside the samples and used to create standard curves with relative peak areas standardised to the 2-ethylbutyrate response. Results were expressed as .mu.mol organic acid/mL fermenta.
As shown in FIG. 3, the presence of the Gold3 gold kiwifruit powder promoted an increase in organic acid production, particularly after the first 12 hours of exposure. Given the increase observed, this indicates that the non-digestible fermentable components (carbohydrates and polyphenols) in the gold powder were broken down and used as a growth and energy-generating substrate. This is consistent with action as a prebiotic.
Example 5
Clinical Trial to Test Gold3 Gold Kiwifruit Powder for Improving Regularity
Clinical Protocol Overview
The study was designed as a randomised double-blind placebo controlled cross-over trial with participants consuming four different interventions for 4 weeks each, with a 2 week washout between each intervention. A schematic view of the trial design is shown in FIG. 4.
Clinical Trial Participants
Two groups of participants were recruited through newspaper and radio advertisements, community, local district health board, Canterbury University (Christchurch, New Zealand), Lincoln University (Lincoln, New Zealand), newsletters, posters in doctors' general practice surgeries and through our existing database of prior participants.
Twenty-nine total participants were recruited from fifty-one total volunteers. The participants were split into two cohorts: cohort 1 ("healthy"): those participants without clinical symptoms of constipation; and cohort 2 ("functionally constipated"): those participants classified as having C3 functional constipation based on the Rome III criteria.
Rome III Criteria:
1) Must include two or more of the following: a) straining during at least 25% of defecations; b) lumpy or hard stools in at least 25% defecations; c) sensation of anorectal obstruction or blockage for at least 25% defecations; d) sensation of incomplete evacuation for at least 25% defecations; e) manual manoeuvres to facilitate at least 25% defecations; f) three or fewer defecations per week; 2) Loose stools are rarely present without the use of laxatives; and 3) Insufficient criteria for irritable bowel syndrome.
Inclusion criteria were: age 18-60; BMI limits between 19 and 30 k/m.sup.2; fasting blood glucose under 5.6 mmol/L; subjects were required to be willing to maintain his or her habitual food and beverage intake (other than substitution of study food for similar products) and physical activity pattern throughout the study period; subjects were asked to exclude high fibre supplements such as Metamucil.RTM., Benefibre.RTM. and Phloe.TM. as well as refraining from eating fresh kiwifruit for the study period; participants were asked to avoid overseas travel for the period of the study due to the impact this may have on diet.
Exclusion criteria were: presence of gastrointestinal alarm symptoms (including blood in stools, frequent diarrhoea, unremitting abdominal pain); dieters or people who are following vegan, raw food diets or very high fibre diets; gastroparesis or lactose intolerance; surgery for weight loss (lapband or gastric bypass); pregnant women; clinically significant renal, hepatic, endocrine, cardiac, pulmonary, pancreatic, neurological, hematologic or biliary disorders; and known allergy or sensitivity to kiwifruit.
The "healthy" group was comprised of participants that were without clinical symptoms of constipation. The "functionally constipated" (FC) group was selected based on Rome III criteria (Drossman 2006) as having C3 functional constipation. Twenty participants (2 male and 18 female) were recruited into the healthy group. The average age was 38 years (range 23-56 years) and the average body mass index was 23 kg/m.sup.2 (range 19-29 kg/m.sup.2). Nine participants (1 male and 8 female) were recruited into the FC group. The average age was 44 years (range 38-54 years) and the average body mass index was 25 kg/m.sup.2 (range 21-29 kg/m.sup.2). See also Table 6, further below.
Nineteen of the twenty participants in the healthy group completed the study. One female participant withdrew due to personal reasons. All nine participants in the FC group completed the study. The order in which participants were allocated their intervention was randomised by a biostatistician using a Williams Latin Square design and computer generated random numbers. Upon completion of the analyses, the study was unblinded to reveal the intervention order. Ethical approval was obtained from the New Zealand Human Disability and Ethics Committee under expedited review (Application number 12/STH/72/AM01), and was registered with the Australia New Zealand Clinical Trials Registry. Registration number ACTRN: 12612001270808.
Clinical Testing Methods
The interventions were delivered in 4.times.600 mg capsules supplied by Anagenix Limited (Wellington, New Zealand) prepared to look identical to preserve intervention blinding (Table 4).
TABLE-US-00005 TABLE 4 Description of intervention composition Delivery - capsules/ Intervention Treatment Dose day ACTAZIN .TM. L Green Kiwifruit 600 mg 1 .times. ACTAZIN .TM. + Powder 3 .times. Placebo ACTAZIN .TM. H Green Kiwifruit 2400 mg 4 .times. ACTAZIN .TM. Powder GOLD Gold (G3) Kiwifruit 2400 mg 4 x GOLD Powder Placebo Isomalt coloured 2400 mg 4 .times. Placebo green (E102, E142)
TABLE-US-00006 TABLE 5 Nutritional information of the interventions used, ACTAZIN .TM. and GOLD Nutrition information (per 100 g) GOLD ACTAZIN .TM. Energy, kJ 1420 1435 Protein, g 3.9 3.4 Fat, total, g 1.8 3.0 Saturated, g 0.34 0.75 Unsaturated, g 1.4 2.4 Monounsaturated, g <0.10 0.53 Polyunsaturated, g 1.4 1.8 Carbohydrate, g 71 67 Sugars, total, g 58 46 Sucrose, g <0.05 <0.05 Glucose, g 27 21 Fructose, g 31 25 Lactose, g <0.05 <0.05 Maltose, g <0.05 <0.05 Dietary fibre, g 12 16 Sodium, mg 18 13 Total polyphenols, mg GAE 1100 900 Actinidin, AUs/g 9100 40700
All participants consumed four different intervention combinations: Placebo (isomalt coloured green) (2400 mg/day), ACTAZIN.TM. L (600 mg/day), ACTAZIN.TM. H (2400 mg/day) and GOLD (2400 mg/day) for 28 d each intervention, with a 14 d washout period between each treatment phase.
ACTAZIN.TM. L (low dose, green kiwifruit) and ACTAZIN.TM. H (high dose, green kiwifruit) were formulated from cold-processed Actinidia deliciosa `Hayward` green kiwifruit and GOLD was formulated from cold-processed Actinidia chinensis `Zesy002` Gold3 gold-fleshed kiwifruit, See Example 1.
At the beginning and end of each 4 week intervention period, participants were asked to provide a faecal sample. The washout period of 2 weeks was chosen to allow sufficient time to return bowel habits to baseline for the parameters measured (microbial ecology, microbial metabolites).
At the beginning and end of each intervention period, participants were also asked to provide a faecal sample and to complete the Birmingham Irritable Bowel Syndrome (IBS) symptom questionnaire (Johnston et al. 2010) as well as an IBS specific quality of life questionnaire (Patrick et al. 1998) relating to wellness.
For each day from baseline until the end of the study, the participants recorded various parameters in the daily diaries provided. These parameters included: 1) number of bowel movements; 2) incomplete and assisted bowel movements; 3) straining; 4) stool form as determined by the Bristol stool scale; 5) bloating; 6) flatulence; 7) abdominal pain; 8) laxative use.
Data were analysed using analysis of variance (ANOVA) in GenStat (v.16, 2013, VSNi Ltd., Hemel Hempstead, UK). Data from the two cohorts were analysed separately. Results from each observation period were analysed as a complete block design, with participant and participant.times.phase as blocks, and phase (1, 2, 3, or 4) and intervention (including washout) as factors. Mean washout data were used as baseline for the purposes of the statistical analysis. Residuals were inspected to ensure the assumptions of ANOVA were met; where necessary data were log-transformed to stabilise variance.
Post hoc subgroup analysis was conducted on the healthy cohort using Cochran's Q test to compare those participants responding to each intervention (i.e., with a rise of at least one bowel movement per week over the preceding washout period). Participants were then classified as either responder (showed a response to at least one of the non-placebo interventions) or non-responder; data from the responders subgroup (14 of 19 participants (74%)) was analysed using ANOVA.
The primary study outcome was a significant increase in stool frequency.
Example 6
Results of Treatment on Improving Regularity
The demographics of the participants are shown in Table 6. Compliance within the healthy and functionally constipated cohorts was 98%.+-.9 and 99%.+-.8, respectively.
TABLE-US-00007 TABLE 6 Demographics of the study participants Baseline characteristics Healthy Functionally constipated N 20 9 Male 2 1 Female 18 8 Age in years (Mean .+-. SD) 38 .+-. 11 44 .+-. 6 Age (Range) 23-56 38-54 Weight in kg (Mean .+-. SD) 68 .+-. 13 67 .+-. 8 Weight (Range) 47-101 53-79 BMI in kg/m.sup.2 (Mean .+-. SD) 23 .+-. 3 25 .+-. 2 BMI (Range) 19-29 21-29 Compliance (%) 98 .+-. 9 99 .+-. 8 BMI--Body Mass Index; SD--Standard Deviation
The results of this study are summarized in Tables 7 and 8.
In the healthy cohort (n=19), significant differences between the interventions and washout were observed for the number of daily bowel movements (p=0.002), Bristol stool score (p=0.036), strain (p=0.044) and flatulence (p=0.007). The number of daily bowel movements for the ACTAZIN-H and GOLD interventions were significantly higher (p=0.014 and p=0.009, respectively) compared to washout, with an approximate increase of 0.8 bowel movements per week with each intervention. Table 7.
In the responder sub-group (n=14), consumption of ACTAZIN-L, ACTAZIN-H and GOLD resulted in a significant increase in daily bowel movements (p=0.005, p<0.001, and p=0.001, respectively) when compared to washout. Table 7.
Consumption of the interventions for 28 days was generally well tolerated with no serious adverse events reported, and no effects (p<0.05) on well-being parameters recorded in the daily questionnaires except for self-reported flatulence, which was higher in the healthy cohort ACTAZIN-H group (p=0.007). Table 7.
In the individuals with functional constipation (n=9), the dietary interventions did not significantly increase the frequency of bowel movements compared with the washout. Table 8. This was attributed to the small sample size of the study, which has limitations in its statistical power to detect significant differences in stool frequency. However, the functionally constipated group showed overall improvement in digestive parameters, and an abatement of other symptoms of constipation.
In the functionally constipated group, comprehensive improvement was seen in the Digestive Health Index. FIG. 5A. Eight out of nine of the functionally constipated participants showed improvement in gastrointestinal health parameters, as calculated from the sum of the average change from washout for: straining, incomplete evacuation, manual manoeuvres, bloating, wind, laxative use, and pain. FIG. 5A. Scoring for each parameter was obtained from the participants' daily diaries.
An increase of greater than one bowel movement per week in a symptomatic population is considered a clinically meaningful magnitude of effect (Food and Drug Administration 2012), and would potentially improve the symptoms of sufferers of mild or occasional constipation. ACTAZIN.TM. and GOLD, which are derived from green (Hayward) and gold (Gold3) kiwifruit, have demonstrated this degree of efficacy in a healthy population. In particular, an increase of approximately 1.5 bowel movements per week each was observed in the responder sub-group of healthy cohorts compared to washout.
In summary, this study showed that ACTAZIN.TM. and GOLD improved regularity and laxation without affecting the stool form for the healthy cohort. For the functionally constipated group, GOLD improved overall digestive parameters and relieved key symptoms of constipation, including straining, incomplete evacuation, manual manoeuvres, bloating, wind, laxative use, and pain.
TABLE-US-00008 TABLE 7 Analysis of variance results for daily diaries, Birmingham IBS symptoms, and IBS-quality of life questionnaires in the healthy cohort Analysis of variance P-value Washout versus Means average of Healthy cohort (n = 19) Placebo ACTAZIN-L ACTAZIN-H GOLD Washout treatments (1 df) Daily diaries questionnaire Number of daily bowel 1.12 1.16 1.19 1.20 1.08 0.002 movements Bristol stool scale 3.61 3.52 3.61 3.62 3.42 0.036 Strain 0.22 0.22 0.24 0.22 0.28 0.044 Incomplete evacuation 0.14 0.14 0.13 0.17 0.18 0.137 Bloating 0.17 0.15 0.13 0.16 0.14 0.497 Flatulence 0.60 0.64 0.67 0.64 0.58 0.007 Manual manoeuvres 0.00 0.02 0.01 0.02 0.01 0.860 Laxatives 0.01 0.00 0.00 0.00 0.00 0.786 Abdominal pain 0.12 0.11 0.05 0.08 0.08 0.339 Birmingham IBS symptom questionnaire Constipation 1.73 1.94 1.45 2.06 2.23 0.093 Diarrhoea 1.22 1.32 1.43 1.28 1.11 0.222 Pain 1.57 1.11 0.69 0.82 1.10 0.707 IBS - Quality of life questionnaire Dysphoria 8.61 8.38 8.33 8.27 8.38 0.891 Interference with 7.39 7.68 7.93 7.42 7.65 0.743 activity Body Image 4.41 4.67 4.45 4.35 4.69 0.114 Health worry 3.61 3.46 3.60 3.35 3.67 0.067 Food avoidance 3.87 4.25 4.42 4.25 4.22 0.855 Social Reaction 4.26 4.27 4.33 4.16 4.35 0.074 Sexual 2 2 2 2 2 -- Relationships 3.09 3.27 3.43 3.05 3.24 0.676 Responders (n = 14) Number of daily bowel 1.27 1.35 1.39 1.38 1.18 <0.001 movements Analysis of variance P-value Treatment Post-hoc P-values differences Washout versus intervention Healthy cohort (n = 19) (3 df) Placebo ACTAZIN-L ACTAZIN-H GOLD Daily diaries questionnaire Number of daily bowel 0.918 0.377 0.060 0.014 0.009 movements Bristol stool scale 0.806 0.134 0.421 0.138 0.113 Strain 0.349 0.157 0.150 0.363 0.166 Incomplete evacuation 0.432 0.310 0.306 0.174 0.699 Bloating 0.490 0.223 0.757 0.631 0.503 Flatulence 0.572 0.511 0.073 0.007 0.075 Manual manoeuvres 0.339 0.247 0.637 0.343 0.234 Laxatives 0.703 0.156 0.494 0.475 0.475 Abdominal pain 0.375 0.021 0.083 0.103 0.980 Birmingham IBS symptom questionnaire Constipation 0.243 0.218 0.471 0.058 0.672 Diarrhoea 0.881 0.691 0.428 0.209 0.514 Pain 0.100 0.037 0.957 0.069 0.202 IBS - Quality of life questionnaire Dysphoria 0.272 0.134 0.958 0.727 0.441 Interference with 0.604 0.186 0.858 0.133 0.235 activity Body Image 0.592 0.202 0.915 0.277 0.121 Health worry 0.907 0.646 0.138 0.607 0.030 Food avoidance 0.063 0.128 0.889 0.383 0.896 Social Reaction 0.323 0.299 0.316 0.823 0.023 Sexual -- -- -- -- -- Relationships 0.058 0.149 0.788 0.064 0.068 Responders (n = 14) Number of daily bowel 0.999 0.117 0.005 <0.001 0.001 movements
TABLE-US-00009 TABLE 8 Analysis of variance results for daily diaries, Birmingham IBS symptoms, and IBS-quality of life questionnaires in the FC cohort ANOVA p-values Washout vs. Difference average of between Placebo ACTAZIN-L ACTAZIN-H GOLD Washout interventions interventions Daily diaries questionnaire Number of 0.96 0.92 0.88 0.99 0.93 0.999 0.840 daily bowel movements Bristol stool 3.00 2.93 2.82 2.92 2.78 0.210 0.215 scale Strain 0.55 0.43 0.38 0.41 0.49 0.321 0.527 Incomplete 0.52 0.40 0.41 0.39 0.41 0.720 0.671 evacuation Bloating 0.09 0.14 0.12 0.14 0.12 0.836 0.533 Wind 0.46 0.32 0.49 0.23 0.43 0.254 0.228 Manual 0.93 0.94 0.81 0.84 0.87 0.609 0.115 manoeuvres Laxatives 0.01 0.01 0.01 0.02 0.01 0.615 0.967 Abdominal 0.27 0.12 0.15 0.12 0.17 0.961 0.639 pain Birmingham IBS symptom questionnaire Constipation 6.06 5.63 6.21 4.10 6.19 0.189 0.251 Diarrhoea 1.58 1.95 2.20 2.10 2.01 0.873 0.761 Pain 3.08 1.97 2.17 1.42 2.86 0.022 0.571 IBS - Quality of life questionnaire Dysphoria 12.30 11.94 11.12 11.39 11.98 0.363 0.705 Interference 11.53 11.29 10.68 10.51 11.03 0.924 0.981 with activity Body Image 8.37 8.51 8.23 7.69 8.81 0.012 0.887 Health worry 5.74 6.45 6.24 6.24 6.61 0.039 0.325 Food 6.01 6.81 5.87 6.05 5.99 0.536 0.881 avoidance Social 6.80 7.03 6.72 6.91 6.78 0.583 0.352 Reaction Sexual 2.94 3.00 2.63 2.93 2.60 0.015 0.230 Relationships 4.68 4.97 4.25 4.59 4.76 0.449 0.930 LSD Washout Intervention Difference from washout vs. interventions vs. vs. p-values intervention intervention Placebo ACTAZIN-L ACTAZIN-H GOLD Daily diaries questionnaire Number of 120% 127% 0.813 0.894 0.479 0.546 daily bowel movements Bristol stool 0.36 0.46 0.223 0.396 0.799 0.437 scale Strain 0.15 0.20 0.433 0.462 0.147 0.305 Incomplete 0.14 0.18 0.155 0.852 0.957 0.749 evacuation Bloating 0.05 0.06 0.199 0.313 0.958 0.461 Wind 0.16 0.20 0.667 0.158 0.474 0.015 Manual 0.08 0.10 0.132 0.072 0.140 0.535 manoeuvres Laxatives 0.01 0.02 0.795 0.354 0.673 0.706 Abdominal 0.09 0.12 0.023 0.316 0.813 0.323 pain Birmingham IBS symptom questionnaire Constipation 1.72 2.22 0.872 0.510 0.982 0.018 Diarrhoea 1.15 1.48 0.441 0.908 0.738 0.872 Pain 0.96 1.24 0.642 0.070 0.156 0.004 IBS - Quality of life questionnaire Dysphoria 1.05 1.36 0.533 0.931 0.106 0.262 Interference 0.96 1.24 0.296 0.582 0.459 0.276 with activity Body Image 0.77 0.99 0.250 0.431 0.132 0.005 Health worry 0.69 0.89 0.014 0.636 0.277 0.281 Food 1.03 1.33 0.975 0.116 0.817 0.905 avoidance Social 0.50 0.64 0.929 0.326 0.808 0.610 Reaction Sexual 0.36 0.46 0.060 0.028 0.830 0.070 Relationships 0.60 0.78 0.775 0.475 0.090 0.571 LSD--Least significant difference between two means at the 5% level.
Example 7
Clinical Trial to Assess Effects of Gold3 Gold Kiwifruit Powder on Colonic Microbial Populations
Overview
The human intervention study described in Example 5 was used to ascertain the effect of kiwifruit-derived supplements on colonic microbial composition and metabolism. As described, two kiwifruit-derived supplements, ACTAZIN.TM. green-fleshed (Actinidia deliciosa `Hayward`) and GOLD gold-fleshed (Actinidia chinensis `Zesy002` Gold3) (Anagenix Ltd, Wellington, New Zealand), were used as dietary interventions in the trial. These capsules were cold-processed dietary supplements formulated to maintain the integrity of innate kiwifruit compounds. Preparation was carried out in accordance with Example 1, above.
Results for ACTAZIN.TM. (2400 mg and 600 mg) and GOLD (2400 mg) kiwifruit supplements were evaluated. The trialists were recruited into a healthy group of 19 participants and a functionally constipated group of 9 participants, each of whom consumed all the treatments and a placebo for 4 weeks in a random crossover manner interspersed with 2 week washout periods. Modification of colonic microbiota composition was determined by 16S rRNA gene sequencing and metabolic end products were measured using gas chromatography.
In the functionally constipated group, it was observed that Faecalibacterium prausnitzii relative abundance significantly increased (P=0.024) from 3.4% to 7.0% following GOLD supplementation. Lower proportions of F. prausnitzii are often associated with gastrointestinal disorders; especially those with an inflammatory pathology. The discovery that GOLD supplementation increased F. prausnitzii abundance offers a strategy for correcting colonic microbiota dysbiosis, as F. prausnitzii is a key butyrate producer and has also been shown to exert anti-inflammatory effects.
DNA Extraction, PCR and 16S rRNA Gene Sequencing
All faecal samples were sent on dry ice to Plant & Food Research, Palmerston North where they were received and stored at -20.degree. C. Two hundred and fifty milligrams of each sample was weighed into a sterile microtube and DNA was extracted from each sample using the MO-BIO PowerSoil.RTM. DNA Isolation Kit (MO-BIO Laboratories, Carlsbad, Calif., US #12888).
PCR was run to amplify variable regions V3-V4 of the 16S rRNA gene (position 341-805 in the Escherichia coli rRNA gene) using forward primer Bakt_341F TCGTCGGCAGCGTCAGATGTGTATAAGAGACAGCCTACGGGNGGCWGCAG (SEQ ID NO: 1) and reverse primer Bakt_805R GTCTCGTGGGCTCGGAGATGTGTATAAGAGACAGGACTACHVGGGTATCTAA TCC (SEQ ID NO: 2) Herlemann et al. 2000; W=A/T, H=A/C/T, V=G/C/A, N=G/A/T/C). The primer sequence shown in bold was used to bind to the amplicon region of interest and the remainder of the primer was used to bind the Illumina.RTM. index adaptors.
Each PCR was performed in a 50 .mu.L total volume consisting of 25 .mu.L of HotStarTaq.RTM. master mix (QIAGEN, Melbourne, Australia), 1 .mu.L template DNA or negative control (sterile H.sub.2O) and 12 .mu.L of each of the forward and reverse primers at a final concentration of 0.1 .mu.M. PCR conditions included an initial denaturation of 95.degree. C. for 15 min, followed by thirty cycles of 30 s denaturation at 95.degree. C., 30 s annealing at 55.degree. C., 30 s extension at 72.degree. C., and finishing with a 5 min extension step at 72.degree. C.
The PCR products were column purified using the QIAquick PCR purification kit, (QIAGEN, Melbourne, Australia), quantified using the Qubit.RTM. 2.0 fluorometer (Life Technologies.TM.), and sent to New Zealand Genomics Ltd (NZGL), Massey Genome Service (MGS), New Zealand (NZ). At NZGL, the second PCR step was performed, the amplicons were library QC checked, diluted and pooled. The libraries were then loaded onto the Illumina.RTM. MiSeq instrument over three 2.times.250 bp paired end (PE) runs.
Bioinformatics
The Illumina.RTM. MiSeq sequencing data was analysed by software (Quantitative Insights into Microbial Ecology (QIIME) software version 1.8.0; Caporaso et al. 2010). To assemble the paired-end reads into a single continuous sequence, PANDASeq was used with parameters of at least 40 bp overlap, a minimum of 350 bp length and maximum of 500 bp length (Masella et al. 2012). Putative chimeras were filtered from the sequences and the reads were clustered into operational taxonomic units (OTUs) based on a 97% identity threshold value using USEARCH and UCLUST (Edgar 2010). A subsample of the total reads was taken to allow faster processing of the samples and to normalise at approximately 15,000 reads per sample, which is sufficient for phylogenetic and taxonomic assignment (Caporaso et al. 2011; Schloss et al. 2012).
Alignment of the sequences was carried out using PyNAST (Caporaso et al. 2010) with reference to the Greengenes core reference database (version 13_8) (DeSantis et al. 2006). Taxonomic assignment was made using the RDP Naive Bayesian classifier (Wang et al. 2007). The healthy and FC groups were analysed separately and the effect of each of the four treatments on microbial community composition was determined by comparing the average abundance of each bacterial genus after each treatment (greater than 1% abundance in at least one of the eight samples) with the average value before treatment.
Organic Acid Quantification by GC
A 500-1000 mg portion of each faecal sample was weighed into a clean tube and diluted 1:10 in phosphate-buffered saline (PBS). The internal standard (ethyl butyrate) was included to give a final concentration of 5 mM. The organic acids were quantified by GC using a modified method as previously described (Richardson et al. 1989).
Analysis was performed on a Shimadzu gas chromatograph system (GC-17A, Kyoto, Japan) equipped with a flame ionisation detector and fitted with a HP-1 column (Agilent Technologies, Santa Clara, Calif., USA). The instrument was controlled and chromatograms acquired using GC Solution Chromatography Data System software (Shimadzu, Version 2.3). The standard curves were prepared following the analysis of standard solutions of formic, acetic, propionic, isobutyric, butyric, lactic, succinic, isovaleric, valeric, heptanoic, and hexanoic acids. Organic acid concentrations were expressed as .mu.mol/g of faeces.
Statistical Analysis
Statistical calculations were conducted in R Studio using the stats package (R Studio 2012). The Wilcoxon Signed Rank test was performed to assess significant differences between taxonomy at the genus level and significant differences between organic acid concentrations before and after each treatment. A P value of less than 0.05 was deemed significant after correcting for multiple comparisons using the False Discovery Rate (FDR) method in the p.adjust function in R Studio (Benjamini and Hochberg 1995).
Example 8
Results of Treatment on Microbial Colonic Populations
16S rRNA Gene Sequencing
High throughput sequencing was carried out for variable regions of the 16S rRNA gene, amplified from faecal sample-derived bacterial DNA. This resulted in 26.3 million reads. After quality filtering, chimera removal and subsampling, a total of 3.72 million reads were obtained at an average of 14879 (14139 minimum-14999 maximum) sequences per sample.
Over all samples, 218 species-level phylotypes were observed at a 97% sequence identity threshold. In the healthy group, Clostridiales increased significantly after the GOLD supplementation from 5.0% to 7.6% (P=0.042) (Table 9). In the FC group, Faecalibacterium prausnitzii significantly increased after GOLD treatment from 3.4% to 7.0% (P=0.024), a two-fold increase, while Dorea spp. increased from 0.9% to 1.4% (P=0.008) after the ACTAZIN.TM. H treatment (Table 10). For the FC group, Ruminococcus spp. decreased from 9.9% to 5.6% (P=0.024) after the placebo treatment period (Table 10).
Of the nine participants that consumed GOLD in the FC group, eight registered a net F. prausnitzii increase, with only one slightly minor reduction being observed (FIG. 5B). When comparing the healthy and FC groups, many of the observed genera were significantly different between groups, most notable being Bacteroides spp. and Ruminococcaceae which were significantly higher in the healthy group and Akkermansia spp. which was significantly elevated in the FC group.
Organic Acid Production
Lactate, formate, and isovalerate were not detected in faecal samples in this study. Hexanoate significantly decreased in concentration from 0.6 mol/g to 0.2 mol/g (P=0.030) after the GOLD treatment in the healthy group (Table 11). Succinate significantly decreased in concentration from 2.3 .mu.mol/g to 1.7 .mu.mol/g (P=0.040) after the placebo treatment in the FC group (Table 12). There were no other significant alterations to organic acid concentrations in any of the treatments. Quantitative differences between before and after each treatment were generally modest, except for acetate which increased or decreased by up to 13 .mu.mol/g after some treatments.
TABLE-US-00010 TABLE 9 Relative abundance of prevalent bacterial groups in response to treatments in the healthy group Placebo GOLD ACTAZIN .TM. L ACTAZIN .TM. H Pre Post Pre Post Pre Post Pre Post Bacteroides 18.8 .+-. 4.0 18.0 .+-. 3.2 23.1 .+-. 4.6 22.0 .+-. 4.2 16.7 .+-. 3.1 18.4 .+-. 3.9 19.4 .+-. 3.2 18.1 .+-. 3.8 Ruminococcaceae .sup.1 16.3 .+-. 2.4 19.6 .+-. 3.0 17.4 .+-. 2.3 17.8 .+-. 2.5 19.9 .+-. 2.5 22.2 .+-. 3.8 18.4 .+-. 2.6 19.9 .+-. 3.3 Lachnospiraceae .sup.1 10.8 .+-. 1.3 11.0 .+-. 1.5 11.9 .+-. 1.9 9.5 .+-. 1.3 11.6 .+-. 1.6 9.3 .+-. 1.7 11.6 .+-. 1.6 11.0 .+-. 1.4 Faecalibacterium 7.0 .+-. 1.5 5.7 .+-. 1.0 7.2 .+-. 1.6 5.3 .+-. 0.9 6.3 .+-. 1.6 4.6 .+-. 0.8 6.7 .+-. 1.1 6.5 .+-. 1.6 Clostridiales .sup.1 5.9 .+-. 0.9 5.7 .+-. 1.0 5.0 .+-. 0.9 7.6 .+-. 1.1* 5.9 .+-. 0.7 5.0 .+-. 1.1 6.6 .+-. 1.2 5.6 .+-. 0.9 Coprococcus 6.6 .+-. 1.0 5.5 .+-. 0.8 5.9 .+-. 1.1 5.1 .+-. 0.7 5.4 .+-. 0.8 5.2 .+-. 0.8 5.1 .+-. 0.8 4.9 .+-. 0.8 Blautia 5.8 .+-. 0.9 4.7 .+-. 1.0 4.3 .+-. 0.6 4.8 .+-. 1.0 4.7 .+-. 0.7 6.3 .+-. 1.7 4.8 .+-. 1.1 6.1 .+-. 1.8 Ruminococcus 4.9 .+-. 1.0 6.6 .+-. 1.6 4.2 .+-. 0.6 4.4 .+-. 1.0 6.4 .+-. 1.0 7.2 .+-. 1.3 4.1 .+-. 0.8 5.6 .+-. 1.2 Rikenellaceae .sup.1 2.8 .+-. 0.9 2.7 .+-. 0.7 2.7 .+-. 0.7 2.9 .+-. 1.0 2.8 .+-. 1.0 2.5 .+-. 0.9 3.0 .+-. 0.6 3.5 .+-. 0.8 Bifidobacterium 3.0 .+-. 1.0 2.3 .+-. 0.6 2.5 .+-. 1.2 2.1 .+-. 0.6 2.0 .+-. 0.4 3.5 .+-. 1.1 2.7 .+-. 0.9 2.6 .+-. 0.8 Bacteroidales .sup.1 2.2 .+-. 1.0 2.2 .+-. 0.8 2.0 .+-. 0.9 1.9 .+-. 0.8 1.3 .+-. 0.4 1.2 .+-. 0.3 2.6 .+-. 1.1 1.7 .+-. 0.6 Lachnospira 1.6 .+-. 0.5 1.1 .+-. 0.2 1.3 .+-. 0.3 1.5 .+-. 0.5 1.0 .+-. 0.2 1.1 .+-. 0.3 1.8 .+-. 0.5 1.3 .+-. 0.4 Parabacteroides 1.2 .+-. 0.3 1.6 .+-. 0.5 1.8 .+-. 0.6 1.1 .+-. 0.2 1.3 .+-. 0.3 1.0 .+-. 0.2 1.7 .+-. 0.3 1.5 .+-. 0.3 Collinsella 1.8 .+-. 0.7 1.2 .+-. 0.4 0.9 .+-. 0.4 1.3 .+-. 0.4 1.6 .+-. 0.6 1.2 .+-. 0.3 1.5 .+-. 0.6 1.1 .+-. 0.3 Akkermansia 1.3 .+-. 0.5 1.4 .+-. 0.6 1.8 .+-. 0.7 1.6 .+-. 0.7 1.6 .+-. 0.6 1.8 .+-. 0.5 1.4 .+-. 0.4 1.0 .+-. 0.3 Oscillospira 1.1 .+-. 0.2 1.1 .+-. 0.2 1.1 .+-. 0.2 1.6 .+-. 0.3 1.4 .+-. 0.2 1.5 .+-. 0.5 1.2 .+-. 0.1 1.5 .+-. 0.2 Prevotella 1.5 .+-. 0.7 2.6 .+-. 1.8 0.8 .+-. 0.4 2.1 .+-. 1.5 2.5 .+-. 1.33 0.7 .+-. 0.3 0.9 .+-. 0.5 1.6 .+-. 0.9 Dorea 1.2 .+-. 0.4 1.2 .+-. 0.3 0.9 .+-. 0.2 1.4 .+-. 0.4 1.1 .+-. 0.2 0.9 .+-. 0.2 0.8 .+-. 0.2 1.0 .+-. 0.2 Clostridiaceae .sup.1 1.2 .+-. 0.4 0.9 .+-. 0.3 0.9 .+-. 0.2 0.9 .+-. 0.2 0.8 .+-. 0.2 1.2 .+-. 0.4 0.8 .+-. 0.2 0.9 .+-. 0.3 Unassigned 0.8 .+-. 0.1 1.0 .+-. 0.2 0.8 .+-. 0.1 1.0 .+-. 0.2 0.9 .+-. 0.1 0.9 .+-. 0.1 0.8 .+-. 0.1 0.8 .+-. 0.1 Illumina .RTM. MiSeq sequencing data displaying genera that are present at greater than one percent abundance in at least one sample. Data are the calculated average values for all participants .+-. standard error of the mean (SEM) before and after each treatment period. *P .ltoreq. 0.05 - Significantly different compared with pre-treatment based on the Wilcoxon Signed Rank test after false discovery rate correction for multiple comparisons. .sup.1 Some bacteria could only be classified as far as the order or family level.
TABLE-US-00011 TABLE 10 Relative abundance of prevalent bacterial groups in response to treatments in the functionally constipated group Placebo GOLD ACTAZIN .TM. L ACTAZIN .TM. H Pre Post Pre Post Pre Post Pre Post Ruminococcaceae .sup.1 17.2 .+-. 2.3 19.9 .+-. 2.9 17.1 .+-. 3.8 16.3 .+-. 2.1 17.9 .+-. 2.6 15.0 .+-. 2.3 16.5 .+-. 3.1 18.8 .+-. 2.1 Bacteroides 12.6 .+-. 3.1 14.4 .+-. 2.2 14.2 .+-. 2.6 15.5 .+-. 2.6 13.9 .+-. 2.2 12.2 .+-. 2.5 14.0 .+-. 2.9 16.3 .+-. 3.1 Lachnospiraceae .sup.1 11.4 .+-. 1.6 8.0 .+-. 2.3 10.0 .+-. 2.5 13.9 .+-. 3.3 10.8 .+-. 3.1 11.0 .+-. 2.3 11.7 .+-. 2.5 8.7 .+-. 2.2 Faecalibacterium 7.9 .+-. 2.8 5.8 .+-. 2.1 3.4 .+-. 1.0 7.0 .+-. 1.1* 4.9 .+-. 1.7 5.0 .+-. 1.4 7.7 .+-. 2.1 3.1 .+-. 1.0 Clostridiales .sup.1 4.8 .+-. 0.6 6.8 .+-. 1.7 6.4 .+-. 1.3 5.5 .+-. 1.1 6.4 .+-. 1.2 6.7 .+-. 1.7 6.0 .+-. 1.4 7.5 .+-. 1.8 Coprococcus 6.5 .+-. 1.4 6.1 .+-. 1.1 6.7 .+-. 1.7 6.6 .+-. 1.4 6.9 .+-. 1.4 8.6 .+-. 1.2 6.0 .+-. 1.2 7.1 .+-. 1.9 Blautia 6.6 .+-. 1.8 3.5 .+-. 0.9 7.1 .+-. 2.0 6.0 .+-. 1.5 6.9 .+-. 1.5 7.5 .+-. 1.8 5.9 .+-. 2.1 5.4 .+-. 1.3 Ruminococcus 9.9 .+-. 2.6 5.6 .+-. 1.0* 6.4 .+-. 1.4 5.5 .+-. 0.7 6.2 .+-. 2.0 7.4 .+-. 1.5 5.5 .+-. 1.1 7.2 .+-. 1.3 Bifidobacterium 2.6 .+-. 1.3 2.6 .+-. 1.0 3.5 .+-. 1.5 2.6 .+-. 1.0 2.7 .+-. 1.5 2.7 .+-. 0.9 4.0 .+-. 1.6 1.8 .+-. 0.8 Akkermansia 2.7 .+-. 1.7 4.8 .+-. 2.0 5.0 .+-. 1.8 2.6 .+-. 1.0 3.3 .+-. 1.1 3.3 .+-. 1.5 3.6 .+-. 1.0 5.6 .+-. 2.3 Rikenellaceae .sup.1 2.3 .+-. 0.6 3.1 .+-. 0.6 3.9 .+-. 1.2 2.4 .+-. 0.5 4.0 .+-. 1.1 3.9 .+-. 1.3 2.6 .+-. 0.7 3.2 .+-. 0.9 Christensenellaceae .sup.1 1.0 .+-. 0.6 1.5 .+-. 0.6 2.2 .+-. 1.4 1.1 .+-. 0.6 1.8 .+-. 0.8 1.4 .+-. 0.6 2.3 .+-. 1.6 2.2 .+-. 1.3 Prevotella 1.8 .+-. 1.1 0.6 .+-. 0.3 0.2 .+-. 0.1 0.5 .+-. 0.3 0.5 .+-. 0.3 0.9 .+-. 0.5 2.0 .+-. 1.1 0.2 .+-. 0.1 Collinsella 1.6 .+-. 0.6 1.2 .+-. 0.3 1.6 .+-. 0.4 1.3 .+-. 0.3 1.2 .+-. 0.4 1.8 .+-. 0.7 1.6 .+-. 0.6 1.4 .+-. 0.3 Unassigned 1.0 .+-. 0.1 1.1 .+-. 0.1 1.1 .+-. 0.2 1.0 .+-. 0.1 1.0 .+-. 0.1 1.0 .+-. 0.1 1.3 .+-. 0.4 1.0 .+-. 0.1 Parabacteroides 1.3 .+-. 0.4 1.3 .+-. 0.4 1.2 .+-. 0.3 1.3 .+-. 0.4 1.7 .+-. 0.4 1.2 .+-. 0.4 1.3 .+-. 0.4 1.5 .+-. 0.3 Oscillospira 1.3 .+-. 0.1 1.5 .+-. 0.3 1.6 .+-. 0.2 1.8 .+-. 0.3 1.6 .+-. 0.2 1.5 .+-. 0.3 1.3 .+-. 0.2 1.8 .+-. 0.3 Lachnospira 1.0 .+-. 0.5 1.0 .+-. 0.4 0.6 .+-. 0.2 1.6 .+-. 0.9 1.3 .+-. 0.5 1.2 .+-. 0.5 1.3 .+-. 0.6 0.5 .+-. 0.1 Dorea 1.5 .+-. 0.4 1.4 .+-. 0.3 1.3 .+-. 0.3 1.2 .+-. 0.3 1.2 .+-. 0.3 1.2 .+-. 0.4 0.9 .+-. 0.2 1.4 .+-. 0.3* Coriobacteriaceae .sup.1 0.9 .+-. 0.3 1.2 .+-. 0.5 1.5 .+-. 0.4 1.2 .+-. 0.5 1.1 .+-. 0.3 1.1 .+-. 0.3 0.8 .+-. 0.2 1.2 .+-. 0.4 Bamesiellaceae .sup.1 0.9 .+-. 0.3 4.0 .+-. 2.4 1.0 .+-. 0.4 1.0 .+-. 0.3 1.1 .+-. 0.3 1.4 .+-. 0.5 0.8 .+-. 0.3 0.8 .+-. 0.3 Clostridiaceae .sup.1 0.4 .+-. 0.1 1.1 .+-. 0.7 0.9 .+-. 0.5 1.0 .+-. 0.7 0.3 .+-. 0.1 0.4 .+-. 0.1 0.4 .+-. 0.1 0.3 .+-. 0.1 Illumina MiSeq sequencing data displaying genera that are present at greater than one percent abundance in at least one sample. Data are the calculated average values for all participants .+-. standard error of the mean (SEM) before and after each treatment period. *P .ltoreq. 0.05 - Significantly different compared to pre-treatment based on the Wilcoxon Signed Rank test after false discovery rate correction for multiple comparisons. .sup.1 Some bacteria could only be classified as far as the order or family level.
TABLE-US-00012 TABLE 11 Organic acid concentrations in faecal samples in response to the four treatments in the healthy group Mean SEM Mean SEM P Pre Pre Post Post value Difference Placebo Acetate 36.7 5.8 43.2 5.2 1.00 6.5 Butyrate 10.5 2.4 13.9 2.6 0.28 3.4 Heptanoate 0.0 0.0 0.0 0.0 0.84 0.0 Hexanoate 0.4 0.2 0.6 0.2 0.58 0.2 Isobutyrate 0.6 0.2 0.8 0.2 0.82 0.2 Propionate 7.8 1.7 10.6 2.3 0.74 2.8 Succinate 1.6 0.6 1.0 0.1 0.48 -0.6 Valerate 1.5 0.2 2.0 0.3 0.34 0.5 GOLD Acetate 43.7 5.5 31.4 4.8 0.05 -12.3 Butyrate 14.2 3.0 9.5 2.7 0.18 -4.7 Heptanoate 0.1 0.1 0.0 0.0 0.20 -0.1 Hexanoate 0.6 0.2 0.2 0.1 0.03* -0.4 Isobutyrate 0.6 0.2 0.4 0.1 0.92 -0.2 Propionate 7.0 1.4 6.0 1.4 0.96 -1.0 Succinate 1.5 0.6 0.9 0.1 1.00 -0.6 Valerate 1.6 0.2 1.3 0.1 0.30 -0.3 ACTAZIN .TM. L Acetate 42.8 5.9 44.0 6.1 1.00 1.2 Butyrate 15.3 2.2 13.5 2.2 1.00 -1.8 Heptanoate 0.1 0.1 0.0 0.0 1.00 -0.1 Hexanoate 0.7 0.3 0.8 0.3 1.00 0.1 Isobutyrate 0.8 0.3 0.7 0.2 1.00 -0.1 Propionate 8.9 1.3 9.9 1.5 1.00 1.0 Succinate 2.2 0.8 1.1 0.2 0.52 -1.1 Valerate 1.7 0.3 1.8 0.2 1.00 0.1 ACTAZIN .TM. H Acetate 45.2 6.7 32.8 5.0 0.32 -12.4 Butyrate 11.9 2.5 10.0 2.4 0.70 -1.9 Heptanoate 0.0 0.0 0.0 0.0 1.00 0.0 Hexanoate 0.3 0.1 0.4 0.2 1.00 0.1 Isobutyrate 0.7 0.2 0.5 0.1 0.76 -0.2 Propionate 8.5 1.1 7.7 1.7 1.00 -0.8 Succinate 2.7 1.6 1.1 0.2 1.00 -1.6 Valerate 1.5 0.2 1.5 0.2 1.00 0.0 Levels measured by gas chromatography (GC), expressed in .mu.mol/g faeces. The difference denotes whether a net increase (positive values) or a net decrease (negative values) was observed after treatments. *P .ltoreq. 0.05 - Significantly different compared to pre-treatment based on the Wilcoxon Signed Rank test after false discovery rate correction for multiple comparisons.
TABLE-US-00013 TABLE 12 Organic acid concentrations in faecal samples in response to the four treatments in the functionally constipated group Mean SEM Mean SEM P Pre Pre Post Post value Difference Placebo Acetate 33.7 7.2 34.7 3.9 1.00 1.0 Butyrate 7.0 2.5 5.9 2.1 1.00 -1.1 Heptanoate 0.0 0.0 0.2 0.2 1.00 0.2 Hexanoate 0.2 0.1 0.2 0.1 1.00 0.0 Isobutyrate 1.2 0.3 1.5 0.3 1.00 0.3 Propionate 8.5 1.5 9.0 1.4 1.00 0.5 Succinate 2.3 0.3 1.7 0.2 0.04* -0.6 Valerate 1.4 0.3 1.5 0.3 1.00 0.1 GOLD Acetate 40.5 8.7 39.1 7.4 1.00 -1.4 Butyrate 8.3 3.8 8.5 2.3 1.00 0.2 Heptanoate 0.0 0.0 0.0 0.0 0.22 0.0 Hexanoate 0.1 0.1 0.4 0.2 0.56 0.3 Isobutyrate 1.0 0.3 1.5 0.2 0.72 0.5 Propionate 9.2 2.1 10.4 2.2 1.00 1.2 Succinate 1.7 0.2 1.8 0.2 1.00 0.1 Valerate 1.4 0.3 1.8 0.3 1.00 0.4 ACTAZIN .TM. L Acetate 35.2 5.4 44.7 10.2 1.00 9.5 Butyrate 9.4 2.4 10.3 3.1 1.00 0.9 Heptanoate 0.1 0.0 0.1 0.1 1.00 0.0 Hexanoate 0.3 0.2 0.7 0.5 1.00 0.4 Isobutyrate 1.6 0.3 1.6 0.3 1.00 0.0 Propionate 9.2 1.7 10.5 2.1 1.00 1.3 Succinate 1.8 0.1 1.7 0.1 0.60 -0.1 Valerate 1.9 0.3 2.0 0.3 1.00 0.1 ACTAZIN .TM. H Acetate 46.0 10.0 32.3 4.2 0.72 -13.7 Butyrate 9.5 3.7 4.0 1.2 1.00 -5.5 Heptanoate 0.2 0.2 0.0 0.0 0.28 -0.2 Hexanoate 0.3 0.2 0.1 0.0 0.40 -0.2 Isobutyrate 1.2 0.4 1.4 0.3 0.72 0.2 Propionate 10.8 3.2 7.5 1.0 1.00 -3.3 Succinate 2.0 0.2 1.9 0.2 1.00 -0.1 Valerate 1.4 0.4 1.3 0.2 1.00 -0.1 Levels measured by gas chromatography (GC), expressed in .mu.mol/g faeces. The difference denotes whether a net increase (positive values) or a net decrease (negative values) was observed after treatments. *P .ltoreq. 0.05 - Significantly different compared with pre-treatment based on the Wilcoxon Signed Rank test after false discovery rate correction for multiple comparisons.
Discussion
It was determined that several bacterial groups were significantly altered in abundance after consumption of kiwifruit-derived supplements. Clostridiales increased by 2.6% after GOLD (Gold3) supplementation in the healthy group, although the implications of this increase are still under investigation. F. prausnitzii relative abundance was significantly elevated (3.6%) in the FC group after a 4 week period of supplementation with the gold kiwifruit based GOLD.
Notably, F. prausnitzii is a known butyrate producer. Butyrate is the preferred energy source for colonic epithelial cells and plays a role in alleviating inflammation as well as mitigating carcinogenesis, pathogenic colonisation, and oxidative stress (Hamer et al. 2008; Macfarlane and Macfarlane 2011). In a recent study, it was demonstrated that administration of a butyrate producing bacterium, Clostridium tyrobutyricum, protected mice from dextran sodium sulphate-induced colitis (Hudcovic et al. 2012). Therefore, increasing the amount of F. prausnitzii in the colon may help mitigate the symptoms of gastrointestinal disorders, through elevated butyrate production.
As the human gastrointestinal tract consists of approximately 10'.sup.4 microbial cells (Egert et al. 2006) and abundance of F. prausnitzii is about 5% (Miquel et al. 2013), this equates to a concentration of approximately five trillion F. prausnitzii cells, which may exert an appreciable effect on microbial activities and metabolism. The present study showed a total proportion of 5.6% abundance of F. prausnitzii from all samples in the FC group (the average taken across all samples in the FC group, including all treatments and washouts), while 6.1% was observed in the healthy group. The samples from participants in the FC group prior to administration of GOLD supplementation had a relatively low abundance of F. prausnitzii of 3.4% which increased two-fold to 7.0% after GOLD treatment. A decrease from 7.2% to 5.3% was observed in the healthy group which could be due to the already high levels at baseline. This has been observed in other studies, where the baseline concentration of a bacterial group has a substantial bearing on the magnitude of effect observed in response to a dietary intervention (Kolida et al. 2007; Tuohy et al. 2001).
There were minor differences between organic acids after treatments which could be attributed to using faecal samples as a proxy for in situ determination of organic acid composition and concentration. Organic acid concentrations decrease distally in the large bowel which is due to secondary fermentation, absorption into the bloodstream and/or utilisation of organic acids (particularly butyrate) by colonocytes (Bach et al. 2000). Therefore, measurement of organic acids in faecal samples may greatly underestimate the concentration of in situ organic acids (Millet et al. 2010).
Butyrate was slightly higher in faecal samples from participants in the FC group, which aligns with the increased F. prausnitzii abundance. Lactate, formate, and isovalerate were not detected in the faecal samples from either group in the study. Lactate is not normally detected in high concentrations in faecal samples from healthy individuals as it is an intermediate in many metabolic networks and is consumed by members of the microbiota as part of normal metabolism (Duncan et al. 2004; Belenguer et al. 2011). Formate also acts as an intermediate and can be converted to methane, carbon dioxide and water as well as only being produced in the initial phase of fermentation, normally in the proximal colon (Pryde et al. 2002; Huda-Faujan et al. 2010).
F. prausnitzii is well characterised in terms of its metabolic capabilities and fermentation profile, despite being an oxygen sensitive bacterium that is difficult to culture in the laboratory (Duncan et al. 2002). In spite of its numerical dominance in the gut and butyrate-producing nature, F. prausnitzii has yet to be utilised to improve digestive health. Given that a depleted abundance of F. prausnitzii is observed in many gastrointestinal disorders, it has been proposed that F. prausnitzii could be formulated as a probiotic and administered to IBS or IBD sufferers (Sokol et al. 2008; Sartor 2011). However, this work is still ongoing. The oxygen sensitivity of F. prausnitzii makes it challenging to formulate as a component for probiotic compositions.
The gold kiwifruit derived supplement, GOLD, provides a means for selectively stimulating the proliferation of the commensal F. prausnitzii, and is therefore considered particularly useful for inflammation-related gastrointestinal disorders. In conclusion, GOLD, has ameliorated F. prausnitzii depleted dysbiosis in functionally constipated participants. As such, the Gold3 gold kiwifruit powder finds use for restoring the microbiota to a healthy state with anti-inflammatory benefits and higher in situ butyrate concentrations.
Example 9
qPCR Analysis of Microbiome for the Human Clinical Trial
Summary
This study investigated the impact of ACTAZIN.TM. (2400 mg) and GOLD (2400 mg) kiwifruit supplements on faecal microbial concentrations in a human intervention study as well as in vitro fermentation experiments. The objective was to determine the effect of kiwifruit-based interventions on the microbial composition of the samples. The modification of colonic microbiota composition was determined by real-time quantitative polymerase chain reaction (qPCR) which supplements existing 16S rRNA gene sequencing data obtained previously. See Examples 7 and 8, above.
Real-time qPCR is a common method used to investigate the microbial ecology of the gastrointestinal tract. It has been used in numerous studies and can give a quantitative indication of microbial numbers. Quantification was carried out on the Roche LightCycler.RTM. 480 instrument. In addition to total bacteria, individual bacterial groups quantified were Clostridium coccoides group, Lachnospiraceae, Bacteroides-Prevotella-Porphyromonas group, Bifidobacteria, Lactobacilli and Faecalibacterium prausnitzii. The above bacterial groups were also quantified for the in vitro fermentation work with the exception of Lactobacilli which was previously tested.
In the functionally constipated group, the concentration of F. prausnitzii increased following GOLD supplementation, just falling short of being statistically significant. Lower proportions of F. prausnitzii are often associated with gastrointestinal disorders; especially those with an inflammatory pathology. The discovery that GOLD supplementation increased F. prausnitzii concentrations concurs with the significant increase in abundance found in the sequencing data and provides support for the prebiotic effects of GOLD consumption.
Background
Green kiwifruit has been shown to improve aspects of gastrointestinal health, including altering the microbial ecology of the colonic environment (Blatchford et al. 2015a; Blatchford et al. 2015b; Parkar et al. 2012). These benefits are thought to derive from the inherent levels of digestion resistant carbohydrates (DRC), polyphenols, and vitamin C (Chan et al. 2007; Ferguson & Ferguson 2003). The benefits of gold kiwifruit have not been clearly established. This study details experiments conducted using samples from the existing human clinical trial (described in Example 5). The randomized, double-blind, placebo-controlled crossover trial, examined the role of two kiwifruit derived ingredients, ACTAZIN.TM. (green kiwifruit) and GOLD (Gold3 gold kiwifruit), on digestive health.
The primary endpoints measured in the original trial were stool frequency, stool form, and quality of life scores. See Examples 5 and 6. Secondary endpoints included measuring short-chain fatty acids (SCFAs), and also measuring changes in the relative abundances of faecal microbial populations using 16S rRNA gene sequencing. The 16S rRNA gene sequencing analysis gave an overall picture of the microbial ecology of the samples (in the form of relative abundance percentages), but not quantitative results. See Examples 7 and 8, above.
Therefore, the following DNA samples obtained from the original trial were used for the current trial: pre- and post-GOLD 2400 mg intervention samples (n=52), ACTAZIN.TM. 2400 mg intervention samples (n=52) and placebo samples (n=52). These samples were used to determine the concentration of select bacterial groups using qPCR, which yields a quantitative measure of bacterial concentrations within a sample.
Materials and Methods
As detailed in Example 5, the study design was a randomised double blind placebo controlled cross-over trial with participants consuming four different treatments for four weeks, with a two-week wash out between each treatment. The interventions were delivered in 4.times.600 mg capsules formulated to appear the same to maintain treatment blinding, as shown in Table 13, below. See also Example 5. As described, the powdered ingredients were prepared from New Zealand green and gold kiwifruit, respectively. See Examples 1 and 5.
TABLE-US-00014 TABLE 13 Description of intervention composition Inter- Delivery (capsules)/ vention Composition Dose day ACTAZIN Green Kiwifruit Powder 2400 mg 4 .times. ACTAZIN .TM. GOLD Gold Kiwifruit Powder 2400 mg 4 .times. GOLD PLACEBO Isomalt coloured green 2400 mg 4 .times. Placebo (E102, E142)
Select bacteria were used as representative genera for each of the seven bacterial groups assessed (Table 14). All isolates were grown anaerobically at 37.degree. C. overnight using Hungate tubes sealed with butyl rubber stoppers unless otherwise stated. All media were obtained from Oxoid (Adelaide, Australia), unless otherwise stated.
Lactobacillus reuteri (DPC 16) was grown in de Man-Rogosa-Sharpe (MRS) broth; Bifidobacterium bifidum (DSM 20082) was grown in MRS broth supplemented with 0.05% (w/v) L-cysteine hydrochloride (Sigma-Aldrich); Roseburia intestinalis (DSM 14610) was grown in rumen bacteria media (DSMZ Medium 330); Lachnospira multipara (ATCC 19207) was grown in RM02 media supplemented with filtered rumen fluid (Leahy et al. 2010); Bacteroides fragilis (ATCC 25285) was grown in Wilkins-Chalgren anaerobe broth supplemented with 0.05% (w/v) L-cysteine hydrochloride (Sigma-Aldrich) for 2 days; Faecalibacterium prausnitzii (DSM 17677) was grown in brain heart infusion (BHI) broth supplemented with 0.5% (w/v) yeast extract, 0.0005% (w/v) haemin (Sigma-Aldrich), 0.0005% (w/v) vitamin K (Sigma-Aldrich) and 0.2% L-cysteine hydrochloride (Sigma-Aldrich); Escherichia coli (Nissle) was grown in tryptic soy broth (TSB) at 37.degree. C. aerobically.
TABLE-US-00015 TABLE 14 Table of primers used - design based on 16S rDNA sequences Bacterial Annealing Annealing Target bacteria standard Primer sequence (5' .fwdarw. 3') temp (.degree. C.) time (s) Reference Total bacteria Escherichia coli Fwd: SEQ ID NO: 3 60 60 (Nadkarni et al. Nissle TCCTACGGGAGGCAGCAGT 2002) Rev: SEQ ID NO: 4 GGACTACCAGGGTATCTAATCCTGTT Bifidobacteria Bifidobacteriton Fwd: SEQ ID NO: 5 66 45 (Kok et al. 1996) bifidum GGGTGGTAATGCCGGATG DSM 20082 Rev: SEQ ID NO: 6 CCACCGTTACACCGGGAA Lactobacilli Lactobacillus Fwd: SEQ ID NO: 7 60 30 (Fu et al. 2006) reuteri CGATGAGTGCTAGGTGTTGGA DPC16 Rev: SEQ ID NO: 8 CAAGATGTCAAGACCTGGTAAG Bacteroides- Bacteroides Fwd: SEQ ID NO: 9 63 20 (Rinttila et al. Prevotella- fragilis GGTGTCGGCTTAAGTGCCAT 2004) Porphyromonas ATCC 25285 Rev: SEQ ID NO: 10 CGGATGTAAGGGCCGTGC Faecalibacterium Faecalibacterium Fwd: SEQ ID NO: 11 60 20 (Ramirez-Farias prausnitzii prausnitzli GGAGGAAGAAGGTCTTCGG et al. 2009) DSM 17677 Rev: SEQ ID NO: 12 AATTCCGCCTACCTCTGCACT C coccoides Roseburia Fwd: SEQ ID NO: 13 50 30 (Matsuki et al. group intestinalis AAATGACGGTACCTGACTAA 2002) DSM 14610 Rev: SEQ ID NO: 14 CtttGAGTTTCATTCTTGCGAA Lachnospiraceae Lachnospira Fwd: SEQ ID NO: 15 63 30 (Paturi et al. multipara GACGGTACCTGACTAAGAAGC 2014) ATCC 19207 Rev: SEQ ID NO: 16 AGTTTCATTCTTGCGAACGT
Specificity of each standard strain to primers was assessed using in silico analysis on SnapGene.RTM. software (www.snapgene.com). Cell density was determined using a Neubauer haemocytometer and cultures were diluted or concentrated as required to 1.0.times.10.sup.8 or 1.0.times.10.sup.9 cells/mL. DNA was then extracted using the MO-BIO PowerSoil.RTM. DNA Isolation Kit (MO-BIO Laboratories, Carlsbad, Calif., US #12888). Standard curves were constructed using dilution series of the bacterial strains representative of each group. Samples and standards were run in triplicate by absolute quantification on the Roche LightCycler.RTM. 480 real-time PCR instrument. Roche SYBR Green I Master Mix (04707516001) detection chemistry was used to detect double stranded DNA amplification. Total reaction volume was 20 .mu.L, consisting of 10 .mu.L SyBr Green I Master mix, 4 .mu.L forward primer (5.times. concentrated at 2.5 .mu.M), 4 .mu.L reverse primer (5.times. concentrated at 2.5 .mu.M) and 2 .mu.L DNA template or sterile water (no template control).
Each qPCR run included one activation cycle (95.degree. C.) for 5 min, 32-40 run cycles (including the denaturation step at 95.degree. C. (30 s), annealing step as in Table 14 and extension step at 72.degree. C. for 1 min), and one melt curve cycle (60 to 95.degree. C. at 0.1.degree. C. per second with continuous fluorescence acquisition) followed by a cooling cycle at 40.degree. C. The melt curve Tm calling cycle enabled the differentiation between target product and non-specific double stranded product such as primer-dimers. Primers were diluted in PCR grade water to a concentration of 2.5 .mu.M. This was then diluted 1:5 to obtain a 0.5 .mu.M concentrated solution in the PCR reaction.
Statistical calculations were conducted in R using the stats package (R Development Core Team 2008). The Wilcoxon Signed Rank test was performed to assess significant differences before and after each treatment. For the in vitro fermentations, significant differences were determined by comparing time 0 with the other time points. A P value of less than 0.05 was deemed significant after correcting for multiple comparisons using the False Discovery Rate (FDR) method in the p.adjust function in R Studio (Benjamini & Hochberg 1995).
Example 10
Results of qPCR Analysis of Microbiome in the Human Clinical Trial
The results of the qPCR data portray a relatively stable microbial profile over time for each bacterial group assessed. Moderate increases or decreases were observed after each treatment. Table 15 depicts LightCycler.RTM. 480 qPCR data displaying bacterial groups as the calculated average 16S rRNA gene copy number/gram faecal sample (LOG transformed) and standard error of the mean (SEM) before and after each treatment period in the healthy group. Table 16 depicts LightCycler.RTM. 480 qPCR data displaying bacterial groups as the calculated average 16S rRNA gene copy number/gram faecal sample (LOG transformed) and standard error of the mean (SEM) before and after each treatment period in the functionally constipated group.
As shown in Table 15 and FIG. 6, in the healthy group after GOLD treatment, moderate increases were observed in the total bacteria, C. coccoides, Lachnospiraceae, Lactobacilli, Bifidobacteria and Bacteroides-Prevotella-Porphyromonas groups, whereas the concentration of F. prausnitzii remained constant. With ACTAZIN.TM. supplementation, slight decreases were seen in the total bacteria, Bacteroides-Prevotella-Porphyromonas, Lactobacilli, Bifidobacteria, and F. prausnitzii groups, whereas the C. coccoides group remained constant and the Lachnospiraceae group increased slightly. The placebo treatment saw elevated concentrations of total bacteria and Bacteroides-Prevotella-Porphyromonas and small decreases in concentrations of the C. coccoides, Lachnospiraceae, Lactobacilli, Bifidobacteria, and F. prausnitzii groups.
As shown in Table 16 and FIG. 7, in the functionally constipated group after GOLD treatment, moderate increases were observed in the total bacteria, Clostridium coccoides, Lachnospiraceae, Bacteroides-Prevotella-Porphyromonas, and Lactobacilli groups, and a minor decrease in Bifidobacterium spp. The concentration of F. prausnitzii increased the most from log 7.03 to 7.45 which almost reached significance (P=0.0503) and concurs with a similar rise reported in the 16S rRNA gene sequencing data. The increase in actual numbers is 231.9 million 16S rRNA gene copy numbers, which is a 179% increase after GOLD treatment. After ACTAZIN.TM. treatment, decreases were observed in the all bacterial groups. Eight out of nine of the functionally constipated participants showed an increase in F. prausnitzii levels following GOLD treatment. See FIG. 5C, The placebo treatment saw elevated concentrations in all bacterial groups except for Lachnospiraceae which remained constant.
TABLE-US-00016 TABLE 15 LightCycler .RTM. 480 qPCR data for the healthy group mean Pre SEM Pre mean Post SEM Post p value fdr p value GOLD Total Bacteria 9.63 0.17 9.77 0.09 0.99 1.00 Clostridium coccoides group 8.91 0.21 9.03 0.15 0.84 1.00 Lachnospiraceae group 7.42 0.18 7.53 0.12 0.81 1.00 Bacteroides-Prevotella-Porphyromonas group 7.44 0.17 7.59 0.13 0.44 0.88 Lactobacillus spp. 7.59 0.14 7.63 0.13 0.95 1.00 Bifidobacterium spp. 6.36 0.23 6.42 0.19 0.99 1.00 Faecalibacterium prausnitzii 6.87 0.18 6.87 0.13 0.72 1.00 ACTAZIN .TM. Total Bacteria 9.79 0.09 9.69 0.17 0.98 1.00 Clostridium coccoides group 8.79 0.11 8.79 0.22 0.56 1.00 Lachnospiraceae group 7.51 0.08 7.52 0.12 0.91 1.00 Bacteroides-Prevotella-Porphyromonas group 7.6 0.1 7.43 0.16 0.60 1.00 Lactobacillus spp. 7.53 0.07 7.44 0.14 0.91 1.00 Bifidobacterium spp. 6.49 0.18 6.41 0.24 0.90 1.00 Faecalibacterium prausnitzii 6.97 0.12 6.78 0.21 0.31 0.62 Placebo Total Bacteria 9.71 0.17 9.74 0.1 0.82 1.00 Clostridium coccoides group 8.98 0.22 8.87 0.19 0.35 0.70 Lachnospiraceae group 7.56 0.2 7.47 0.15 0.51 1.00 Bacteroides-Prevotella-Porphyromonas group 7.47 0.18 7.56 0.14 0.87 1.00 Lactobacillus spp. 7.62 0.19 7.6 0.13 0.66 1.00 Bifidobacterium spp. 6.59 0.22 6.55 0.18 0.56 1.00 Faecalibacterium prausnitzii 6.91 0.21 6.83 0.17 0.60 1.00
TABLE-US-00017 TABLE 16 LightCycler .RTM. 480 qPCR data for the functionally constipated group mean Pre SEM Pre mean Post SEM Post p value fdr p value GOLD Total Bacteria 10.01 0.09 10.21 0.07 0.16 0.32 Clostridium coccoides group 9.35 0.17 9.5 0.16 0.86 1.00 Lachnospiraceae group 7.85 0.11 7.96 0.11 1.00 1.00 Bacteroides-Prevotella-Porphyromonas group 7.65 0.15 7.88 0.15 0.22 0.44 Lactobacillus spp. 7.64 0.11 7.79 0.07 0.49 0.98 Bifidobacterium spp. 6.76 0.3 6.64 0.35 0.80 1.00 Faecalibacterium prausnitzii 7.03 0.16 7.45 0.13 0.05 0.10 ACTAZIN .TM. Total Bacteria 10.13 0.15 9.98 0.11 0.34 0.68 Clostridium coccoides group 9.11 0.2 8.93 0.19 0.60 1.00 Lachnospiraceae group 7.78 0.19 7.56 0.17 0.55 1.00 Bacteroides-Prevotella-Porphyromonas group 7.82 0.17 7.5 0.13 0.16 0.32 Lactobacillus spp. 7.75 0.15 7.67 0.12 0.73 1.00 Bifidobacterium spp. 6.95 0.15 6.43 0.27 0.22 0.44 Faecalibacterium prausnitzii 7.19 0.29 6.86 0.2 0.33 0.66 Placebo Total Bacteria 9.96 0.16 10.08 0.12 0.49 0.98 Clostridium coccoides group 9.23 0.2 9.35 0.17 0.60 1.00 Lachnospiraceae group 7.8 0.17 7.8 0.17 1.00 1.00 Bacteroides-Prevotella-Porphyromonas group 7.65 0.24 7.84 0.15 0.49 0.98 Lactobacillus spp. 7.24 0.1 7.29 0.12 0.93 1.00 Bifidobacterium spp. 6.53 0.32 6.93 0.26 0.26 0.52 Faecalibacterium prausnitzii 7.12 0.29 7.16 0.26 0.73 1.00
FIGS. 6 and 7 display the bacterial concentration data graphically in both the log transformed and natural data forms for the healthy and functionally constipated groups, respectively. Viewing the data in this form highlights how stable the composition of the faecal microbiota is over time.
It is noted that bacteria in the Bacteroides-Prevotella-Porphyromonas group constitute a considerable collection of primary degraders in the human colonic community. They play an important role in accessing unabsorbed carbohydrate using specialised scavenging mechanisms. Principal among these are cellulose, starch, inulin and xylan degraders such as Bacteroides thetaiotaomicron, Bacteroides ovatus, and Bacteroides cellulosilyticus (Flint et al. 2008; Walker et al. 2008). Roseburia intestinalis, Roseburia inulinovorans, Ruminococcus bromii, and Ruminococcus flavefaciens are also key primary degraders that are members of the C. coccoides group (Kurakawa et al. 2015).
The C. coccoides group constitutes the largest bacterial subgroup in the colon, typically making up 25-60% of total bacterial abundance (Hold et al. 2002) and are composed of a large proportion of butyrate producers (Louis & Flint 2009). Two principal microorganisms with proven probiotic status are Bifidobacteria and Lactobacilli. Bifidobacteria have often been associated with healthy microbiota and are acetate producers, which can have beneficial effects on host health. Lactobacilli consist of a group of lactic acid commensal bacteria that have been exploited for centuries in dairy product production and have been studied in hundreds of trials with respect to their probiotic efficacy (Reid 1999).
The increase in F. prausnitzii concentration was just short of being significant (P=0.0503) after the 4 week period of supplementation with the Gold3 gold-kiwifruit-based GOLD. F. prausnitzii is one of the most populous species in the human gastrointestinal tract, being typically observed at over 5% of the total proportion of the colonic microbiota of healthy adults (Miquel et al. 2013). Members of the Firmicutes phylum, F. prausnitzii are commensal inhabitants of the human large bowel, with demonstrated anti-inflammatory properties in vivo (Furet et al. 2010; Sokol et al. 2009). F. prausnitzii generate butyrate as a result of carbohydrate fermentation, as well as lactate and formate (Duncan et al. 2002; Duncan et al. 2004). Butyrate is the preferred energy source for colonic epithelial cells and plays a role in alleviating inflammation as well as mitigating carcinogenesis, pathogenic colonisation, and oxidative stress (Hamer et al. 2008; Macfarlane & Macfarlane 2011). GOLD selectively stimulates the proliferation of the commensal F. prausnitzii and therefore may be considered as helpful for inflammation-related gastrointestinal disorders.
In summary, qPCR data confirms the microbial relative abundance data and shows that the Gold3 gold-kiwifruit-derived supplement has increased the concentration of F. prausnitzii in functionally constipated participants. This demonstrates a beneficial outcome as F. prausnitzii is known to grow in the large bowel and generate butyrate which has protective functions/health benefits in the gut.
These results are considered as significant, given that F. prausnitzii is highly sensitive to oxygen (Rigottier-Gois 2013), and therefore challenging for formulation and storage as a probiotic agent. Therefore, the gold kiwifruit compositions of the invention provide an efficient and effective means for increasing F. prausnitzii levels, which would be otherwise difficult to modulate.
Persons of ordinary skill can utilise the disclosures and teachings herein to produce other embodiments and variations without undue experimentation. All such embodiments and variations are considered to be part of this invention.
Accordingly, one of ordinary skill in the art will readily appreciate from the disclosure that later modifications, substitutions, and/or variations performing substantially the same function or achieving substantially the same result as embodiments described herein may be utilised according to such related embodiments of the present invention. Thus, the invention is intended to encompass, within its scope, the modifications, substitutions, and variations to processes, manufactures, compositions of matter, compounds, means, methods, and/or steps disclosed herein.
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