Effects of Docosahexanoic Acid on Gut Microbiota and Fecal Metabolites in HIV-Infected Patients With Neurocognitive Impairment: A 6-Month Randomized, Double-Blind, Placebo-Controlled Trial

Ruihua Dong; Haijiang Lin; Yingying Ding; Xiaoxiao Chen; Ruizi Shi; Shiying Yuan; Jing Li; Bowen Zhu; Xiaohui Xu; Weiwei Shen; Keran Wang; Ding Ding; Na He

doi:10.3389/fnut.2021.756720

Effects of Docosahexanoic Acid on Gut Microbiota and Fecal Metabolites in HIV-Infected Patients With Neurocognitive Impairment: A 6-Month Randomized, Double-Blind, Placebo-Controlled Trial

Front Nutr. 2022 Jan 21:8:756720. doi: 10.3389/fnut.2021.756720. eCollection 2021.

Authors

Ruihua Dong^{1

2}, Haijiang Lin^{2

3}, Yingying Ding², Xiaoxiao Chen³, Ruizi Shi², Shiying Yuan², Jing Li², Bowen Zhu², Xiaohui Xu², Weiwei Shen³, Keran Wang², Ding Ding⁴, Na He^{2

5}

Affiliations

¹ Department of Nutrition and Food Hygiene, School of Public Health, Fudan University, Shanghai, China.
² Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
³ Taizhou City Center for Disease Control and Prevention, Taizhou City, China.
⁴ Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
⁵ Shanghai Institute of Infectious Diseases and Biosafety, Fudan University, Shanghai, China.

Abstract

Neurocognitive impairment (NCI) and gut microbiota dysbiosis are prevalent in patients with HIV infection. Docosahexanoic acid (DHA) supplementation may alleviate multiple neurocognitive diseases symptoms and plays important role in regulating gut microbiota. However, it is not known whether DHA algae oil supplements can alleviate neurocognitive impairment (NCI) and regulate gut microbiota and fecal metabolites. A randomized, double-blind, placebo-controlled trial was performed on 68 HIV-infected patients with NCI. Participants were randomized to receive a 3.15 g daily DHA algae oil supplement or placebo for 6 months. We collected blood and fecal samples from these patients before and after the trial. Mini mental state examination (MMSE) and neuropsychological tests (NP tests) were administered to assess the cognitive status of participants. The influence of DHA algae oil on the gut microbiota, fecal metabolomics, plasma proinflammatory, and oxidative stress factors was also investigated. There were no significant changes in NCI according to global diagnosis score (GDS) and MMSE score within the two groups, while patients receiving DHA had improvement in several blood lipids, pro-inflammatory and oxidative stress factors. The DHA supplement increased α-diversity indexes, increased abundances of Blautia, Bifidobacterium, Dorea, Lactobacillus, Faecalibacterium, Fusobacterium, and Agathobacter, and decreased abundances of Bacteroides and Prevotella_9. Furthermore, DHA supplement was correlated with improved fecal lipid metabolites as indicated by ceramides, bile acids, glycerophospholipids. In addition, the DHA supplement was associated with altered cholesterol metabolism and purine metabolism pathways. A daily supplement of DHA algae oil for 6 months has been shown to promote favorable transformations in gut microbiota, profiles of fecal metabolomic, and factors responsible for proinflammatory and oxidative stress, which might be beneficial for the prognosis of HIV-infected patients with NCI in the long-term.

Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT04242004, identifier: NCT04242004.

Keywords: HIV; docosahexanoic acid (DHA); fecal metabolites; gut microbiota; neurocognitive impairment (NCI).

Associated data

ClinicalTrials.gov/NCT04242004