Dietary Fibers (Gum Arabic) Supplementation Modulates Hepatic and Renal Profile Among Rheumatoid Arthritis Patients, Phase II Trial

Ebtihal Kamal; Lamis AbdelGadir Kaddam; Alnour Alagib; Amal Saeed

doi:10.3389/fnut.2021.552049

Dietary Fibers (Gum Arabic) Supplementation Modulates Hepatic and Renal Profile Among Rheumatoid Arthritis Patients, Phase II Trial

Front Nutr. 2021 Mar 10:8:552049. doi: 10.3389/fnut.2021.552049. eCollection 2021.

Authors

Ebtihal Kamal¹, Lamis AbdelGadir Kaddam², Alnour Alagib³, Amal Saeed⁴

Affiliations

¹ Department of Microbiology and Immunology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.
² Department of Physiology, Faculty of Medicine, Alneelain University, Khartoum, Sudan.
³ Department of Rheumatology, Military Hospital, Khartoum, Sudan.
⁴ Department of Physiology, Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

Abstract

Background: Rheumatoid arthritis (RA) is an autoimmune disease that mainly affects the synovial joints with systemic manifestations. RA has a major impact on liver and kidney functions as part of the disease pathogenesis or as a sequel of disease medications or, mostly, both of them. The kidney and liver involvement increases the RA morbidity and mortality. Nowadays, dietary interventions are proposed as potential modifiers for disease severity. Gum Arabic (GA) is acacia senegal exudates; it is soluble fiber with prebiotic properties. GA has been discovered to be protective against experimental nephrotoxicity and hepatotoxicity, with comparable findings in human studies. This article addresses the effect of GA on hepatic and renal profile among RA patients. Methods: Forty patients aged 18-70 received GA daily for 12 weeks as a single dose of 30 g. The liver enzymes, total protein level, serum albumin, serum globulin level, urea, creatinine, and serum electrolytes have been measured as a baseline after 4 weeks and by the end of the study. Cobas C311 (Roche, Germany) automated chemistry analyzer directly determined the values for total protein, albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and creatinine. The study ethically has been approved by the Ethical Committee of the National Medicines and Poisons Board. Trial Registration Identifier: NCT02804581. Results: Regarding the liver enzymes, GA has significantly decreased the liver enzymes apart from alkaline phosphatase, which showed no significant change. In contrast, GA has increased the serum albumin level with a minor impact on the serum globulin level. Furthermore, GA has also significantly decreased the level of urea (P = 0.0001) and level of Sodium (P = 0.002) with nonsignificant change on creatinine and potassium concentrations. Conclusion: GA presents hepatic and renal protective effects among RA patients, evidenced by the significant reduction of urea and liver enzymes. Thus, it can be recommended as a dietary supplement for RA patients. Nonetheless, we recommend further investigation to support our findings.

Keywords: clinical trial; dietary fibers; gum acacia; hepatic profile; renal function; rheumatoid arthritis.