Interindividual variability in gut microbiome mediates the efficacy of resistant starch on MASLD.
Summary
Resistant starch benefits MASLD but shows substantial heterogeneity driven by baseline microbiota. Prevotella suppresses RS-degrading taxa to blunt efficacy, while Bifidobacterium pseudocatenulatum RRP01 restores RS utilization and response; a predictive model (AUC 0.74–0.87) supports microbiome-guided patient stratification.
Key Findings
- RS improved MASLD outcomes but ~30% were low responders across trials.
- Prevotella inhibited RS-degrading bacteria, impairing RS utilization and response.
- Bifidobacterium pseudocatenulatum RRP01 restored RS degradation and therapeutic efficacy.
- A baseline microbiome-plus-clinical model predicted response (AUC 0.74–0.87).
Clinical Implications
Baseline microbiome profiling could identify MASLD patients likely to benefit from resistant starch and guide adjunct probiotic selection (e.g., B. pseudocatenulatum) to convert low responders.
Why It Matters
This study integrates randomized clinical evidence with mechanistic multi-omics and FMT to explain who benefits from a common prebiotic and how to rescue non-response, advancing precision nutrition for MASLD.
Limitations
- Sample size and duration details are not provided in the abstract
- Generalizability to broader MASLD populations and long-term outcomes remain to be established
- Efficacy of single-strain probiotic may vary across diets and geographies
Future Directions
Prospective, microbiome-stratified trials testing RS with or without targeted probiotics; evaluate durability, liver histology, and scalability in diverse populations.
Study Information
- Study Type
- RCT
- Research Domain
- Treatment
- Evidence Level
- I - Randomized, placebo-controlled clinical trial evidence with mechanistic validation
- Study Design
- OTHER