Short-Chain Fatty Acids in Lypopolysaccharide-Induced Inflammation and Executive Function

Overview

Short-chain fatty acids (SCFAs) are substances produced by gut bacteria when they ferment dietary fiber. They can act as signals between the gut and the brain and may help regulate the body's immune and stress responses. Earlier work has shown that delivering SCFAs to the colon can lower the stress hormone response to a mental stress task in healthy people, and laboratory studies suggest SCFAs can reduce inflammation. However, it is not yet known whether SCFAs can reduce inflammation in humans, or whether doing so protects mental performance. This study uses a controlled, acute, and short-lasting challenge. Healthy adults receive a single, low dose of a bacterial substance called lipopolysaccharide (LPS) through a vein. LPS briefly activates the immune system and causes mild, flu-like symptoms (such as fatigue, headache, and feeling unwell) that pass on their own within a few hours. It does not cause a real infection. Participants are randomly assigned to take either SCFA capsules or inactive placebo capsules on the morning of the test day, before the LPS challenge. Neither the participants, the researchers running the visit, nor the researchers analyzing the results know who received which capsules until the study is complete (triple-blind). The main goal of the study is to test whether SCFAs, compared with placebo, reduce the inflammatory response to LPS, measured by markers of inflammation in the blood. The study also examines whether SCFAs reduce the associated sickness symptoms and whether they protect performance on tasks that measure core executive functions: the ability to keep relevant information in mind (working memory), the ability to hold back automatic responses or thoughts (inhibition), and the ability to switch flexibly between tasks or rules (cognitive flexibility). Blood, saliva, and stool samples are collected to measure inflammation markers, SCFA levels, stress hormones, and gut bacteria. Participants attend a screening visit, a test day with monitoring for several hours, and a short follow-up visit the next day.

INFLEX is a single-center, randomized, triple-blind, placebo-controlled, parallel-group interventional trial conducted at UZ Leuven / KU Leuven. Its primary aim is to test whether a single acute dose of colon-delivered SCFAs, relative to placebo, attenuates the systemic inflammatory response induced by experimental endotoxemia in healthy adults. Secondary aims are to test whether SCFAs attenuate LPS-induced sickness behaviour and mitigate endotoxemia-induced changes in core executive functioning, and to characterize associations between systemic SCFA uptake, the inflammatory response, and these outcomes. Eligible participants are randomized to receive SCFA colon-delivery capsule or placebo capsules, taken on the morning of the test day with a standardized low-fiber breakfast. One hour after capsule intake, participants receive a single intravenous bolus of purified Escherichia coli lipopolysaccharide (0.4 ng/kg body weight), which serves as a fixed inflammatory challenge applied to all participants. The timing is designed so that peak circulating SCFA concentrations (approximately 3-4 hours after colonic delivery) coincide with the peak of LPS-induced cytokines and sickness behaviour (approximately 2-3 hours post-injection). Participants are monitored for a minimum of 6 hours after the LPS challenge. Vital signs, sickness symptoms, and blood and saliva samples are collected hourly to quantify inflammatory markers (including IL-6 and hs-CRP), serum SCFA, cortisol, and ACTH. Core executive-function tasks are administered before and after the LPS challenge and at a 24-hour follow-up visit. A fecal sample collected at home prior to the test day is used for gut microbiota profiling. To standardize endogenous SCFA production, participants follow a low-fiber diet for three days before the test day and avoid caffeine, alcohol, and strenuous exercise beforehand. The night prior to the test day, participants are instructed to consume a standard dinner that is provided to them. The study comprises three visits: a screening visit (\~1 hour), the laboratory test day (\~8 hours), and a follow-up visit (\~30 minutes) 24 hours after the LPS challenge.