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EFFECTS OF ESG TREATMENT ON MICROBIOTA COMPOSITION: RESULTS FROM A PROSPECTIVE STUDY

Nicolò Citterio 1, Margareth Martino 2, Annamaria Altomare 2, Claudia Di Rosa 2, Dario Biasutto 3, Benedetto Neri 4, Tommaso Mancuso 2, Alessia Falcone 2, Giovanni De Carlo 2, Monica Pandolfi 1, Michele Cicala 5, Francesco Di Matteo 6, Michele Pier Luca Guarino 2

Affiliations

1 Fondazione Policlinico Universitario Campus Bio-medico, Rome, Italy

2 Campus Bio Medico University, Rome, Italy

3 Campus Bio-Medico University of Rome, Rome, Italy

4 Fondazione Policlinico Campus Bio Medico di Roma, Rome, Italy

5 Università Campus Bio Medico, Roma, Italy

6 Campus Bio-Medico Of Rome, Roma, Italy

Summary

AI Generated

Endoscopic Sleeve Gastroplasty in 31 patients with obesity achieved significant weight loss at 8 months and was associated with reduced Proteobacteria levels that inversely correlated with weight loss outcomes.

Body weight and BMI significantly decreased at 4 and 8 months post-ESG, with total body weight loss of 13.1% and 13.3% respectively, and excess weight loss of 23.9% and 24.8% at the same timepoints.
Proteobacteria concentration showed a statistically significant reduction at 8 months compared to 4 months, and this reduction inversely correlated with both percentage excess weight loss and total body weight loss.
Increased whole-wheat bread consumption at 8 months significantly correlated with proliferation of F. prausnitzii, a beneficial bacterial species, at 4 months.
No procedural complications or gastrointestinal symptoms during healthy food reintroduction were observed in the 20 patients who completed 8-month follow-up.
This material may be most relevant for gastroenterologists and bariatric specialists interested in endoscopic weight loss interventions and their effects on gut microbiota.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Obesity is associated with gut dysbiosis, partially restored after a nutritional or surgical intervention. In the latter, the anatomical modification due to bariatric surgery, together with multiple antibiotic therapies, could be responsible for heterogeneous reported results. Endoscopic Sleeve Gastroplasty (ESG) is a minimally invasive treatment for patients with obesity (PWO).

Aims & Methods

This prospective observational study aimed to assess the effects of the ESG treatment on weight loss and gut microbiota.
Adult PWOs were consecutively enrolled and underwent ESG at the Therapeutic Endoscopy Unit of Policlinico Campus Bio-medico of Rome. At the baseline (T0) and at four (T1) and eight (T2) months after ESG, anthropometric parameters (body weight, BMI, waist (WC), hip (HC), umbilical (UC), neck (NC) circumferences), and the food frequencies questionnaire (FFQ) were assessed. Moreover, stool samples were collected at each visit, then analyzed using Next Generation Sequencing techniques (NGS) to evaluate microbiota changes. Significance was assessed for a p-value < 0.05.

Results

A total of 31 patients were enrolled in this study; 20 patients complete T2. No procedural complications were observed.
Body weight and BMI significantly decreased at T1 and T2 (p< 0.0001) compared to the baseline. WC, HC, UC and NC significantly decreased at T1 (p<0.0001) and T2 (p=0.0002, p=0.0003, p=0.0003 and p<0.0001 respectively) compared to the T0. The percentage of excess weight loss (%EWL) at T1 and T2 were respectively 23.9±12.9% and 24.8±16.9%. The percentage of total body weight loss (%TBWL) at 4 and 8 months after endoscopic procedure were 13.1 ± 5.7% and 13.3 ± 7.7% respectively.
At T1 participants reduced the consumption of pasta (T0: 4±0.08 vs T1: 1.19±1.17, p=0.007), that increased again at T2 (T1: 1.19±1.17 vs T2: 3.09±2.83, p=0.01). Weekly consumption of whole-wheat bread significantly increased at T2 when compared to T0 (T0: 1.26±0.02 vs T2: 3.8±3.4, p<0.02). None of the patients devolps gastrointestinal symptoms during the reintroduction of healthy food.
The concentration of Proteobacteria was comparable in stool samples collected at T0 and T1, but showed a statistical significant reduction at T2 with respect of T1 (T0: 2±2.7, T1: 11.3±9.2, T2: 6±4.6; T0 vs T1 p=0.1; T1 vs T2 p=0-03).
An inverse correlation between %EWL and %TBWL, and a decrease of Proteobacteria concentration at T2 was observed (r=-0.50, p=0.031 and r=-0.53, p=0.019 respectively). Moreover, the decrease of dysbiosis index and reduction of Proteobacteria at T2 significantly correlated (r=0.64, p=0.003). A significant correlation was observed between increased consumption of whole-wheat bread and proliferation of F. Prausnitzii at T1 (r=0.58, p=0.036).

Conclusion

This study confirms the effectiveness and safety of ESG in reducing body weight. It seems to positively modulate intestinal microbiota, decreasing pro-inflammatory phylum, such as Proteobacteria, which inversely correlates with %EWL and %TBWL. Moreover, a significant direct correlation between proliferation of beneficial species, such as F. prausnitzii, and increased intake of whole foods was observed, thanks to a good tolerance in the reintroduction of healthy foods after ESG treatment.

Conference

UEG Week Berlin 2025

Topics

Small Intestine & Nutrition

Submission format

Abstract

Session

Obesity (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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