Pasteurized Akkermansia muciniphila MucT for weight loss maintenance in people with overweight and obesity: a controlled randomized trial
Preclinical research demonstrated that the mucosal symbiont Akkermansia muciniphila prevents diet-induced obesity. In this randomized controlled trial, adults with overweight/obesity (n=90) underwent an 8-week low-energy diet for >=8% weight loss, followed by a 24-weeks healthy ad libitum diet with daily supplementation of 30 billion pasteurized A.muciniphila MucT cells or placebo. The MucT group maintained greater weight loss (3.1+/-0.7kg) and higher insulin sensitivity (Matsuda Index) than placebo. The improved weight loss maintenance may be partly attributed to increased fecal energy loss and transcriptional changes in abdominal subcutaneous adipose tissue, reflecting reduced inflammation and a more metabolically active phenotype, that may counteract weight regain. Individuals with low initial levels of Akkermansia spp. showed less weight regain and more pronounced improvements in cardiometabolic health. Our findings highlight the potential of pasteurized A.muciniphila MucT as a strategy for weight management, particularly in individuals with low Akkermansia levels, highlighting opportunities for targeted microbiome-based interventions.This trial is registered at ClinicalTrials.gov NCT05417360.Keywords: Obesity, host-microbe interaction, adipose tissue transcriptional signatures, post-diet weight control, baseline Akkermansia spp., next-generation microbes