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Martins D, Mendes F, Schmitt F. Microbiome: A Supportive or a Leading Actor in Lung Cancer? Pathobiology 2020; 88:198-207. [PMID: 33352574 DOI: 10.1159/000511556] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/09/2020] [Indexed: 12/24/2022] Open
Abstract
Lung cancer is still the leading cause of cancer death worldwide. Despite the major diagnostic and therapeutic innovations, the effect on mortality has been modest and the overall survival is still poor. Better understanding of the pathology of these tumors is necessary in order to develop personalized therapeutic strategies in lung cancer patients. Human microbiome has been associated with normal physiology and function, and increasing evidence points towards a key role of the microbiome in promoting the progression of lung disease. Studies have shown that although poorly understood, lung has a distinctive microbiome that may an important role in lung cancer development and progression, and interactions between microbial populations have the potential to influence disease, suggesting that microbiome can be an emerging target in cancer therapeutics. We will review mechanisms how the lung microbiota influences carcinogenesis, focusing on the bacterial dysbiosis and inflammation. Moreover, we will discuss the link between the microbiome and cancer and the consequences induced by the immune system, as the host microbiota plays an essential role in activating and modulating the immune response. We summarize current research advances in the lung microbiome and demonstrate the potential to exploit microbiome as a mechanism to prevent carcinogenesis and modulate therapeutic strategy, suggesting microbiome as a valuable approach in lung cancer patients.
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Affiliation(s)
- Diana Martins
- I3S, Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.,IPATIMUP, Institute of Molecular Pathology and Immunology of University of Porto, Porto, Portugal.,Polytechnic Institute of Coimbra, ESTESC-Coimbra Health School, Department of Biomedical Laboratory Sciences, Coimbra, Portugal.,University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Biophysics Institute of Faculty of Medicine, Coimbra, Portugal.,University of Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Fernando Mendes
- Polytechnic Institute of Coimbra, ESTESC-Coimbra Health School, Department of Biomedical Laboratory Sciences, Coimbra, Portugal.,University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR) area of Environment Genetics and Oncobiology (CIMAGO), Biophysics Institute of Faculty of Medicine, Coimbra, Portugal.,University of Coimbra, Center for Innovative Biomedicine and Biotechnology (CIBB), Coimbra, Portugal.,Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Fernando Schmitt
- I3S, Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal, .,IPATIMUP, Institute of Molecular Pathology and Immunology of University of Porto, Porto, Portugal, .,FMUP, Faculty of Medicine, University of Porto, Porto, Portugal,
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52
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Lin S, Shen Y. The efficacy and safety of probiotics for prevention of chemoradiotherapy-induced diarrhea in people with abdominal and pelvic cancer: A systematic review and meta-analysis based on 23 randomized studies. Int J Surg 2020; 84:69-77. [DOI: 10.1016/j.ijsu.2020.10.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/11/2020] [Accepted: 10/12/2020] [Indexed: 01/05/2023]
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53
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Abstract
Complementary and alternative medicine (CAM) approaches are widely used by patients throughout a broad range of medical fields and diseases, and often self-administered by patients without the involvement of physicians or other members of the health care team. CAM use is well documented in cancer and chronic illnesses, and emerging data in radiation oncology show CAM usage of 26% to 97% in radiation therapy patients. No information is, however, available on CAM usage in radiology and in the imaging procedure fields. This article reviews the fundamental principles and the experience with the wide spectrum of CAM in radiation oncology-a field that shares many parallels with radiology, such as prevalence of imaging, procedural requirements, and cooperation demanded from patients.CAM is defined as "approaches and practices that are typically not part of conventional medical care," and includes the use of mind- and body-based practices (eg, meditation, massage, acupuncture), natural products (eg, herbs, vitamins, minerals), and other interventions. Supplements are used frequently to alleviate side effects of therapy and promote overall well-being. Specifically, the mindfulness/meditation approaches of CAM are known to reduce anxiety and enhance physical and emotional wellbeing in patients with chronic diseases, such as cancer or neurologic diseases, through physiological, psychological, and perhaps placebo mechanisms. Such patients often require repetitive and invasive imaging examinations or procedures, such as for cancer treatment, cancer surveillance/follow-up, or monitoring of chronic diseases, for example, surveillance MRI in multiple sclerosis. Such parallels suggest that the vastly understudied area of CAMs deserve further investigation in both the radiation oncology and the imaging fields. Further research on CAM is needed to develop refined recommendations and national/and international guidelines on its use.
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54
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Miarons M, Roca M, Salvà F. The role of pro-, pre- and symbiotics in cancer: A systematic review. J Clin Pharm Ther 2020; 46:50-65. [PMID: 33095928 DOI: 10.1111/jcpt.13292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 09/14/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Cancer is one of the most important causes of morbidity and mortality worldwide. Pro-, pre- and symbiotics can modulate host metabolism and gut microbiota and potentially help prevent cancer and modulate the adverse effects (AEs) of treatments. Numerous studies on this role for pro-, pre- and symbiotics have reported inconsistent results. The purpose of this review was to examine current scientific evidence from randomized controlled trials (RCTs) on the effects of pro-, pre- and symbiotics on the incidence of complications and AEs, especially diarrhoea, in cancer management. METHODS A systematic literature search was implemented in MEDLINE using the MeSH terms "probiotics", "prebiotics", "symbiotics" and "neoplasms", according to PRISMA guidelines. Reference lists were also handsearched to identify additional eligible RCTs. Three reviewers independently assessed the eligibility of each RCT. Of 714 retrieved abstracts, 22 articles with 2287 participants were included in the analysis. RESULTS AND DISCUSSION The most studied bacteriotherapies were probiotics and symbiotics, in 10 and 7 studies, respectively. Both Lactobacillus and Bifidobacterium strains were used in 18 studies, while Lactobacillus and Bifidobacterium strains were individually used in 9 and 2 studies, respectively. Diarrhoea incidence rates were 3.2%-39.1% in intervention groups and 6.7%-60.9% in control groups, while infection incidence rates were 11.1%-22.7% in intervention groups and 17.3%-28.7% in control groups. WHAT IS NEW AND CONCLUSIONS Pro-, pre- and symbiotics may potentially be efficacious in reducing complications associated with chemotherapy, radiotherapy and surgery in patients with cancer.
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Affiliation(s)
- Marta Miarons
- Pharmacy Department, Vall d'Hebron Hospital, Barcelona, Spain.,Pharmacy Department, Mataró Hospital, Barcelona, Spain
| | - Maria Roca
- Nutrition Department, Mataró Hospital, Barcelona, Spain
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55
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Pace F, Macchini F, Massimo Castagna V. Safety of probiotics in humans: A dark side revealed? Dig Liver Dis 2020; 52:981-985. [PMID: 32563720 DOI: 10.1016/j.dld.2020.04.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Fabio Pace
- Gastroenterology Unit, Bolognini Hospital, ASST Bergamo Est, Seriate, BG, Italy
| | - Federico Macchini
- Gastroenterology Unit, Bolognini Hospital, ASST Bergamo Est, Seriate, BG, Italy.
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Žuntar I, Petric Z, Bursać Kovačević D, Putnik P. Safety of Probiotics: Functional Fruit Beverages and Nutraceuticals. Foods 2020; 9:E947. [PMID: 32708933 PMCID: PMC7404568 DOI: 10.3390/foods9070947] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/05/2020] [Accepted: 07/13/2020] [Indexed: 02/07/2023] Open
Abstract
Over the last decade, fruit juice consumption has increased. Their rise in popularity can be attributed to the belief that they are a quick way to consuming a dietary portion of fruit. Probiotics added to fruit juices produce various bioactive compounds, thus probiotic fruit juices can be considered as a new type of functional foods. Such combinations could improve nutritional properties and provide health benefits of fruit juices, due to delivering positive health attributes from both sources (fruit juices and probiotics). However, this review discusses the other side of the same coin, i.e., the one that challenges general beliefs that probiotics are undoubtedly safe. This topic deserves more acknowledgments from the medical and nutritional literature, as it is highly important for health care professionals and nutritionists who must be aware of potential probiotic issues. Still, clinical trials have not adequately questioned the safety of probiotics, as they are generally considered safe. Therefore, this reviews aims to give an evidence-based perspective of probiotic safety, focusing on probiotic fruit beverages and nutraceuticals, by providing documented clinical case reports and studies. Finally, the paper deals with some additional insights from the pharmacological and toxicological point of views, such as pharmacological repercussions of probiotics on health.
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Affiliation(s)
- Irena Žuntar
- Faculty of Pharmacy and Biochemistry, University of Zagreb, Ante Kovačića 1, 10000 Zagreb, Croatia;
| | - Zvonimir Petric
- Unit of Pharmacokinetics and Drug Metabolism, Department of Pharmacology at the Institute of Neuroscience and Physiology Sahlgrenska Academy at the University of Gothenburg, 40530 Göteborg, Sweden;
| | - Danijela Bursać Kovačević
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia;
| | - Predrag Putnik
- Faculty of Food Technology and Biotechnology, University of Zagreb, Pierottijeva 6, 10000 Zagreb, Croatia;
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Zeng Z, Mishuk AU, Qian J. Safety of dietary supplements use among patients with cancer: A systematic review. Crit Rev Oncol Hematol 2020; 152:103013. [PMID: 32570150 DOI: 10.1016/j.critrevonc.2020.103013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/22/2020] [Accepted: 05/27/2020] [Indexed: 12/14/2022] Open
Abstract
Dietary supplements (DS) are commonly taken by patients with cancer, but safety of DS use remains unclear. A systematic literature search was conducted using PubMed, ClinicalTrials.gov, International Pharmaceutical Abstracts and Alt HealthWatch databases from inception through October 12, 2018. Included studies were limited to clinical trials including patients with cancer, DS products as interventions, evaluation of safety endpoints of DS use, and published in English. Sixty-five studies were included to evaluate 20 different DS among patients with 12 types of cancer. Botanical DS (n = 13), vitamins (n = 8), and probiotics/synbiotics (n = 7) were the top 3 types of DS evaluated in these trials. Majority of studied DS appeared safe. Among 19 trials including patients with cancer undergoing chemotherapy, most (n = 18) of studied DS (e.g., vitamins, botanical, omega-3 fatty acid) were found to be safe. Evaluation of DS use and its safety should be regularly incorporated in clinical trials among patients with cancer.
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Affiliation(s)
- Zhen Zeng
- Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | | | - Jingjing Qian
- Auburn University Harrison School of Pharmacy, Auburn, AL, USA.
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58
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Zanecosky R. Pediatric Patients and Dietary Choices: Examining Alternative Options, Decision Making, and Misinformation. Clin J Oncol Nurs 2020; 24:290-295. [PMID: 32441693 DOI: 10.1188/20.cjon.290-295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Nutrition is a key component of oncologic therapies and treatments. Patients and families are interested in the integration of alternative diets to promote therapy response as well as counteract the cancer. With the expansion of online and social media presence comes the endorsement of nonscientific claims. OBJECTIVES The purpose of this article is to review alternative diets and discuss the basis of good nutrition in pediatric patients with cancer. This article will also explore where patients and families are likely to seek their information and assess their level of trust in the information. METHODS Five alternative diets and two supplements were assessed through a literature review for their effect on pediatric patients with cancer. FINDINGS Additional research is needed to prove consistent and definitive dietary benefits for pediatric patients with cancer; however, some diets have demonstrated promising results. A general diet for pediatric patients with cancer consists of an appropriate distribution of nutritious carbohydrates, proteins, and fats. However, unregulated sources of information remain a risk.
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59
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Wang D, Zhu X, Tang X, Li H, Yizhen X, Chen D. Auxiliary antitumor effects of fungal proteins from Hericium erinaceus by target on the gut microbiota. J Food Sci 2020; 85:1872-1890. [PMID: 32460371 DOI: 10.1111/1750-3841.15134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 03/11/2020] [Accepted: 03/16/2020] [Indexed: 12/18/2022]
Abstract
Cancer represents a major disease burden worldwide. Despite continuous advances obtained in medical therapies recently, resistance to standard drugs and adverse effects still represent important causes of therapeutic failure. There is growing evidence that the gut microbiota can affect the response to chemo- and immunotherapeutic drugs by modulating efficacy and/or toxicity, and diet is the most important factor affecting the gut microbiota. In this study, we assessed the auxiliary antitumor effects of immunomodulatory fungal proteins from Hericium erinaceus (HEP) administered with the chemotherapy drug 5-Fluorouracil (5-Fu), and we attempted to identify new potential prebiotic bacteria for auxiliary antitumor treatment. There were 1,455 proteins identified from H. erinaceus. In a xenografted mouse model of cancer, HEP with 5-Fu significantly suppressed tumor growth, inhibited inflammatory markers such as interferon (IFN)-γ, interleukin (IL)-1β, IL-2, IL-6, tumor necrosis factor (TNF)-α, and lipopolysaccharide (LPS), and regulated the expression of Akt, CCDN1, CKD4, FOXM1, MMP7, MYC, PPAR-α, and PPAR-γ. 16S rRNA sequencing showed that HEP ameliorated the dysbacteriosis induced by 5-Fu, as it inhibited certain aerobic and microaerobic bacteria including Parabacteroides, Flavobacteriaceae, Christensenellaceae, Anoxybacillus, Aggregatibacter, Comamonadaceae, Planococcaceae, Desulfovibrionaceae, Sporosarcina, Staphylococcus, Aerococcaceae, and Bilophila in the xenografted mice, and increase some probiotic bacteria such as Bifidobacterium, Gemellales, Blautia, Sutterella, Anaerostipes, Roseburia, Lachnobacterium, Lactobacillus, and Desulfovibrio. This demonstrates that HEP could promote the antitumor efficacy of 5-Fu by improving the microbiota composition, the immune inflammatory response, and homeostasis.
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Affiliation(s)
- Dongdong Wang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China
| | - Xiangxiang Zhu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China.,Academy of Life Sciences, Jinan Univ., Guangzhou, Guangdong Province, 510000, China
| | - Xiaocui Tang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China
| | - Hongye Li
- Academy of Life Sciences, Jinan Univ., Guangzhou, Guangdong Province, 510000, China
| | - Xie Yizhen
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China
| | - Diling Chen
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, 510070, China
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Xu X, Feng X, He M, Zhang Z, Wang J, Zhu H, Li T, Wang F, Sun M, Wang Z. The effect of acupuncture on tumor growth and gut microbiota in mice inoculated with osteosarcoma cells. Chin Med 2020; 15:33. [PMID: 32292489 PMCID: PMC7140491 DOI: 10.1186/s13020-020-00315-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 03/26/2020] [Indexed: 02/07/2023] Open
Abstract
Background Cancer is a complex systemic disease. As a key component of traditional Chinese medicine, acupuncture is a clinically proven medical treatment for many diseases, and it also has preventative effects as it balances the body, allowing it to self-regulate. For cancer patients, acupuncture is widely used as complementary therapy to boost the immune system and reduce the side effects of radiotherapy and chemotherapy. However, few studies have determined how acupuncture against cancer, especially in regulating the intestinal flora of the tumor-burdened mice. Methods We treated osteosarcoma tumor-burdened mice by using needling on different acupoints and acupoints combination, thereafter determined the effects of acupuncture on tumor growth by using imaging technology in vitro. In addition, intestinal bacteria were analyzed for further understanding the holistic and systemic treatment effects of acupuncture in osteosarcoma tumor-burdened mice. Results Acupuncture treatment can delay tumor growth and changes of intestinal bacteria in osteosarcoma tumor-burdened mice. In detail, the loss of body weight and the development of tumor volume of mice have been postposed by needling specific acupoints. In addition, acupuncture treatment has delayed the changes of the relative abundance of Bacteroidetes, Firmicutes and Candidatus Saccharibacteria at the phylum level. Moreover, the relative abundance of many bacteria (e.g., Catabacter, Acetatifactor and Aestuariispira) has been regulated by using acupuncture treatment, and the trend of structural changes of these bacteria at the genus level has also been postposed compared to that of the tumor-burdened mice model group. Conclusion Our results suggest that acupuncture may provide a systemic treatment for cancer. Our findings encourage new and extensive research into the effects of acupuncture on changes of the intestinal microbiome associated with the development of cancer.
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Affiliation(s)
- Xiaoru Xu
- 1Changchun University of Chinese Medicine, No. 1035, Boshuo Rd, Jingyue Economic Development District, Changchun, 130117 China
| | - Xiangru Feng
- 2Key Laboratory of Polymer Ecomaterials, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, 5625 Renmin Street, Changchun, 130022 People's Republic of China
| | - Min He
- 1Changchun University of Chinese Medicine, No. 1035, Boshuo Rd, Jingyue Economic Development District, Changchun, 130117 China
| | - Zepeng Zhang
- 1Changchun University of Chinese Medicine, No. 1035, Boshuo Rd, Jingyue Economic Development District, Changchun, 130117 China.,3Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin China
| | - Jiajia Wang
- 1Changchun University of Chinese Medicine, No. 1035, Boshuo Rd, Jingyue Economic Development District, Changchun, 130117 China
| | - Haiyu Zhu
- 1Changchun University of Chinese Medicine, No. 1035, Boshuo Rd, Jingyue Economic Development District, Changchun, 130117 China
| | - Tie Li
- 1Changchun University of Chinese Medicine, No. 1035, Boshuo Rd, Jingyue Economic Development District, Changchun, 130117 China
| | - Fuchun Wang
- 1Changchun University of Chinese Medicine, No. 1035, Boshuo Rd, Jingyue Economic Development District, Changchun, 130117 China
| | - Mengmeng Sun
- 1Changchun University of Chinese Medicine, No. 1035, Boshuo Rd, Jingyue Economic Development District, Changchun, 130117 China.,4SKL of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, N22 Avenida da Universidade, Taipa, Macau China
| | - Zhihong Wang
- 1Changchun University of Chinese Medicine, No. 1035, Boshuo Rd, Jingyue Economic Development District, Changchun, 130117 China
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Gao R, Zhang X, Huang L, Shen R, Qin H. Gut Microbiota Alteration After Long-Term Consumption of Probiotics in the Elderly. Probiotics Antimicrob Proteins 2020. [PMID: 29520675 DOI: 10.1007/s12602-018-9403-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Gut microbiota has been proven to be of crucial importance in maintaining human health. However, the microbiota profile changes with aging, while the loss of microbiota diversity and the alterations in the optimal composition and quantity of beneficial microbes are believed to increase the risk of many diseases. Although the short-term modulatory impact of probiotics on gut microbiota has been revealed in various studies, no studies focused on longer time consumption of probiotics have been demonstrated. In this study, we found that microbial diversity in the probiotic group was similar to that in the control. We identified a panel of microbiota changes, such as Blautia (10.24 vs. 3.76%, P = 0.006), Streptococcus (7.38 vs. 1.16%, P = 0.004), and Enterococcus (0.13 vs. 0.00%, P = 0.030) were more abundant in the probiotic group. Faecalibacterium, a genus containing anti-inflammatory property, also had a higher abundance in the probiotic group in the gut. The microbiota architecture in the different probiotic dose groups was also revealed. No statistical difference was observed in regard to the short-chain fatty acid concentration between the groups. High-dose intake of probiotics resulted in lower microbial richness. The profile of inflammatory factors indicated that only the level of IL-1β was higher in the probiotic population. Taken together, our study demonstrated that the long-time intake of probiotics caused significant changes in the gut microbiota structure, including an increase in the composition of beneficial microorganisms, which might contribute to the maintenance of host health and homeostasis of microenvironment. More prospective cohorts were needed to illustrate the influences of probiotics on the gut microbiota.
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Affiliation(s)
- Renyuan Gao
- Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai, China.,Research Institute of Intestinal Diseases, Tongji University School of Medicine, Shanghai, China
| | - Xiaohui Zhang
- Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai, China.,Research Institute of Intestinal Diseases, Tongji University School of Medicine, Shanghai, China.,Medical College of Soochow University, Suzhou, China
| | - Linsheng Huang
- Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai, China.,Research Institute of Intestinal Diseases, Tongji University School of Medicine, Shanghai, China
| | - Rongrong Shen
- Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai, China
| | - Huanlong Qin
- Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai, China. .,Research Institute of Intestinal Diseases, Tongji University School of Medicine, Shanghai, China. .,Medical College of Soochow University, Suzhou, China.
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Li Y, Yin Z, Zhang Y, Liu J, Cheng Y, Wang J, Pi F, Zhang Y, Sun X. Perspective of Microbe-based Minerals Fortification in Nutrition Security. FOOD REVIEWS INTERNATIONAL 2020. [DOI: 10.1080/87559129.2020.1728308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ying Li
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, People’s Republic of China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, People’s Republic of China
- Synergetic Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, People’s Republic of China
| | - Ziye Yin
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, People’s Republic of China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, People’s Republic of China
- Synergetic Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, People’s Republic of China
| | - Yuanyuan Zhang
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, People’s Republic of China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, People’s Republic of China
- Synergetic Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, People’s Republic of China
| | - Jinghan Liu
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, People’s Republic of China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, People’s Republic of China
- Synergetic Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, People’s Republic of China
| | - Yuliang Cheng
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, People’s Republic of China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, People’s Republic of China
- Synergetic Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, People’s Republic of China
| | - Jiahua Wang
- College of Food Science and Engineering, Wuhan Polytechnic University, Wuhan, People’s Republic of China
| | - Fuwei Pi
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, People’s Republic of China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, People’s Republic of China
- Synergetic Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, People’s Republic of China
| | - Yinzhi Zhang
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, People’s Republic of China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, People’s Republic of China
- Synergetic Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, People’s Republic of China
| | - Xiulan Sun
- State Key Laboratory of Food Science and Technology, School of Food Science and Technology, Jiangnan University, Wuxi, People’s Republic of China
- National Engineering Research Center for Functional Food, Jiangnan University, Wuxi, People’s Republic of China
- Synergetic Innovation Center of Food Safety and Quality Control, Jiangnan University, Wuxi, People’s Republic of China
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Herremans KM, Riner AN, Cameron ME, Trevino JG. The Microbiota and Cancer Cachexia. Int J Mol Sci 2019; 20:ijms20246267. [PMID: 31842339 PMCID: PMC6940781 DOI: 10.3390/ijms20246267] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 12/05/2019] [Accepted: 12/10/2019] [Indexed: 12/12/2022] Open
Abstract
Cancer cachexia is a multifactorial syndrome defined by weight loss, muscle wasting, and systemic inflammation. It affects the majority of patients with advanced cancer and is associated with poor treatment response, early mortality and decreased quality of life. The microbiota has been implicated in cancer cachexia through pathways of systemic inflammation, gut barrier dysfunction and muscle wasting. The imbalance of the microbiota, known as dysbiosis, has been shown to influence cancer cachexia. Bacteria that play beneficial and detrimental roles in the disease pathogenesis have been identified. The phenotype of cancer cachexia is associated with decreased levels of Lactobacillales and increased levels of Enterobacteriaceae and Parabacteroides. Currently, there are no treatment options that demonstrate increased survival or the quality of life in patients suffering from cancer cachexia. Through the manipulation of beneficial bacteria in the gut microbiota, different treatment options have been explored. Prebiotics and probiotics have been shown to improve outcomes in animal models of cachexia. Expounding on this mechanism, fecal microbiota transplant (FMT) holds promise for a future treatment of cancer cachexia. Further research is necessary to address this detrimental disease process and improve the lives of patients suffering from cancer cachexia.
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Schallock H, Bartmann B, Keinki C, Huebner J. Online information on oncologists' and non-medical practitioners' websites in Germany: A critical comparison. PATIENT EDUCATION AND COUNSELING 2019; 102:2038-2048. [PMID: 31147090 DOI: 10.1016/j.pec.2019.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To survey websites of oncologists and non-medical practitioners (NMPs) in Germany regarding range of treated symptoms, diagnostic tools and therapies offered to cancer patients as well as the quality of websites. METHODS Analysis of 98 websites of oncologists and NMPs was conducted between April and July 2018 with a standardized tool. RESULTS Range of diagnostic and therapeutic methods was high and differed between both groups. Many NMPs (65.3%) intended to support conventional therapy rather than to treat cancer. Most oncologists (85.7%) did not mention the role of complementary and alternative medicine (CAM). Texts on oncologists' websites, showed high complexity according to readability analysis using LIX score as opposed to those on NMPs websites that showed medium complexity. Only small difference of quality of websites between both groups could be detected. CONCLUSION Methods not acknowledged by evidence-based medicine as well as methods at risk for interaction with conventional cancer therapy but also treatment offers with potential benefits for cancer patients were found on NMPs websites. PRACTICE IMPLICATIONS As evidence-based CAM methods can be a useful support of cancer treatment, risk of herb drug interactions can be minimized by oncologists offering reasonable CAM.
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Affiliation(s)
- Henriette Schallock
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Berit Bartmann
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Christian Keinki
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
| | - Jutta Huebner
- Dept. of Hematology and Medical Oncology, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany.
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Chandel D, Sharma M, Chawla V, Sachdeva N, Shukla G. Isolation, characterization and identification of antigenotoxic and anticancerous indigenous probiotics and their prophylactic potential in experimental colon carcinogenesis. Sci Rep 2019; 9:14769. [PMID: 31611620 PMCID: PMC6791833 DOI: 10.1038/s41598-019-51361-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 09/27/2019] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer, the third most commonly diagnosed cancer, is a lifestyle disease where diet and gut microbiome contribute intricately in its initiation and progression. Prophylactic bio-interventions mainly probiotics offer an alternate approach towards reducing or delaying its progression. Therefore, the present study was designed wherein a robust protocol for the isolation, characterization, and identification of indigenous probiotics having antigenotoxic and anticancerous activity was followed along with their prophylactic potential assessment in early experimental colorectal carcinogenesis. Among forty-six isolated lactic acid bacterial strains, only three were selected on the basis of antigenotoxicity against N,N-Dimethyl dihydrazine dihydrochloride and 4-Nitroquinoline 1-oxide and probiotic attributes. All three selected probiotic strains exhibited anticancerous potential as is evident by the reduced Aberrant Crypt Foci, reduced fecal pH, enhanced fecal lactic acid bacteria and altered fecal enzymes (β-glucuronidase, nitroreductase, β-glucosidase) that modulated gut microbiota and microenvironment resulting into restored histoarchitecture of the colon. The results are a clear indicator of the prophylactic potential of selected indigenous probiotics which may be used as an alternative prophylactic biological therapy against colon carcinogenesis particularly in highly susceptible individuals.
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Affiliation(s)
- Deepika Chandel
- Department of Microbiology, Panjab University, Chandigarh, 160014, India
| | - Mridul Sharma
- Department of Microbiology, Panjab University, Chandigarh, 160014, India
| | - Vibhindika Chawla
- Department of Microbiology, Panjab University, Chandigarh, 160014, India
| | - Naresh Sachdeva
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India
| | - Geeta Shukla
- Department of Microbiology, Panjab University, Chandigarh, 160014, India.
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66
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Sha S, Ni L, Stefil M, Dixon M, Mouraviev V. The human gastrointestinal microbiota and prostate cancer development and treatment. Investig Clin Urol 2019; 61:S43-S50. [PMID: 32055753 PMCID: PMC7004837 DOI: 10.4111/icu.2020.61.s1.s43] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/16/2019] [Indexed: 01/14/2023] Open
Abstract
The human gastrointestinal microbiome contains commensal bacteria and other microbiota that have been gaining increasing attention in the context of cancer development and response to treatment. Microbiota play a role in the maintenance of host barrier surfaces that contribute to both local inflammation and other systemic metabolic functions. In the context of prostate cancer, the gastrointestinal microbiome may play a role through metabolism of estrogen, an increase of which has been linked to the induction of prostatic neoplasia. Specific microbiota such as Bacteroides, Streptococcus, Bacteroides massiliensis, Faecalibacterium prausnitzii, Eubacterium rectalie, and Mycoplasma genitalium have been associated with differing risks of prostate cancer development or extensiveness of prostate cancer disease. In this Review, we discuss gastrointestinal microbiota's effects on prostate cancer development, the ability of the microbiome to regulate chemotherapy for prostate cancer treatment, and the importance of using Next Generation Sequencing to further discern the microbiome's systemic influence on prostate cancer.
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Affiliation(s)
- Sybil Sha
- Dartmouth Medical School, Hanover, NH, USA
| | - Liqiang Ni
- University of Central Florida, Orlando, FL, USA
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Sotoudegan F, Daniali M, Hassani S, Nikfar S, Abdollahi M. Reappraisal of probiotics’ safety in human. Food Chem Toxicol 2019; 129:22-29. [DOI: 10.1016/j.fct.2019.04.032] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 04/16/2019] [Accepted: 04/17/2019] [Indexed: 02/07/2023]
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68
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Gill CM, Hughes MSA, LaPlante KL. A Review of Nonantibiotic Agents to Prevent Urinary Tract Infections in Older Women. J Am Med Dir Assoc 2019; 21:46-54. [PMID: 31227473 DOI: 10.1016/j.jamda.2019.04.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 04/15/2019] [Accepted: 04/16/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE This article provides a comprehensive literature review on nonantibiotic agents used for the prevention of urinary tract infections (UTIs) in women ≥45 years of age. DESIGN A structured review was performed by conducting a literature search to identify relevant studies pertaining to the use of nonantibiotic agents to prevent UTIs in women who were perimenopausal through postmenopausal. Recommendations were made for or against the use of each nonantibiotic agent, unless data were unavailable. Levels of evidence were assigned to each recommendation made. SETTING AND PARTICIPANTS Studies on the prevention of UTIs with women subjects ≥45 years of age in the community, inpatient, and long-term care settings were considered for inclusion. MEASURE The efficacy and safety of using ascorbic acid, cranberry products, d-mannose, estrogens, lactobacilli, and methenamine hippurate for prevention of UTIs was assessed. RESULTS There is evidence to support use of estrogens (A-I) in postmenopausal women, and cranberry capsules (C-I) in women ≥45 years of age for the prevention of UTIs. There was a lack of evidence to make recommendations for or against the use of ascorbic acid, cranberry juice, cranberry capsules with high proanthocyanidin (PAC) content, d-mannose, lactobacillus, and methenamine hippurate in this population. CONCLUSIONS/IMPLICATIONS Current studies support that estrogens and cranberry capsules may have a role in preventing UTIs in women ≥45 years of age. Further research is needed to elucidate the role of these nonantibiotic agents and how they may be used to decrease antibiotic use.
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Affiliation(s)
| | - Maria-Stephanie A Hughes
- University of Rhode Island, Department of Pharmacy Practice, College of Pharmacy, Kingston, RI; Veterans Affairs Medical Center, Infectious Diseases Research Program, Providence, RI
| | - Kerry L LaPlante
- University of Rhode Island, Department of Pharmacy Practice, College of Pharmacy, Kingston, RI; Veterans Affairs Medical Center, Infectious Diseases Research Program, Providence, RI; Warren Alpert Medical School of Brown University, Division of Infectious Diseases, Providence, RI.
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69
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Li Y, Liu M, Zhou J, Hou B, Su X, Liu Z, Yuan J, Li M. Bacillus licheniformis Zhengchangsheng® attenuates DSS-induced colitis and modulates the gut microbiota in mice. Benef Microbes 2019; 10:543-553. [DOI: 10.3920/bm2018.0122] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Human inflammatory bowel disease (IBD) and experimental colitis models in mice are associated with shifts in gut microbiota composition, and several probiotics are widely used to improve gastrointestinal health. Here, we investigated whether the probiotic Bacillus licheniformis Zhengchangsheng® (BL) ameliorates dextran sulphate sodium (DSS)-induced colitis through alteration of the gut microbiota. Experimental colitis was induced in BALB/C mice by dissolving 3% DSS in their drinking water for 7 days, which were gavaged with 0.2 ml phosphate-buffered saline or BL (3×107 cfu/ml) once a day. Administration of BL attenuated several effects of DSS-induced colitis, including weight loss, increased disease activity index, and disrupted intestinal barrier integrity. In addition, BL mitigated the reduction in faecal microbiota richness in DSS treated mice. Interestingly, BL was found to reduce the elevated circulating endotoxin level in mice with colitis by modulating the microbial composition of the microbiota, and this was highly associated with a proportional decrease in gut Bacteroidetes. Our results demonstrate that BL can attenuate DSS-induced colitis and provide valuable insight into microbiota interactions during IBD.
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Affiliation(s)
- Y. Li
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, China P.R
| | - M. Liu
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China P.R
| | - J. Zhou
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China P.R
| | - B. Hou
- Department of Dermatology and Venerology, the First Affiliated Hospital of Dalian Medical University, Dalian, China P.R
| | - X. Su
- Research Institute of Northeastern Pharmaceutical Group (NEPG), Shenyang, China P.R
| | - Z. Liu
- Advanced Institute for Medical Sciences, Dalian Medical University, Dalian, China P.R
| | - J. Yuan
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China P.R
| | - M. Li
- Department of Microecology, College of Basic Medical Science, Dalian Medical University, Dalian, China P.R
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Nagano T, Otoshi T, Hazama D, Kiriu T, Umezawa K, Katsurada N, Nishimura Y. Novel cancer therapy targeting microbiome. Onco Targets Ther 2019; 12:3619-3624. [PMID: 31190864 PMCID: PMC6526180 DOI: 10.2147/ott.s207546] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/10/2019] [Indexed: 12/23/2022] Open
Abstract
In the human intestinal tract, there are more than 100 trillion symbiotic bacteria, which form the gut microbiota. Approximately 70% of the human immune system is in the intestinal tract, which prevents infection by pathogenic bacteria. When the intestinal microbiota is disturbed, causing dysbiosis, it can lead to obesity, diabetes mellitus, inflammatory bowel disease, rheumatoid arthritis, multiple sclerosis, autism spectrum disorder and cancer. Recent metabolomics analyses have also made the association between the microbiota and carcinogenesis clear. Here, we review the current evidence on the association between the microbiota and gastric, bladder, hepatobiliary, pancreatic, lung and colorectal cancer. Moreover, several animal studies have revealed that probiotics seem to be effective for the prevention of carcinogenesis to some extent. In this review, we focused on this relationship between the microbiota and cancer, and considered how to prevent cancer using strategies involving the gut microbiota.
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Affiliation(s)
- Tatsuya Nagano
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Takehiro Otoshi
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Daisuke Hazama
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Tatsunori Kiriu
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Kanoko Umezawa
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Naoko Katsurada
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
| | - Yoshihiro Nishimura
- Division of Respiratory Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan
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Effect of probiotic and synbiotic supplementation on inflammatory markers in health and disease status: A systematic review and meta-analysis of clinical trials. Clin Nutr 2019; 39:789-819. [PMID: 31060892 DOI: 10.1016/j.clnu.2019.04.004] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 02/06/2023]
Abstract
The current systematic review and meta-analysis investigated the effect of probiotic/synbiotic on a wide range of inflammatory and anti-inflammatory markers in healthy and various disease conditions. PubMed, SCOPUS and Web of Science databases were searched. All clinical trials which investigated the effect of oral administration of probiotic or synbiotic on inflammatory markers (C-reactive protein (CRP), interleukin (IL) 1β, IL-4, IL-6, IL-8, IL-10, IL-12, tumor necrosis factor (TNF) α, interferon (IFN) γ and transforming growth factor (TGF) β) for more than one week with concurrent control groups were included. One-hundred sixty seven publications was analysed. Results were as follows: CRP decreased in healthy, metabolic disorders, inflammatory bowel disease (IBD), arthritis and critically ill condition but not in renal failure. IL-1B: no change in healthy subjects and arthritis. TNF-α: decreased in healthy, fatty liver, IBD and hepatic cirrhosis, no change in diabetes, metabolic syndrome (MS) + PCOS (polycystic ovary syndrome) and arthritis. IL-6: no change in healthy, metabolic disorders and arthritis, increased in cirrhosis and renal failure, decreased in PCOS + MS. IL-10: no change in healthy, IBD and metabolic disorders, increased in arthritis. IL-4, IL-8, IL-12, IFN-g and TGF-b: no change in healthy subjects. In conclusion, probiotic/synbiotic decreased some of the inflammatory markers. The intervention was most effective in CRP and TNF-α reduction in healthy or disease state. Moreover, the intervention decreased inflammation most effectively in the following disease conditions, respectively: IBD, arthritis, fatty liver. PROSPERO REGISTRATION NUMBER: CRD42018088688.
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72
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Qiu G, Yu Y, Wang Y, Wang X. The significance of probiotics in preventing radiotherapy-induced diarrhea in patients with cervical cancer: A systematic review and meta-analysis. Int J Surg 2019; 65:61-69. [PMID: 30928672 DOI: 10.1016/j.ijsu.2019.03.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 02/01/2019] [Accepted: 03/22/2019] [Indexed: 10/27/2022]
Abstract
AIMS A systematic review and meta-analysis was designed to evaluate the efficacy and safety of probiotics for prevention of radiotherapy-induced diarrhea (RID) in patients with cervical cancer. Previous studies failed to give a comprehensive analysis of the efficacy and safety of probiotics in this point. METHODS We searched the Cochrane Library, PubMed, EMBASE and Web of Science up to June 4, 2018. We also hand searched some studies included in previous reviews. Our primary outcome aims to compare the incidence of all Common Toxicity Criteria (CTC) grades of RID and adverse events (AEs) in both probiotics groups and placebo groups. Relative risk (RR) with its 95% confidence interval (CI) was used to compare the efficacy of probiotics in prevention of RID, and the pooled RRs were estimated using a fixed- or random-effect model; heterogeneity was assessed with Cochran's Q and Higgins I2 test. Two reviewers assessed trial quality and extracted data independently. The analysis and bias for each of included studies were performed and assessed using Review Manager 5.2. RESULTS Nine randomized, placebo-controlled studies (N = 1508 participants) were included for assessing the efficacy of probiotics. Compared with placebo groups, participants in probiotic groups experienced much lower incidence of RID with RR of 0.61 (95% CI 0.46-0.81; P = 0.0007). In addition, significant results were also observed in CTC grade ≥2 and grade ≥3 RID, with the pooled RRs of 0.52 (95% CI 0.30-0.98; P = 0.02) and 0.32 (95% CI 0.12-0.82; P = 0.02) respectively. Eight studies, included 1410 participants (726 consuming probiotics, 657 consuming placebo, 27 lost to follow-up), were used for the analysis of safety of probiotics. Of the 8 studies, 4 studies had no AEs caused by probiotics, while another 4 studies reported varying degrees of AEs during their treatment. CONCLUSIONS Probiotics may have a beneficial effect in prevention of RID generally, especially for Grade ≥2 or 3 diarrhea. Probiotics may be safe and rarely cause severe AEs during treatment.
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Affiliation(s)
- Guijing Qiu
- Department of Gynecology, Tiantai Branch of Zhejiang Provincial People's Hospital, Tiantai, 317200, China
| | - Yan Yu
- Department of Gynecology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China
| | - Yanpeng Wang
- Department of Gynecology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China
| | - Xinyan Wang
- Department of Gynecology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, China.
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73
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Biesiada G, Krycińska R, Czepiel J, Stażyk K, Kędzierska J, Garlicki A. Meningoencephalitis caused by Lactobacillus plantarum - case report. Int J Neurosci 2019; 129:715-718. [PMID: 29813007 DOI: 10.1080/00207454.2018.1482293] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Specific strains of Lactobacillus spp. are widely used as probiotic agents but it has been repeatedly reported that may have a pathogenic potential. We present the report on a case of meningoencephalitis caused by Lactobacillus plantarum in a 63-year-old man with newly diagnosed metastatic planoepitheliale lung cancer. The patient was hospitalised due to newly diagnosed cancer and during the course of hospitalisation developed symptoms of neuroinfection. On the basis of the symptoms and results of the conducted tests the patient was diagnosed with bacterial meningoencephalitis. In microbiological tests of the blood and cerebrospinal fluid L. plantarum was cultured. During the course of antibiotic therapy the patient's condition improved. Lactobacilli are now recognised as a causative agent of infection, most notably bacteraemia. To our knowledge, this is the fourth documented case of Lactobacillus-associated neuroinfection, and only the second in an adult. Lactobacilli cause mostly opportunistic infections in immunocompromised individuals.
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Affiliation(s)
- Grażyna Biesiada
- a Department of Infectious and Tropical Diseases , Jagiellonian University Medical College , Krakow , Poland
| | - Róża Krycińska
- b Students' Scientific Society , Jagiellonian University Medical College , Krakow , Poland
| | - Jacek Czepiel
- a Department of Infectious and Tropical Diseases , Jagiellonian University Medical College , Krakow , Poland
| | - Katarzyna Stażyk
- a Department of Infectious and Tropical Diseases , Jagiellonian University Medical College , Krakow , Poland
| | | | - Aleksander Garlicki
- a Department of Infectious and Tropical Diseases , Jagiellonian University Medical College , Krakow , Poland
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Vivarelli S, Salemi R, Candido S, Falzone L, Santagati M, Stefani S, Torino F, Banna GL, Tonini G, Libra M. Gut Microbiota and Cancer: From Pathogenesis to Therapy. Cancers (Basel) 2019; 11:cancers11010038. [PMID: 30609850 PMCID: PMC6356461 DOI: 10.3390/cancers11010038] [Citation(s) in RCA: 302] [Impact Index Per Article: 60.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 12/27/2018] [Indexed: 02/07/2023] Open
Abstract
Cancer is a multifactorial pathology and it represents the second leading cause of death worldwide. In the recent years, numerous studies highlighted the dual role of the gut microbiota in preserving host’s health. Gut resident bacteria are able to produce a number of metabolites and bioproducts necessary to protect host’s and gut’s homeostasis. Conversely, several microbiota subpopulations may expand during pathological dysbiosis and therefore produce high levels of toxins capable, in turn, to trigger both inflammation and tumorigenesis. Importantly, gut microbiota can interact with the host either modulating directly the gut epithelium or the immune system. Numerous gut populating bacteria, called probiotics, have been identified as protective against the genesis of tumors. Given their capability of preserving gut homeostasis, probiotics are currently tested to help to fight dysbiosis in cancer patients subjected to chemotherapy and radiotherapy. Most recently, three independent studies show that specific gut resident species may potentiate the positive outcome of anti-cancer immunotherapy. The highly significant studies, uncovering the tight association between gut microbiota and tumorigenesis, as well as gut microbiota and anti-cancer therapy, are here described. The role of the Lactobacillus rhamnosus GG (LGG), as the most studied probiotic model in cancer, is also reported. Overall, according to the findings here summarized, novel strategies integrating probiotics, such as LGG, with conventional anti-cancer therapies are strongly encouraged.
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Affiliation(s)
- Silvia Vivarelli
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
| | - Rossella Salemi
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
| | - Saverio Candido
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
| | - Luca Falzone
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
| | - Maria Santagati
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, 95123 Catania, Italy.
| | - Stefania Stefani
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of Catania, 95123 Catania, Italy.
| | - Francesco Torino
- Department of Systems Medicine, Medical Oncology, Tor Vergata University of Rome, 00133 Rome, Italy.
| | | | - Giuseppe Tonini
- Department of Medical Oncology, University Campus Bio-Medico of Rome, 00128 Rome, Italy.
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, Oncologic, Clinic and General Pathology Section, University of Catania, 95123 Catania, Italy.
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy.
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75
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Gately S. Human Microbiota and Personalized Cancer Treatments: Role of Commensal Microbes in Treatment Outcomes for Cancer Patients. Cancer Treat Res 2019; 178:253-264. [PMID: 31209849 DOI: 10.1007/978-3-030-16391-4_10] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The human gut microbiota consists of about 3.8 × 1013 microorganisms that play an essential role in health, metabolism, and immunomodulation. These gut microbes alter therapeutic response and toxicity to cancer therapies including cytotoxic chemotherapy, radiation therapy, kinase inhibitors, and immunotherapy agents. The gut microbiota generates short-chain fatty acids that are significant regulators of histone post-translational modifications that fundamentally regulate gene expression, linking the microbiota to cellular metabolism and transcriptional regulation. The short-chain fatty acids not only act locally but can be taken up in the blood stream to inhibit the activity of histone deacetylases, regulate gene expression in distant organs as well as the effector function of CD8+ T cells. Cancer and the treatments for it negatively impact the microbiome often resulting in dysbiosis. This can diminish a patient's response to treatment as well as increase systemic toxicities from these therapies. In addition to the gut microbiota, microbes have been detected in tumors that can modulate chemotherapeutic drug response and can result in immune suppression. The gut microbiota and tumor-associated bacteria may be a significant contributor to the interindividual differences and heterogeneous responses to cancer therapies and drug tolerability and strategies that support and/or manipulate the microbiota to improve therapeutic outcome is an emerging area for personalized cancer treatment.
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Affiliation(s)
- Stephen Gately
- Translational Drug Development (TD2), Scottsdale, AZ, USA.
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76
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Quigley EMM. Prebiotics and Probiotics in Digestive Health. Clin Gastroenterol Hepatol 2019; 17:333-344. [PMID: 30267869 DOI: 10.1016/j.cgh.2018.09.028] [Citation(s) in RCA: 172] [Impact Index Per Article: 34.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 02/07/2023]
Abstract
As the importance of the gut microbiota in health and disease is increasingly recognized interest in interventions that can modulate the microbiota and its interactions with its host has soared. Apart from diet, prebiotics and probiotics represent the most commonly used substances taken in an effort to sustain a healthy microbiome or restore balance when it is believed bacterial homeostasis has been disturbed in disease. While a considerable volume of basic science attests to the ability of various prebiotic molecules and probiotic strains to beneficially influence host immune responses, metabolic processes and neuro-endocrine pathways, the evidence base from human studies leaves much to be desired. This translational gap owes much to the manner in which this sector is regulated but also speaks to the challenges that confront the investigator who seeks to explore microbiota modulation in either healthy populations or those who suffer from common digestive ailments. For many products marketed as probiotics, some of the most fundamental issues relating to quality control, such as characterization, formulation, viability safety are scarcely addressed.
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Affiliation(s)
- Eamonn M M Quigley
- Division of Gastroenterology and Hepatology, Lynda K. and David M. Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas.
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77
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Kothari D, Patel S, Kim SK. Probiotic supplements might not be universally-effective and safe: A review. Biomed Pharmacother 2018; 111:537-547. [PMID: 30597307 DOI: 10.1016/j.biopha.2018.12.104] [Citation(s) in RCA: 183] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 12/09/2018] [Accepted: 12/23/2018] [Indexed: 02/07/2023] Open
Abstract
Last few decades have witnessed the unprecedented growth in the application of probiotics for promoting the general gut health as well as their inception as biotherapeutics to alleviate certain clinical disorders related to dysbiosis. While numerous studies have substantiated the health-restoring potentials for a restricted group of microbial species, the marketed extrapolation of a similar probiotic label to a large number of partially characterized microbial formulations seems biased. In particular, the individuals under neonatal stages and/or those with some clinical conditions including malignancies, leaky gut, diabetes mellitus, and post-organ transplant convalescence likely fail to reap the benefits of probiotics. Further exacerbating the conditions, some probiotic strains might take advantage of the weak immunity in these vulnerable groups and turn into opportunistic pathogens engendering life-threatening pneumonia, endocarditis, and sepsis. Moreover, the unregulated and rampant use of probiotics potentially carry the risk of plasmid-mediated antibiotic resistance transfer to the gut infectious pathogens. In this review, we discuss the safety perspectives of probiotics and their therapeutic interventions in certain at-risk population groups. The embodied arguments and hypotheses certainly will shed light on the fact why probiotic usage should be treated with caution.
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Affiliation(s)
- Damini Kothari
- Department of Animal Science and Technology, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, Republic of Korea
| | - Seema Patel
- Bioinformatics and Medical Informatics Research Center, San Diego State University, San Diego, 92182, USA.
| | - Soo-Ki Kim
- Department of Animal Science and Technology, Konkuk University, 120 Neungdong-ro, Gwangjin-gu, Seoul, 05029, Republic of Korea.
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78
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Abughanimeh O, Qasrawi A, Kaddourah O, Al Momani L, Abu Ghanimeh M. Clostridium difficile infection in oncology patients: epidemiology, pathophysiology, risk factors, diagnosis, and treatment. Hosp Pract (1995) 2018; 46:266-277. [PMID: 30296190 DOI: 10.1080/21548331.2018.1533673] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Clostridium difficile infection (CDI) is one of the most common healthcare-associated infections in the United States. Its incidence has been increasing in the recent years despite preventative measures. CDI increases annual expenses by 1.5 billion dollars. Cancer patients are at higher risk to acquire CDI, as explained by their frequent exposure to risk factors. CDI in cancer patients is associated with higher mortality rates and prolonged hospitalization. Furthermore, CDI affects the course of the disease by delaying treatments such as chemotherapy. Chemotherapeutics drugs are considered independent risk factors for CDI. This review discusses Clostridium difficile infection in cancer patients, including those who are receiving chemotherapy. Herein, we summarize recent data regarding the epidemiology, risk factors, including chemotherapy regimens, pathogenesis, diagnostic techniques and treatment options, including newer agents. Method: A literature search was performed using the PubMed and Google Scholar databases. The MeSH terms utilized in different combinations were 'clostridium difficile', 'neoplasia/cancer/oncology', 'chemotherapy', 'diagnosis', and 'treatment', in addition to looking up each treatment option individually to generate a comprehensive search. The articles were initially screened by title alone, followed by screening through abstracts. Full texts of pertinent articles (including letters to editors, case reports, case series, cohort studies, and clinical trials) were included in this review.
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Affiliation(s)
- Omar Abughanimeh
- a School of Medicine Internal Medicine , University of Missouri , Kansas City , USA
| | - Ayman Qasrawi
- a School of Medicine Internal Medicine , University of Missouri , Kansas City , USA
| | - Osama Kaddourah
- a School of Medicine Internal Medicine , University of Missouri , Kansas City , USA
| | - Laith Al Momani
- b East Tennessee State University James H Quillen College of Medicine - Internal Medicine , USA
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Bossi P, Antonuzzo A, Cherny NI, Rosengarten O, Pernot S, Trippa F, Schuler U, Snegovoy A, Jordan K, Ripamonti CI. Diarrhoea in adult cancer patients: ESMO Clinical Practice Guidelines. Ann Oncol 2018; 29:iv126-iv142. [PMID: 29931177 DOI: 10.1093/annonc/mdy145] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- P Bossi
- Head and Neck Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano
| | - A Antonuzzo
- U.O. Oncologia Medica 1, Polo Oncologico Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | - N I Cherny
- Oncology Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - O Rosengarten
- Oncology Institute, Shaare Zedek Medical Center, Jerusalem, Israel
| | - S Pernot
- Department of Hepato-Gastroenterology and Digestive Oncology, Georges Pompidou European Hospital, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - F Trippa
- Radiation Oncology Centre, "S. Maria" Hospital, Terni, Italy
| | - U Schuler
- Department of Internal Medicine I, Palliative Care Centre, University Hospital Carl Gustav Carus, Dresden, Germany
| | - A Snegovoy
- N.N. Blokhin Russian Cancer Research Center, Moscow, Russia
| | - K Jordan
- Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - C I Ripamonti
- Oncology-Supportive Care in Cancer Unit, Department Onco-Haematology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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80
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Thomsen M, Clarke S, Vitetta L. The role of adjuvant probiotics to attenuate intestinal inflammatory responses due to cancer treatments. Benef Microbes 2018; 9:899-916. [PMID: 30232908 DOI: 10.3920/bm2017.0172] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Chemotherapy and radiotherapy treatment regimens for gastrointestinal, peritoneal and pelvic tumours can disrupt the intestinal microbiome and intestinal epithelia. Such disturbances can provoke symptoms such as diarrhoea, nausea and vomiting. Chemotherapy and radiotherapy induced gastrointestinal toxicity aggravating intestinal microbiome dysbiosis is postulated to adversely alter the intestinal microbiome, with a consequent induced pro-inflammatory effect that disrupts the intestinal microbiome-epithelia-mucosal immunity axis. Although not widely recognised, the intestinal mucosa is the largest and most densely and dynamically populated immune-environment. Cancer treatment adverse effects that affect intestinal and mucosal cells inadvertently target and disrupt resident intestinal macrophages, the cells that marshal immune activity in the intestinal mucosa by shaping pro-inflammatory and anti-inflammatory activities to control and eradicate infectious insults and maintain local homeostasis. Pathobionts (bacteria capable of pathogenic pro-inflammatory activity) and noxious environmental and bacterial antigens use the intestinal epithelia and gap junctions as a point of entry into the systemic circulation. This translocation movement promotes toxic sequelae that obstruct intestinal macrophage functions resulting in uncontrolled local and systemic pro-inflammatory activity, loss of phagocytic function and loss of expression of tight junction proteins. Probiotic bacteria as an adjunctive treatment shows efficacy in ameliorating enteropathies such as mucositis/diarrhoea resulting from chemotherapy or radiotherapy regimens. As such we posit that an important benefit that warrants a further focused research effort is the administration of adjuvant probiotics to help reduce the incidence of febrile neutropenia.
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Affiliation(s)
- M Thomsen
- 1 The University of Sydney, School of Medicine, Faculty of Medicine and Health, NSW 2006, Australia
| | - S Clarke
- 1 The University of Sydney, School of Medicine, Faculty of Medicine and Health, NSW 2006, Australia.,2 Northern Clinical School, Kolling Institute of Medical Research, Pacific Hwy, St Leonards NSW 2065, Australia
| | - L Vitetta
- 1 The University of Sydney, School of Medicine, Faculty of Medicine and Health, NSW 2006, Australia.,3 Medlab Clinical Ltd., 66 McCauley St., Sydney, 2006 NSW, Australia
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81
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Hendler R, Zhang Y. Probiotics in the Treatment of Colorectal Cancer. MEDICINES (BASEL, SWITZERLAND) 2018; 5:E101. [PMID: 30205429 PMCID: PMC6164107 DOI: 10.3390/medicines5030101] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 09/05/2018] [Accepted: 09/05/2018] [Indexed: 12/19/2022]
Abstract
The human microbiome plays many roles in inflammation, drug metabolism, and even the development of cancer that we are only beginning to understand. Colorectal cancer has been a focus for study in this field as its pathogenesis and its response to treatment have both been linked to the functioning of microbiota. This literature review evaluates the animal and human studies that have explored this relationship. By manipulating the microbiome with interventions such as probiotic administration, we may be able to reduce colorectal cancer risk and improve the safety and effectiveness of cancer therapy even though additional clinical research is still necessary.
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Affiliation(s)
- Robert Hendler
- Department of Hematology and Oncology, Stony Brook University Hospital, Stony Brook, New York, NY 11794, USA.
| | - Yue Zhang
- Department of Hematology and Oncology, Stony Brook University Hospital, Stony Brook, New York, NY 11794, USA.
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82
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Wei D, Heus P, van de Wetering FT, van Tienhoven G, Verleye L, Scholten RJPM. Probiotics for the prevention or treatment of chemotherapy- or radiotherapy-related diarrhoea in people with cancer. Cochrane Database Syst Rev 2018; 8:CD008831. [PMID: 30168576 PMCID: PMC6513393 DOI: 10.1002/14651858.cd008831.pub3] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Treament-related diarrhoea is one of the most common and troublesome adverse effects related to chemotherapy or radiotherapy in people with cancer. Its reported incidence has been as high as 50% to 80%. Severe treatment-related diarrhoea can lead to fluid and electrolyte losses and nutritional deficiencies and could adversely affect quality of life (QoL). It is also associated with increased risk of infection in people with neutropenia due to anticancer therapy and often leads to treatment delays, dose reductions, or treatment discontinuation. Probiotics may be effective in preventing or treating chemotherapy- or radiotherapy-induced diarrhoea. OBJECTIVES To evaluate the clinical effectiveness and side effects of probiotics used alone or combined with other agents for prevention or treatment of chemotherapy- or radiotherapy-related diarrhoea in people with cancer. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 7), MEDLINE (1946 to July week 2, 2017), and Embase (1980 to 2017, week 30). We also searched prospective clinical trial registers and the reference lists of included studies. SELECTION CRITERIA We included randomised controlled trials (RCTs) investigating the effects of probiotics for prevention or treatment of chemotherapy- or radiotherapy-related diarrhoea in people with cancer. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data, and assessed risk of bias. We used random-effects models for all meta-analyses. If meta-analysis was not possible, we summarised the results narratively. MAIN RESULTS We included 12 studies involving 1554 participants. Eleven studies were prevention studies, of which seven compared probiotics with placebo (887 participants), one compared two doses of probiotics with each other and with placebo (246 participants), and three compared probiotics with another active agent (216 participants).The remaining study assessed the effectiveness of probiotics compared with placebo for treatment of radiotherapy-related diarrhoea (205 participants).For prevention of radiotherapy (with or without chemotherapy)-induced diarrhoea, review authors identified five heterogeneous placebo-controlled studies (with 926 participants analysed). Owing to heterogeneity, we could not carry out a meta-analysis, except for two outcomes. For occurrence of any diarrhoea, risk ratios (RRs) ranged from 0.35 (95% confidence interval (CI) 0.26 to 0.47) to 1.0 (95% CI 0.94 to 1.06) (three studies; low-certainty evidence). A beneficial effect of probiotics on quality of life could neither be demonstrated nor refuted (two studies; low-certainty evidence). For occurrence of grade 2 or higher diarrhoea, the pooled RR was 0.75 (95% CI 0.55 to 1.03; four studies; 420 participants; low-certainty evidence), and for grade 3 or higher diarrhoea, RRs ranged from 0.11 (95% CI 0.06 to 0.23) to 1.24 (95% CI 0.74 to 2.08) (three studies; low-certainty evidence). For probiotic users, time to rescue medication was 36 hours longer in one study (95% CI 34.7 to 37.3), but another study reported no difference (moderate-certainty evidence). For the need for rescue medication, the pooled RR was 0.50 (95% CI 0.15 to 1.66; three studies; 194 participants; very low-certainty evidence). No study reported major differences between groups with respect to adverse effects. Although not mentioned explicitly, no studies reported deaths, except one in which one participant in the probiotics group died of myocardial infarction after three sessions of radiotherapy.Three placebo-controlled studies, with 128 analysed participants, addressed prevention of chemotherapy-induced diarrhoea. For occurrence of any diarrhoea, the pooled RR was 0.59 (95% CI 0.36 to 0.96; two studies; 106 participants; low-certainty evidence). For all other outcomes, a beneficial effect of probiotics could be neither demonstrated nor refuted (one to two studies; 46 to 106 participants; all low-certainty evidence). Studies did not address quality of life nor time to rescue medication.Three studies compared probiotics with another intervention in 213 participants treated with radiotherapy (with or without chemotherapy). One very small study (21 participants) reported less diarrhoea six weeks after treatment when dietary counselling was provided (RR 0.30, 95% CI 0.11 to 0.81; very low-certainty evidence). In another study (148 participants), grade 3 or 4 diarrhoea occurred less often in the probiotics group than in the control group (guar gum containing nutritional supplement) (odds ratio (OR) 0.38, 95% CI 0.16 to 0.89; low-certainty evidence), and two studies (63 participants) found less need for rescue medication of probiotics versus another active treatment (RR 0.44, 95% CI 0.22 to 0.86; very low-certainty evidence). Studies did not address quality of life nor time to rescue medication.One placebo-controlled study with 205 participants addressed treatment for radiotherapy-induced diarrhoea and could not demonstrate or refute a beneficial effect of probiotics on average diarrhoea grade, time to rescue medication for diarrhoea (13 hours longer in the probiotics group; 95% CI -0.9 to 26.9 hours), or need for rescue medication (RR 0.74, 95% CI 0.53 to 1.03; moderate-certainty evidence). This study did not address quality of life.No studies reported serious adverse events or diarrhoea-related deaths. AUTHORS' CONCLUSIONS This review presents limited low- or very low-certainty evidence supporting the effects of probiotics for prevention and treatment of diarrhoea related to radiotherapy (with or without chemotherapy) or chemotherapy alone, need for rescue medication, or occurrence of adverse events. All studies were underpowered and heterogeneous. Severe side effects were absent from all studies.Robust evidence on this topic must be provided by future methodologically well-designed trials.
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Affiliation(s)
- Dang Wei
- Karolinska InstitutetDepartment of Public Health SciencesSolnavägen 1EStockholmSweden11365, Solna
| | - Pauline Heus
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityCochrane NetherlandsRoom Str. 6.131PO Box 85500UtrechtNetherlands3508 GA
| | - Fleur T van de Wetering
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityCochrane NetherlandsRoom Str. 6.131PO Box 85500UtrechtNetherlands3508 GA
| | - Geertjan van Tienhoven
- Academic Medical CenterRadiation Oncology and HyperthermiaP.O. Box 22700Meibergdreef 9AmsterdamNetherlands1100 DE
| | - Leen Verleye
- Belgian Health Care Knowledge CentreKruidtuinlaan 55BrusselsBelgium1000
| | - Rob JPM Scholten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht UniversityCochrane NetherlandsRoom Str. 6.131PO Box 85500UtrechtNetherlands3508 GA
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83
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Thomsen M, Vitetta L. Adjunctive Treatments for the Prevention of Chemotherapy- and Radiotherapy-Induced Mucositis. Integr Cancer Ther 2018; 17:1027-1047. [PMID: 30136590 PMCID: PMC6247548 DOI: 10.1177/1534735418794885] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Background: Chemoradiotherapy-associated mucositis can manifest as
pain, inflammation, dysphagia, diarrhea, weight loss, rectal bleeding, and
infection. Mucositis is a major dose-limiting side effect of chemotherapy,
affecting nutritional intake and oral and intestinal function. Despite several
interventions being available, there is a need for safe and effective
preventative and treatment options for treatment-induced mucositis. The goals of
this review are to discuss interventions based on foods and natural products and
present the research to date. Methods: A narrative literature
review identified 60 clinical studies examining various nutritional compounds
and 20 examining probiotics. 9 studies on probiotics for the prevention of
diarrhea were also assessed on methodological quality and limitations
identified. Results: Several compounds have been posited as useful
adjuvants for cancer treatment–related mucositis. Probiotics demonstrate
efficacy for the prevention and treatment of chemoradiotherapy-induced
gastrointestinal toxicity without significant side effects. Glutamine and
activated charcoal were reported to reduce chemotherapy-induced diarrhea but not
radiation-induced intestinal mucositis. Honey has been reported to decrease
treatment interruptions, weight loss, and delays the onset of oral mucositis.
Zinc, glutamine, and topical vitamin E were demonstrated efficacy for oral
mucositis. Conclusion: There is plausible clinical evidence for the
administration of several adjunctive treatments for the prevention and treatment
of mucositis. Probiotics were reported to reduce the burden of intestinal
mucositis and treatment-induced diarrhea. Activated charcoal and glutamine are
beneficial for chemotherapy-induced diarrhea, whereas the administration of
honey, zinc, and glutamine reduce the risk of developing oral mucositis during
chemotherapy or radiotherapy.
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Affiliation(s)
| | - Luis Vitetta
- 1 University of Sydney, Sydney, New South Wales, Australia.,2 Medlab Clinical Ltd, Sydney, New South Wales, Australia
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84
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Evidence-based Palliative Care Approaches to Non-pain Physical Symptom Management in Cancer Patients. Semin Oncol Nurs 2018; 34:227-240. [DOI: 10.1016/j.soncn.2018.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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85
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Protection from chemotherapy- and antibiotic-mediated dysbiosis of the gut microbiota by a probiotic with digestive enzymes supplement. Oncotarget 2018; 9:30919-30935. [PMID: 30112118 PMCID: PMC6089397 DOI: 10.18632/oncotarget.25778] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 07/05/2018] [Indexed: 01/20/2023] Open
Abstract
There are numerous downstream consequences of marketed drugs like antineoplastic agents on the gut microbiome, an effect that is suggested to contribute to adverse event profiles and may also influence drug responses. In cancer, progress is needed toward modulation of the host microbiome to prevent off-target side effects of drugs such as gastrointestinal mucositis that result from gut dysbiosis. The objective of this study was evaluation of the bioactivity of a supplement consisting of capsules with a blend of 9 probiotic organisms of the genera Lactobacillus and Bifidobacterium plus 10 digestive enzymes, in protecting the human gastrointestinal tract from chemotherapy and an antibiotic. We used the Simulator of Human Intestinal Microbial Ecosystem (SHIME) model, an in vitro model of a stable colon microbiota, and introduced 5-fluorouracil (5-FU) and vancomycin as microbiome-disrupting drugs. The probiotic with digestive enzymes supplement, added in capsules at in vivo doses, improved fermentation activity in the colon reactors and accelerated the recovery of microbial populations following 5-FU/vancomycin treatment. The supplement restored the Bacteroidetes to Firmicutes ratios in the colon reactors, increased the diversity of microbiota, and induced the production of microbial metabolites that elicited anti-inflammatory cytokines in an in vitro model of intestinal inflammation. In the proximal colon, preventative administration of the supplement resulted in full recovery of the gut microbial community after cessation of 5-FU and vancomycin treatment. These results identify a probiotic with digestive enzymes formulation that protects against drug-induced gut dysbiosis, highlighting its potential utility as a component of routine cancer care.
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86
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Daliri EBM, Tango CN, Lee BH, Oh DH. Human microbiome restoration and safety. Int J Med Microbiol 2018; 308:487-497. [DOI: 10.1016/j.ijmm.2018.05.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 04/04/2018] [Accepted: 05/07/2018] [Indexed: 02/07/2023] Open
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Khan S, Wardill HR, Bowen JM. Role of toll-like receptor 4 (TLR4)-mediated interleukin-6 (IL-6) production in chemotherapy-induced mucositis. Cancer Chemother Pharmacol 2018; 82:31-37. [PMID: 29845394 DOI: 10.1007/s00280-018-3605-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 05/22/2018] [Indexed: 12/12/2022]
Abstract
Despite significant advances in our ability to treat cancer, cytotoxic chemotherapy continues to be the mainstay treatment for many solid tumours. Chemotherapy is commonly associated with a raft of largely manageable adverse events; however, gastrointestinal (GI) toxicity (also termed mucositis) remains a significant challenge with little in the way of preventative and therapeutic options. The inability to manage GI complications likely reflects our incomplete understanding of its aetiology and the idiosyncrasies of each chemotherapeutic agent. This review highlights aims to provide a narrative for the involvement of Toll-like receptor (TLR4) in the development of chemotherapy-induced GI mucositis, an already emerging theme within this field. Particular focus will be placed upon the signalling interaction between TLR4 and interleukin (IL)-6. This parallels recent preclinical findings showing that TLR4 knockout mice, which are protected from developing severe GI mucositis, completely lack an IL-6 response. As such, we suggest that this signalling pathway presents as a novel mechanism with potential for therapeutic intervention.
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Affiliation(s)
- S Khan
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Hannah R Wardill
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
- Centre for Nutrition and Gastrointestinal Disease, South Australian Health and Medical Research Institute, North Terrace, Adelaide, SA, 5000, Australia.
| | - J M Bowen
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
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88
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Hassan H, Rompola M, Glaser AW, Kinsey SE, Phillips RS. Systematic review and meta-analysis investigating the efficacy and safety of probiotics in people with cancer. Support Care Cancer 2018; 26:2503-2509. [PMID: 29704110 DOI: 10.1007/s00520-018-4216-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 04/13/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND/OBJECTIVES Probiotics are living microorganisms that confer a health benefit on the host when administered. This systematic review and meta-analysis investigates the efficacy and safety of probiotics in adult and paediatric patients diagnosed with cancer. METHODS A systematic review and meta-analysis was undertaken (PROSPERO registration: CRD42016050252). Randomised controlled trials (RCT), identified through screening multiple databases were included for analysis of efficacy. Non-randomised controlled trials and case reports were included for safety analysis. Outcomes included the reduction in the incidence and severity of diarrhoea, and adverse events. Where possible, data were combined for meta-analysis using a random-effects model. Planned subgroup analyses were not possible through marked heterogeneity of study characteristics. RESULTS Twenty one studies (N = 2982 participants) were included for assessment of efficacy. Probiotics may reduce the incidence of diarrhoea in patients with cancer [odds ratio (OR) = 0.52, 95% confidence interval (CI) 0.34-0.78, 95% prediction interval (PI) 0.3-0.92, I-sq 36.9%, 5 studies] and the duration of pyrexia [standardised mean difference 0.39 days, 95% CI 0.35-0.43, I-sq 0.01%, 5 studies]. Twenty five studies (N = 2242) were included in the safety analysis. Five case reports showed probiotic-related bacteraemia/fungaemia/positive blood cultures. Definitions and reporting of adverse events were variable and inconsistent. CONCLUSIONS There remain insufficient studies to assess the true effect of probiotics in people with cancer. Meta-analysis suggests probiotics may be beneficial but further studies are still required. Improved reporting of outcomes and adverse events in clinical trials are required to improve accuracy and confidence of conclusions drawn in future updates.
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Affiliation(s)
- Hadeel Hassan
- Department of Paediatric Haematology and Oncology, Leeds Teaching Hospital NHS Trust, Leeds, UK. .,Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, LS2 9JT, UK.
| | - M Rompola
- Department of Paediatric Haematology and Oncology, Leeds Teaching Hospital NHS Trust, Leeds, UK.,Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, LS2 9JT, UK
| | - A W Glaser
- Department of Paediatric Haematology and Oncology, Leeds Teaching Hospital NHS Trust, Leeds, UK.,Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, LS2 9JT, UK
| | - S E Kinsey
- Department of Paediatric Haematology and Oncology, Leeds Teaching Hospital NHS Trust, Leeds, UK.,Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, LS2 9JT, UK
| | - R S Phillips
- Department of Paediatric Haematology and Oncology, Leeds Teaching Hospital NHS Trust, Leeds, UK.,Centre for Reviews and Dissemination, University of York, York, UK
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89
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Seely D, Ennis JK, McDonell E, Zhao L. Naturopathic Oncology Care for Thoracic Cancers: A Practice Survey. Integr Cancer Ther 2018; 17:793-805. [PMID: 29558830 PMCID: PMC6142094 DOI: 10.1177/1534735418759420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background and Objectives: There is a lack of information on
therapies recommended by naturopathic doctors (NDs) for lung and
gastroesophageal cancer care. Study objectives were to: (1) identify the most
common interventions considered for use by NDs; (2) identify interventions NDs
recommend to support key therapeutic goals; and (3) identify potential
contraindications between integrative and conventional therapies.
Methods: Oncology Association of Naturopathic Physicians
(OncANP) members (n = 351) were invited to complete an electronic survey.
Respondents provided information on interventions considered for thoracic cancer
pre- and postoperatively across 4 therapeutic domains (supplemental natural
health products, physical, mental/emotional, and nutritional), therapeutic
goals, and contraindications. This survey was part of the development of the
Thoracic Perioperative Integrative Surgical Evaluation trial.
Results: Forty-four NDs completed the survey (12.5% response
rate), all of whom were trained at accredited colleges in North America and the
majority of whom were Fellows of the American Board of Naturopathic Oncology
(FABNO) (56.8%). NDs identified significantly more interventions in the
postoperative compared to preoperative setting. The most frequently identified
interventions included modified citrus pectin, arnica, omega-3 fatty acids,
vitamin D, probiotics, exercise, acupuncture, meditation, stress reduction, low
glycemic index diet, and Mediterranean diet. Potential contraindications with
conventional treatment (surgery, chemotherapy, radiotherapy) differed across
natural health products. Conclusions: These findings highlight
naturopathic interventions with a high level of use in thoracic cancer care,
describe and characterize therapeutic goals and the interventions used to
achieve these goals, and provide insight on how practice changes relative to
conventional cancer treatment phase.
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Affiliation(s)
- Dugald Seely
- 1 Ottawa Integrative Cancer Centre, Ottawa, Ontario, Canada.,2 Canadian College of Naturopathic Medicine, North York, Ontario, Canada
| | - Julie K Ennis
- 1 Ottawa Integrative Cancer Centre, Ottawa, Ontario, Canada.,2 Canadian College of Naturopathic Medicine, North York, Ontario, Canada
| | - Ellen McDonell
- 1 Ottawa Integrative Cancer Centre, Ottawa, Ontario, Canada.,2 Canadian College of Naturopathic Medicine, North York, Ontario, Canada
| | - Linlu Zhao
- 1 Ottawa Integrative Cancer Centre, Ottawa, Ontario, Canada.,2 Canadian College of Naturopathic Medicine, North York, Ontario, Canada
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90
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Du SX, Jia YR, Ren SQ, Gong XJ, Tang H, Wan-Shui W, Li-Ming S. The protective effects of Bacillus licheniformis preparation on gastrointestinal disorders and inflammation induced by radiotherapy in pediatric patients with central nervous system tumor. Adv Med Sci 2018; 63:134-139. [PMID: 29120854 DOI: 10.1016/j.advms.2017.09.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/01/2017] [Accepted: 09/26/2017] [Indexed: 12/20/2022]
Abstract
PURPOSE we studied the effect of Bacillus licheniformis preparation (ZCS) on CNST (central nervous system tumor) patients undergoing the gastrointestinal symptoms and inflammation induced by radiotherapy. MATERIALS AND METHODS 160 CNST patients with craniospinal irradiation (CSI) treatment were divided into experiment and control group. The experiment group patients took one capsule per time of ZCS and three times a day until the end of radiotherapy, starting one day before radiotherapy. While the patients in control group were administrated placebo without any probiotics. Serum from one day before radiotherapy and the first day after radiotherapy were collected to measure the ET, CRP, TNF-α, IL-1β and IL-6. RESULTS More than 70% CNST pediatric patients suffered from different degrees of gastrointestinal symptoms after radiotherapy, including mouth ulcer, nausea, vomiting, abdominal pain and diarrhea. And there was an obviously increased of serum ET, TNF-α, IL-1β, IL-6 and CRP after RT. Importantly, a markedly decreased of ET, CRP and inflammatory cytokines were detected in the experiment group comparing to the control group after radiotherapy, as well as the relief of the gastrointestinal symptoms. However, improvement of probiotics (or ZCS) of the survival rate of CNST children and the recurrence of tumor are not observed in this study. CONCLUSIONS Prophylactically administrated ZCS during radiotherapy for CNST patients can relieve RT-related gastrointestinal symptoms and inflammatory reaction.
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Affiliation(s)
- Shu-Xu Du
- Department of Pediatrics, BeijingShijitan Hospital, Capital Medical University, Beijing, 100038, China.
| | - Yong-Rui Jia
- Health Science Center, Peking University, Beijing, 100191, China
| | - Si-Qi Ren
- Department of Pediatrics, BeijingShijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Xiao-Jun Gong
- Department of Pediatrics, BeijingShijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Hong Tang
- Department of Pediatrics, BeijingShijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Wu Wan-Shui
- Department of Pediatrics, BeijingShijitan Hospital, Capital Medical University, Beijing, 100038, China
| | - Sun Li-Ming
- Department of Pediatrics, BeijingShijitan Hospital, Capital Medical University, Beijing, 100038, China
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Probiotics and infective endocarditis in patients with hereditary hemorrhagic telangiectasia: a clinical case and a review of the literature. BMC Infect Dis 2018; 18:65. [PMID: 29390976 PMCID: PMC5796351 DOI: 10.1186/s12879-018-2956-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 01/09/2018] [Indexed: 12/29/2022] Open
Abstract
Background In the last decades, probiotics have been widely used as food supplements because of their putative beneficial health effects. They are generally considered safe but rare reports of serious infections caused by bacteria included in the definition of probiotics raise concerns on their potential pathogenic role in patients with particular predisposing factors. Patients with hereditary hemorrhagic telangiectasia (HHT) are exposed to infections because of telangiectasias and arteriovenous malformations (AVMs). We describe what is, to our knowledge, the first case of infective endocarditis (IE) caused by Lactobacillus rhamnosus in a patient with HHT. A systematic review of the relevant medical literature is presented. Case presentation A patient with HHT and an aortic bioprosthesis was admitted because of prolonged fever not responding to antibiotics. The patient had a history of repeated serious infections with hospitalizations and prolonged use of antibiotics, and used to assume large amounts of different commercial products containing probiotics. Weeks before the onset of symptoms the patient had been treated with nasal packings and with surgical closure of a nasal bleeding site because of recurrent epistaxis. A diagnosis of IE of the aortic bioprosthesis was made. All blood coltures were positive for L. rhamnosus. The patients responded to a cycle of 6 weeks of amoxicillin/clavulanate plus gentamicin. A systematic review of IE linked to consumption of probiotics, and of infective endocarditis in patients with HHT was conducted. 10 cases of IE linked to probiotics consumption and 6 cases of IE in patients with HHT were found. Conclusions Consumption of probiotics can pose a risk of serious infections in patients with particular predisposing factors. Patients with HHT can be considered at risk because of their predisposition to infections. Prophylaxis with antibiotics before nasal packings in patients with HHT can be considered. Electronic supplementary material The online version of this article (10.1186/s12879-018-2956-5) contains supplementary material, which is available to authorized users.
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Schmidt-Hieber M, Bierwirth J, Buchheidt D, Cornely OA, Hentrich M, Maschmeyer G, Schalk E, Vehreschild JJ, Vehreschild MJGT. Diagnosis and management of gastrointestinal complications in adult cancer patients: 2017 updated evidence-based guidelines of the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). Ann Hematol 2018; 97:31-49. [PMID: 29177551 PMCID: PMC5748412 DOI: 10.1007/s00277-017-3183-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 11/11/2017] [Indexed: 12/15/2022]
Abstract
Cancer patients frequently suffer from gastrointestinal complications. In this manuscript, we update our 2013 guideline on the diagnosis and management of gastrointestinal complications in adult cancer patients by the Infectious Diseases Working Party (AGIHO) of the German Society of Hematology and Medical Oncology (DGHO). An expert group was put together by the AGIHO to update the existing guideline. For each sub-topic, a literature search was performed in PubMed, Medline, and Cochrane databases, and strengths of recommendation and the quality of the published evidence for major therapeutic strategies were categorized using the 2015 European Society for Clinical Microbiology and Infectious Diseases (ESCMID) criteria. Final recommendations were approved by the AGIHO plenary conference. Recommendations were made with respect to non-infectious and infectious gastrointestinal complications. Strengths of recommendation and levels of evidence are presented. A multidisciplinary approach to the diagnosis and management of gastrointestinal complications in cancer patients is mandatory. Evidence-based recommendations are provided in this updated guideline.
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Affiliation(s)
- M Schmidt-Hieber
- Clinic for Hematology, Oncology, Tumor Immunology and Palliative Care, HELIOS Klinikum Berlin-Buch, Berlin, Germany
| | - J Bierwirth
- Deutsches Beratungszentrum für Hygiene, BZH GmbH, Freiburg, Germany
| | - D Buchheidt
- 3rd Department of Internal Medicine - Hematology and Oncology - Mannheim University Hospital, University of Heidelberg, Heidelberg, Germany
| | - O A Cornely
- 1st Department of Internal Medicine, University of Cologne, Cologne, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany
- Clinical Trials Centre Cologne, ZKS Köln, University of Cologne, Cologne, Germany
| | - M Hentrich
- Department III for Internal Medicine, Hematology and Oncology, Rotkreuzklinikum München, Munich, Germany
| | - G Maschmeyer
- Department of Hematology, Oncology and Palliative Care, Ernst-von-Bergmann Klinikum, Potsdam, Germany
| | - E Schalk
- Department of Hematology and Oncology, Medical Center, Otto-von-Guericke University, Magdeburg, Germany
| | - J J Vehreschild
- 1st Department of Internal Medicine, University of Cologne, Cologne, Germany
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany
| | - Maria J G T Vehreschild
- 1st Department of Internal Medicine, University of Cologne, Cologne, Germany.
- German Center for Infection Research (DZIF), partner site Bonn-Cologne, Cologne, Germany.
- 1st Department of Internal Medicine, Hospital of the University of Cologne, Kerpener Str. 62, 50937, Köln, Germany.
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Effect of a Lactobacillus Salivarius Probiotic on a Double-Species Streptococcus Mutans and Candida Albicans Caries Biofilm. Nutrients 2017; 9:nu9111242. [PMID: 29135948 PMCID: PMC5707714 DOI: 10.3390/nu9111242] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 10/26/2017] [Accepted: 11/08/2017] [Indexed: 01/03/2023] Open
Abstract
The aim of the study was to evaluate the anti-cariogenic effects of Lactobacillus salivarius by reducing pathogenic species and biofilm mass in a double-species biofilm model. Coexistence of S. mutans with C. albicans can cause dental caries progression or recurrence of the disease in the future. Fifty-nine children with diagnosed early childhood caries (ECC) were recruited onto the study. The condition of the children's dentition was defined according to the World Health Organization guidelines. The participants were divided into children with initial enamel demineralization and children showing dentin damage. The study was performed on the S. mutans and C. albicans clinical strains, isolated from dental plaque of patients with ECC. The effect of a probiotic containing Lactobacillus salivarius on the ability of S. mutans and C. albicans to produce a double-species biofilm was investigated in an in vitro model. The biomass of the formed/non-degraded biofilm was analyzed on the basis of its crystal violet staining. The number of colonies of S. mutans and C. albicans (CFU/mL, colony forming units/mL) forming the biofilm was determined. Microorganism morphology in the biofilm was evaluated using a scanning electron microscope (SEM). In vitro analysis demonstrated that the presence of S. mutans increased the number of C. albicans colonies (CFU/mL); the double-species biofilm mass and hyphal forms produced in it by the yeast. L. salivarius inhibited the cariogenic biofilm formation of C. albicans and S. mutans. Under the influence of the probiotic; the biofilm mass and the number of S. mutans; C. albicans and S. mutans with C. albicans colonies in the biofilm was decreased. Moreover; it can be noted that after the addition of the probiotic; fungi did not form hyphae or germ tubes of pathogenic potential. These results suggest that L. salivarius can secrete intermediates capable of inhibiting the formation of cariogenic S. mutans and C. albicans biofilm; and may inhibit fungal morphological transformation and thereby reduce the pathogenicity of C. albicans; weakening its pathogenic potential. Further research is required to prove or disprove the long-term effects of the preparation and to achieve preventive methods.
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Loupakis F, Stein A, Ychou M, Hermann F, Salud A, Österlund P. A Review of Clinical Studies and Practical Guide for the Administration of Triplet Chemotherapy Regimens with Bevacizumab in First-line Metastatic Colorectal Cancer. Target Oncol 2017; 11:293-308. [PMID: 26687849 PMCID: PMC4901088 DOI: 10.1007/s11523-015-0400-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Colorectal cancer is the third most common cancer worldwide. A significant proportion of patients presents with unresectable metastatic disease or develops metachronous metastases following surgical resection of the primary tumor. The prognosis of the disease has improved over the past two decades, with extended multimodality treatment options and the development of increasingly intensified chemotherapy regimens that now typically include targeted biologics. A recent advance in therapy is a treatment regimen composed of three chemotherapeutic agents (i.e., triplet chemotherapy: 5-fluorouracil [5-FU]/leucovorin [LV], oxaliplatin, and irinotecan; FOLFOXIRI) in combination with the vascular endothelial growth factor inhibitor bevacizumab. This regimen has been shown to elicit significantly improved objective response rates and median progression-free survival compared with 5-FU/LV and irinotecan in combination with bevacizumab. However, triplet chemotherapy has been associated with increased rates of chemotherapy-related adverse events, and treatment-emergent adverse events should be properly managed to minimize treatment interruption or discontinuation. We present herein a review of clinical studies evaluating the safety and efficacy of FOLFOXIRI with bevacizumab in metastatic colorectal cancer, and propose a practical guide for the management of adverse events associated with the regimen. ![]()
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Affiliation(s)
- Fotios Loupakis
- Istituto Toscano Tumori, U.O. Oncologia Medica 2 Universitaria, Azienda Ospedaliero-Universitaria Pisana, Via Roma, 67, 56126, Pisa, Italy.
| | - Alexander Stein
- University Cancer Center Hamburg, University of Hamburg, Hamburg, Germany
| | - Marc Ychou
- ICM Val d'Aurelle, 34000, Montpellier, France
| | | | - Antonieta Salud
- Department of Medical Oncology, Arnau de Vilanova University Hospital, Lleida, Spain
| | - Pia Österlund
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
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95
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Zhao R, Wang Y, Huang Y, Cui Y, Xia L, Rao Z, Zhou Y, Wu X. Effects of fiber and probiotics on diarrhea associated with enteral nutrition in gastric cancer patients: A prospective randomized and controlled trial. Medicine (Baltimore) 2017; 96:e8418. [PMID: 29069041 PMCID: PMC5671874 DOI: 10.1097/md.0000000000008418] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 09/29/2017] [Accepted: 10/02/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Diarrhea is a common complication of enteral nutrition (EN), which affects recovery and prolongs the length of hospital stay (LOHS). To investigate the effect of fiber and probiotics in reducing diarrhea associated with EN in postoperative patients with gastric cancer (GC), the authors designed this prospective randomized-controlled trial. METHODS AND STUDY DESIGN This study included 120 patients with GC, and the patients were classified into 3 groups via random picking of envelopes: fiber-free nutrition formula (FF group, n = 40), fiber-enriched nutrition formula (FE group, n = 40), and fiber- and probiotic-enriched nutrition formula (FEP group, n = 40). All patients were given EN formulas for 7 consecutive days after surgery. RESULTS The number of diarrhea cases was higher in the FF group than in the FE group (P = .007). The FEP group had a lower number of diarrhea cases compared with the FE group (P = .003). Patients in the FE group had a significantly shorter first flatus time than the FF group (P = .002). However, no significant difference was observed between the FE group and FEP group (P = .30). Intestinal disorders were similar between the FE group and FF group (P = .38). The FEP group had a lower number of intestinal disorder cases than the FF group (P = .03). LOHS in the FE and FEP groups was shorter than that in the FF group (P = .004; P < .001). However, no significant difference was observed between the FE and FEP groups (P = .28). In addition, no significant difference was observed between the 3 groups in terms of total lymphocyte count, albumin, prealbumin, and transferrin levels on day 7 of enteral feeding. CONCLUSIONS The combination of fiber and probiotics was significantly effective in treating diarrhea that is associated with EN in postoperative patients with GC.
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Affiliation(s)
- Rui Zhao
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
| | - Yong Wang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
| | - Yuqian Huang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
| | - Yaping Cui
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
| | - Lin Xia
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
| | - Zhiyong Rao
- Department of Clinical Nutrition, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Zhou
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
| | - Xiaoting Wu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University
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96
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Banna GL, Torino F, Marletta F, Santagati M, Salemi R, Cannarozzo E, Falzone L, Ferraù F, Libra M. Lactobacillus rhamnosus GG: An Overview to Explore the Rationale of Its Use in Cancer. Front Pharmacol 2017; 8:603. [PMID: 28919861 PMCID: PMC5585742 DOI: 10.3389/fphar.2017.00603] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/21/2017] [Indexed: 12/14/2022] Open
Abstract
Cancer is the second leading cause of death in the western world. In the era of precision medicine, a significant number of cancer patients can be cured with several anti-cancer therapeutic regimens. However, therapy failure may be caused by treatment side effects, such as diarrhea, especially occurring in patients with gastrointestinal or pelvic malignancies. In particular, diarrhea is one of the most frequent gastrointestinal toxicity during cancer treatment and it can result from nearly bot chemo- and radio-therapeutic strategies currently used. Diarrhea has a serious impact on patients’ quality of life and treatment dosing and schedule modification due to its severity can negatively influence treatment outcomes. In this context, probiotics may play an interesting role in several human diseases with an inflammatory bowel involvement and, among these, Lactobacillus rhamnosus GG (LGG) is one of the most characterized and utilized. In particular, LGG is able to reverse intestinal dysbiosis and moderate diarrhea. Moreover, preclinical studies have documented its effects in reducing chronic inflammation associated with cancer development. This review summarizes the preclinical results of LGG on cancer cells proliferation and tumor invasion as well as the potential role of LGG use in cancer patients for the prevention and management of diarrhea associated with cancer treatment. Overall, these encouraging data support further investigation on the use of LGG in stratified patients undergoing specific therapeutic protocols, including chemotherapy and pelvic radiotherapy, in order to reduce the development of severe diarrhea and thus improve the adherence to the therapy and patients’ quality of life.
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Affiliation(s)
| | - Francesco Torino
- Department of Systems Medicine, Chair of Medical Oncology, Tor Vergata University of RomeRome, Italy
| | | | - Maria Santagati
- Department of Biomedical and Biotechnological Sciences, Section of Microbiology, University of CataniaCatania, Italy
| | - Rossella Salemi
- Department of Biomedical and Biotechnological Sciences, Laboratory of Translational Oncology and Functional Genomics, Section of General and Clinical Pathology and Oncology, University of CataniaCatania, Italy
| | - Elisa Cannarozzo
- Department of Biomedical and Biotechnological Sciences, Laboratory of Translational Oncology and Functional Genomics, Section of General and Clinical Pathology and Oncology, University of CataniaCatania, Italy
| | - Luca Falzone
- Department of Biomedical and Biotechnological Sciences, Laboratory of Translational Oncology and Functional Genomics, Section of General and Clinical Pathology and Oncology, University of CataniaCatania, Italy
| | - Francesco Ferraù
- Division of Medical Oncology, San Vincenzo HospitalTaormina, Italy
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, Laboratory of Translational Oncology and Functional Genomics, Section of General and Clinical Pathology and Oncology, University of CataniaCatania, Italy
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97
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Elshaghabee FMF, Rokana N, Gulhane RD, Sharma C, Panwar H. Bacillus As Potential Probiotics: Status, Concerns, and Future Perspectives. Front Microbiol 2017; 8:1490. [PMID: 28848511 PMCID: PMC5554123 DOI: 10.3389/fmicb.2017.01490] [Citation(s) in RCA: 413] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 07/24/2017] [Indexed: 01/09/2023] Open
Abstract
Spore-forming bacilli are being explored for the production and preservation of food for many centuries. The inherent ability of production of large number of secretory proteins, enzymes, antimicrobial compounds, vitamins, and carotenoids specifies the importance of bacilli in food chain. Additionally, Bacillus spp. are gaining interest in human health related functional food research coupled with their enhanced tolerance and survivability under hostile environment of gastrointestinal tract. Besides, bacilli are more stable during processing and storage of food and pharmaceutical preparations, making them more suitable candidate for health promoting formulations. Further, Bacillus strains also possess biotherapeutic potential which is connected with their ability to interact with the internal milieu of the host by producing variety of antimicrobial peptides and small extracellular effector molecules. Nonetheless, with proposed scientific evidences, commercial probiotic supplements, and functional foods comprising of Bacillus spp. had not gained much credential in general population, since the debate over probiotic vs pathogen tag of Bacillus in the research and production terrains is confusing consumers. Hence, it’s important to clearly understand the phenotypic and genotypic characteristics of selective beneficial Bacillus spp. and their substantiation with those having GRAS status, to reach a consensus over the same. This review highlights the probiotic candidature of spore forming Bacillus spp. and presents an overview of the proposed health benefits, including application in food and pharmaceutical industry. Moreover, the growing need to evaluate the safety of individual Bacillus strains as well as species on a case by case basis and necessity of more profound analysis for the selection and identification of Bacillus probiotic candidates are also taken into consideration.
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Affiliation(s)
| | - Namita Rokana
- Department of Dairy Microbiology, College of Dairy Science and Technology, Guru Angad Dev Veterinary and Animal Sciences UniversityLudhiana, India
| | - Rohini D Gulhane
- Department of Dairy Microbiology, College of Dairy Science and Technology, Guru Angad Dev Veterinary and Animal Sciences UniversityLudhiana, India
| | - Chetan Sharma
- Department of Dairy Microbiology, College of Dairy Science and Technology, Guru Angad Dev Veterinary and Animal Sciences UniversityLudhiana, India
| | - Harsh Panwar
- Department of Dairy Microbiology, College of Dairy Science and Technology, Guru Angad Dev Veterinary and Animal Sciences UniversityLudhiana, India
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Abstract
Evidence is growing that the gut microbiota modulates the host response to chemotherapeutic drugs, with three main clinical outcomes: facilitation of drug efficacy; abrogation and compromise of anticancer effects; and mediation of toxicity. The implication is that gut microbiota are critical to the development of personalized cancer treatment strategies and, therefore, a greater insight into prokaryotic co-metabolism of chemotherapeutic drugs is now required. This thinking is based on evidence from human, animal and in vitro studies that gut bacteria are intimately linked to the pharmacological effects of chemotherapies (5-fluorouracil, cyclophosphamide, irinotecan, oxaliplatin, gemcitabine, methotrexate) and novel targeted immunotherapies such as anti-PD-L1 and anti-CLTA-4 therapies. The gut microbiota modulate these agents through key mechanisms, structured as the 'TIMER' mechanistic framework: Translocation, Immunomodulation, Metabolism, Enzymatic degradation, and Reduced diversity and ecological variation. The gut microbiota can now, therefore, be targeted to improve efficacy and reduce the toxicity of current chemotherapy agents. In this Review, we outline the implications of pharmacomicrobiomics in cancer therapeutics and define how the microbiota might be modified in clinical practice to improve efficacy and reduce the toxic burden of these compounds.
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99
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Saito Y, Mihara T, Maruyama K, Saito J, Ikeda M, Tomonaga A, Kumagai T. Effects of intake of Lactobacillus casei subsp. casei 327 on skin conditions: a randomized, double-blind, placebo-controlled, parallel-group study in women. BIOSCIENCE OF MICROBIOTA FOOD AND HEALTH 2017; 36:111-120. [PMID: 28748132 PMCID: PMC5510156 DOI: 10.12938/bmfh.16-031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/26/2017] [Indexed: 12/13/2022]
Abstract
Lactic acid bacteria are gut flora that play key roles in intestinal homeostasis, which may affect a variety of physiological functions. Our preliminary double-blind, placebo-controlled, parallel-group trials have suggested that
intake of heat-killed Lactobacillus casei subsp. casei 327 (designated L. K-1) is effective for improving skin conditions. The aim of this study was to confirm the effect of L. K-1 intake in a
randomized, double-blind, placebo-controlled, parallel-group study in healthy female volunteers. Sixty-four subjects were allocated to either the placebo food group (group P, n=32) or active food group (group A, n=32), in which
subjects consumed lactobacillus K-1 50 mg (approximately 1 × 1011 bacteria) daily for 8 weeks. After excluding subjects who declined to participate (n=1), violated restrictions (n=4), or were judged ineligible by the
principal investigators (n=1), data obtained with 58 subjects (30 in group A and 28 in group P) were analyzed for efficacy by comparing differences from pretrial levels between the two groups. When the level of transepidermal
water loss (TEWL) was measured at the arm, the level of TEWL at week 4 of the intake period was significantly lower in group A than group P (p=0.021), suggesting an improvement of skin barrier function. Analysis of skin condition
questionnaire data revealed a significant reduction in skin flakiness on the face (week 4). No adverse events were associated with intake of the test foods. The safety of L. K-1 was also confirmed in an independent open-label
trial in 11 healthy subjects who consumed excessive amounts of L. K-1 250 mg (approximately 5 × 1011 bacteria). Intake of L. K-1 may therefore be beneficial to skin condition improvement.
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Affiliation(s)
- Yuhi Saito
- Kameda Seika Co., Ltd., 3-1-1 Kameda-Kogyodanchi, Konan-ku, Niigata-shi, Niigata 950-0198, Japan
| | - Toshihiro Mihara
- Kameda Seika Co., Ltd., 3-1-1 Kameda-Kogyodanchi, Konan-ku, Niigata-shi, Niigata 950-0198, Japan
| | - Kentaro Maruyama
- Kameda Seika Co., Ltd., 3-1-1 Kameda-Kogyodanchi, Konan-ku, Niigata-shi, Niigata 950-0198, Japan
| | - Jiro Saito
- Medical Station Clinic, 3-12-8, Takaban, Meguro-ku, Tokyo, 152-0004, Japan
| | - Masumi Ikeda
- Shirayuri Dermatology Orthopedic Surgery, 3012-2 Shinohara-cho, Kohoku-ku, Yokohama-shi, Kanagawa, 222-0026, Japan
| | - Akihito Tomonaga
- Tana Orthopaedic Surgery, 15-7 Tana-cho, Aoba-ku, Yokohama-shi, Kanagawa, 227-0064, Japan
| | - Takehisa Kumagai
- Kameda Seika Co., Ltd., 3-1-1 Kameda-Kogyodanchi, Konan-ku, Niigata-shi, Niigata 950-0198, Japan
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Roy U, Jessani LG, Rudramurthy SM, Gopalakrishnan R, Dutta S, Chakravarty C, Jillwin J, Chakrabarti A. Seven cases of Saccharomyces fungaemia related to use of probiotics. Mycoses 2017; 60:375-380. [PMID: 28133894 DOI: 10.1111/myc.12604] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/15/2016] [Accepted: 01/06/2017] [Indexed: 11/28/2022]
Abstract
Probiotics are increasingly used in critically ill patients without enough safety data. The aim of the present study was to determine the association of probiotics with Saccharomyces cerevisiae fungaemia. Seven patients with S. cerevisiae fungaemia were reported at two hospitals in India between July 2014 and September 2015. Detailed clinical history of patients was recorded. Besides the seven patient isolates, three probiotics sachets used in those patients and five unrelated clinical isolates were used for association study by Fluorescent amplified fragment length polymorphism (FAFLP). Antifungal susceptibility testing was performed by broth microdilution technique of CLSI (M27-A3) and interpreted according to CLSI (M27S4). Two patients were premature neonates and five were adults. They were admitted in intensive care unit and were on probiotics containing S. boulardii (except one adult patient). FAFLP analysis showed 96.4-99.7% similarity between blood and corresponding probiotic isolates. Of the three AFLP types (group I, II, II) identified, all the probiotic isolates clustered in group I (major cluster) including majority of the blood isolates. The isolates were susceptible to all antifungal agents tested. Five patients, who could be evaluated, responded promptly to echinocandins or voriconazole. As the prescription of probiotic containing S. boulardii in critically ill patient's leads to the fungaemia, we recommend avoiding this probiotic in those patients.
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Affiliation(s)
| | | | - Shivaprakash M Rudramurthy
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Soma Dutta
- Apollo Gleneagles Hospitals, Kolkata, India
| | | | - Joseph Jillwin
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arunaloke Chakrabarti
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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