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Chen J, Zhao J, Wu H, Wang T, Gao C. Efficacy and safety of oral probiotic supplementation in mitigating postoperative surgical site infections in patients undergoing colorectal cancer surgery: A systematic review and meta-analysis. Int Wound J 2024; 21:e14603. [PMID: 38155392 PMCID: PMC10961893 DOI: 10.1111/iwj.14603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/09/2023] [Accepted: 12/10/2023] [Indexed: 12/30/2023] Open
Abstract
Surgical site infections (SSIs) pose significant risks to patients undergoing colorectal cancer (CRC) surgery. With increasing evidence on the benefits of oral probiotics in various clinical contexts, there is a need to assess their efficacy and safety in reducing SSIs following CRC surgery. A systematic review and meta-analysis were conducted in line with PRISMA guidelines using the PICO framework. On 19 September 2023, four major databases (PubMed, Embase, Web of Science and Cochrane Library) were searched without any temporal or language restrictions. Rigorous inclusion and exclusion criteria were employed. Data extraction was independently undertaken by two assessors, and any discrepancies were discussed. The Cochrane Collaboration's risk of bias instrument was utilized to assess study quality. The meta-analysis incorporated a fixed-effects model or random-effects model based on the I2 statistic to assess heterogeneity. The initial search yielded 1282 articles, of which 10 met the inclusion criteria and were analysed. Probiotic administration not only significantly reduced the incidence of SSIs but also curtailed the duration of hospital stays. Moreover, the subgroup analysis indicated that interventions employing multiple strains of probiotics were more effective in reducing postoperative infections than those utilizing a single strain. Probiotics effectively prevent postoperative infections and shorten hospital stays. Multi-strain probiotics outperform single strain in efficacy. Future studies should focus on their safety and optimal clinical use.
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Affiliation(s)
- Jiahong Chen
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated HospitalGuangdong Medical UniversityDongguanChina
- Department of Venereal Diseases and Integrated Chinese and Western Medicine and Bone ParalysisThe Third Hospital of Guangdong Medical University (Longjiang Hospital of Shunde District)FoshanChina
| | - Jie Zhao
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated HospitalGuangdong Medical UniversityDongguanChina
- Personnel SectionHuadu Clinical Medical College of Guangdong Medical University (Maternal and Child Health Hospital)GuangzhouChina
| | - Hongfu Wu
- Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, The First Dongguan Affiliated HospitalGuangdong Medical UniversityDongguanChina
| | - Tao Wang
- Department of Venereal Diseases and Integrated Chinese and Western Medicine and Bone ParalysisThe Third Hospital of Guangdong Medical University (Longjiang Hospital of Shunde District)FoshanChina
| | - Cifeng Gao
- Personnel SectionHuadu Clinical Medical College of Guangdong Medical University (Maternal and Child Health Hospital)GuangzhouChina
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2
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Lee SY, Park HM, Kim CH, Kim HR. Dysbiosis of gut microbiota during fecal stream diversion in patients with colorectal cancer. Gut Pathog 2023; 15:40. [PMID: 37596621 PMCID: PMC10439566 DOI: 10.1186/s13099-023-00566-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND The effect of fecal stream diversion on the gut microbiota is still uncertain. The present study was designed to assess the effect of fecal stream diversion on the composition of the gut microbiota in patients with colorectal cancer. We included patients undergoing left-sided colorectal cancer surgery with (ileostomy group) or without (control group) diverting ileostomy. Fecal samples were collected from 10 patients in each group before surgery (t1) and after ileostomy repair in the ileostomy group and 6-12 months after the initial surgery in the control group (t2). The fecal microbiota was assessed using 16S rRNA sequencing, and changes in the composition of the fecal microbiota were compared between the two groups. RESULTS Alpha diversity analysis revealed that the complexity of fecal microbiota decreased between t1 and t2 only in the ileostomy group. Beta diversity analysis also showed dissimilarity between t1 and t2 only in the ileostomy group. The composition of the microbiota was similar between the two groups at t1. However, at t2, the ileostomy group had lower proportion of beneficial bacteria (Lachnospiraceae, 3.8% vs. 29.9%, p < 0.001; Ruminococcaceae, 0.6% vs. 18.4%, p < 0.001; Blautia, 0.1% vs. 9.1%, p < 0.001; Faecalibacterium, 0.2% vs. 7.5%, p < 0.001) and a higher proportion of harmful bacteria (Proteobacteria, 17.9% vs. 5.1%, p = 0.006; Clostridium, 16.2% vs. 1.1%, p = 0.013; Streptococcus, 17.7% vs. 1.6%, p = 0.002) than the control group. CONCLUSIONS Fecal stream diversion was closely associated with less diversity and dysbiosis of the gut microbiota.
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Affiliation(s)
- Soo Young Lee
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-Ro Hwasun-Eup, Hwasun-Gun, Jeonnam, 58128, South Korea
| | - Hyeung-Min Park
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-Ro Hwasun-Eup, Hwasun-Gun, Jeonnam, 58128, South Korea
| | - Chang Hyun Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-Ro Hwasun-Eup, Hwasun-Gun, Jeonnam, 58128, South Korea
| | - Hyeong Rok Kim
- Department of Surgery, Chonnam National University Hwasun Hospital and Medical School, 322 Seoyang-Ro Hwasun-Eup, Hwasun-Gun, Jeonnam, 58128, South Korea.
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3
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Preoperative Nutritional Optimization of the Oncology Patient: A Scoping Review. J Am Coll Surg 2022; 234:384-394. [PMID: 35213503 DOI: 10.1097/xcs.0000000000000055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Malnutrition is common among patients with cancer and is a known risk factor for poor postoperative outcomes; however, preoperative nutritional optimization guidelines are lacking in this high-risk population. The objective of this study was to review the evidence regarding preoperative nutritional optimization of patients undergoing general surgical operations for the treatment of cancer. METHODS A literature search was performed across the Ovid (MEDLINE), Cochrane Library (Wiley), Embase (Elsevier), CINAHL (EBSCOhost), and Web of Science (Clarivate) databases. Eligible studies included randomized clinical trials, observational studies, reviews, and meta-analyses published between 2010 and 2020. Included studies evaluated clinical outcomes after preoperative nutritional interventions among adult patients undergoing surgery for gastrointestinal cancer. Data extraction was performed using a template developed and tested by the study team. RESULTS A total of 5,505 publications were identified, of which 69 studies were included for data synthesis after screening and full text review. These studies evaluated preoperative nutritional counseling, protein-calorie supplementation, immunonutrition supplementation, and probiotic or symbiotic supplementation. CONCLUSIONS Preoperative nutritional counseling and immunonutrition supplementation should be considered for patients undergoing surgical treatment of gastrointestinal malignancy. For malnourished patients, protein-calorie supplementation should be considered, and for patients undergoing colorectal cancer surgery, probiotics or symbiotic supplementation should be considered.
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Ohta H, Miyake T, Ueki T, Kojima M, Kawasaki M, Tatsuta T, Iuchi T, Kamitani S, Shimizu T, Mekata E, Tani M. Predictors and clinical impact of postoperative diarrhea after colorectal cancer surgery: a prospective, multicenter, observational study (SHISA-1602). Int J Colorectal Dis 2022; 37:657-664. [PMID: 35080636 PMCID: PMC8885501 DOI: 10.1007/s00384-022-04097-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE Postoperative diarrhea, including high-output stoma (HOS), frequently occurs after colorectal surgery; its risk factors and clinical implications on subsequent complications remain unknown. This study aimed to evaluate the risk factors and clinical implications of postoperative diarrhea after primary colorectal cancer (CRC) surgery. METHODS This prospective observational study included patients with CRC who underwent radical surgery at six hospitals between June 2016 and December 2017. The patients were categorized into three groups (non-stoma, colostoma, and ileostoma groups). RESULTS A total of 178 patients participated in the study. In the non-stoma group, the incidence of postoperative diarrhea was 18.4% (27/147). The incidence of HOS was 28.6% (4/14) in the ileostoma group, and 0% in the colostoma group. Multivariable analyses of the incidence of diarrhea in the non-stoma group indicated that habitual smoking and hypertension were significantly associated with postoperative diarrhea (P = 0.012 and P = 0.0274, respectively). Postoperative diarrhea was more likely to occur in patients with rectal cancer than in those with colon cancer (P = 0.0501). In the non-stoma and ileostoma groups, the probability of the occurrence of other complications with Clavien-Dindo (C-D) grades II or higher was significantly higher in patients with C-D grade I diarrhea, including HOS, than in patients without diarrhea (39.3% vs. 14.6%, P = 0.0061). CONCLUSIONS Smoking and hypertension are the independent predictors of postoperative diarrhea after an elective CRC surgery. Rectal cancer surgery seems to be associated with postoperative diarrhea more than colon cancer surgery does. Mild postoperative diarrhea may lead to more severe complications.
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Affiliation(s)
- Hiroyuki Ohta
- Department of Comprehensive Surgery, Shiga University of Medical Science, Seta-tsukinowacho, Otsu, Shiga 520-2192 Japan ,Department of Surgery, Higashi-Ohmi General Medical Center, Higashi-ohmi, Japan
| | - Toru Miyake
- Department of Gastrointestinal Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Tomoyuki Ueki
- Department of Gastrointestinal Surgery, Shiga University of Medical Science, Otsu, Japan
| | - Masatsugu Kojima
- Department of Gastrointestinal Surgery, Shiga University of Medical Science, Otsu, Japan
| | | | - Takeshi Tatsuta
- Department of Surgery, Tesseikai Neurosurgical Hospital, Sijounawate, Japan
| | - Takekazu Iuchi
- Department of Surgery, Toyosato Hospital, Toyosato, Inukami-gun Japan
| | | | - Tomoharu Shimizu
- Department of Medical Safety, Shiga University of Medical Science, Otsu, Japan
| | - Eiji Mekata
- Department of Comprehensive Surgery, Shiga University of Medical Science, Seta-tsukinowacho, Otsu, Shiga 520-2192 Japan ,Department of Surgery, Higashi-Ohmi General Medical Center, Higashi-ohmi, Japan
| | - Masaji Tani
- Department of Gastrointestinal Surgery, Shiga University of Medical Science, Otsu, Japan
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Kwon H, Chae SH, Jung HJ, Shin HM, Ban OH, Yang J, Kim JH, Jeong JE, Jeon HM, Kang YW, Park CK, Won DD, Lee JK. The effect of probiotics supplementation in postoperative cancer patients: a prospective pilot study. Ann Surg Treat Res 2021; 101:281-290. [PMID: 34796144 PMCID: PMC8564079 DOI: 10.4174/astr.2021.101.5.281] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 08/03/2021] [Accepted: 09/24/2021] [Indexed: 12/21/2022] Open
Abstract
Purpose Microbiota manipulation through selected probiotics may be a promising tool to prevent cancer development as well as onset, to improve clinical efficacy for cancer treatments. The purpose of this study was to evaluate change in microbiota composition after-probiotics supplementation and assessed the efficacy of probiotics in improving quality of life (QOL) in postoperative cancer patients. Methods Stool samples were collected from 30 cancer patients from February to October 2020 before (group I) and after (group II) 8 weeks of probiotics supplementation. We performed 16S ribosomal RNA gene sequencing to evaluate differences in gut microbiota between groups by comparing gut microbiota diversity, overall composition, and taxonomic signature abundance. The health-related QOL was evaluated through the EORTC Quality of life Questionnaire Core 30 questionnaire. Results Statistically significant differences were noted in group II; increase of Shannon and Simpson index (P = 0.004 and P = 0.001), decrease of Bacteroidetes and Fusobacteria at the phylum level (P = 0.032 and P = 0.014, retrospectively), increased of beneficial bacteria such as Weissella (0.096% vs. 0.361%, P < 0.004), Lactococcus (0.023% vs. 0.16%, P < 0.001), and Catenibacterium (0.0% vs. 0.005%, P < 0.042) at the genus level. There was a significant improvement in sleep disturbance (P = 0.039) in group II. Conclusion Gut microbiota in cancer patients can be manipulated by specific probiotic strains, result in an altered microbiota. Microbiota modulation by probiotics can be considered as part of a supplement that helps to increase gut microbiota diversity and improve QOL in cancer patients after surgery.
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Affiliation(s)
- Hyeji Kwon
- Cancer Genomic Research Institute, Immunology Laboratory, Seoul Song Do Colorectal Hospital, Seoul, Korea
| | - Song Hwa Chae
- Cancer Genomic Research Institute, Immunology Laboratory, Seoul Song Do Colorectal Hospital, Seoul, Korea
| | - Hyo Jin Jung
- Cancer Genomic Research Institute, Immunology Laboratory, Seoul Song Do Colorectal Hospital, Seoul, Korea
| | - Hyeon Min Shin
- Cancer Genomic Research Institute, Immunology Laboratory, Seoul Song Do Colorectal Hospital, Seoul, Korea
| | | | | | - Jung Ha Kim
- Cancer Immune Clinic, Seoul Song Do Colorectal Hospital, Seoul, Korea.,Department of Surgery, Pelvic Floor Center, Seoul Song Do Colorectal Hospital, Seoul, Korea
| | - Ji Eun Jeong
- Cancer Immune Clinic, Seoul Song Do Colorectal Hospital, Seoul, Korea
| | - Hae Myung Jeon
- Cancer Genomic Research Institute, Immunology Laboratory, Seoul Song Do Colorectal Hospital, Seoul, Korea.,Cancer Immune Clinic, Seoul Song Do Colorectal Hospital, Seoul, Korea
| | - Yong Won Kang
- Department of Surgery, Pelvic Floor Center, Seoul Song Do Colorectal Hospital, Seoul, Korea
| | - Chan Kum Park
- Department of Pathology, Seoul Song Do Colorectal Hospital, Seoul, Korea
| | - Daeyoun David Won
- Department of Surgery, Pelvic Floor Center, Seoul Song Do Colorectal Hospital, Seoul, Korea
| | - Jong Kyun Lee
- Cancer Immune Clinic, Seoul Song Do Colorectal Hospital, Seoul, Korea.,Department of Surgery, Pelvic Floor Center, Seoul Song Do Colorectal Hospital, Seoul, Korea
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Probiotic/Synbiotic Treatment and Postoperative Complications in Colorectal Cancer Patients: Systematic Review and Meta-analysis of Randomized Controlled Trials. Clin Transl Gastroenterol 2021; 11:e00268. [PMID: 33512803 PMCID: PMC7714058 DOI: 10.14309/ctg.0000000000000268] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer (CRC) is a leading cause of morbidity and mortality. Post-CRC resection complications and lower quality of life (QoL) are associated with a lower long-term survival. Perioperative administration of probiotics/synbiotics might lower prevalence of side effects and improve QoL and survival among CRC patients. Medline, Web of Science, Cochrane database, Embase, and clinical trials registries were searched in January 2020. Altogether, 16 randomized placebo-controlled probiotic/synbiotic clinical trials that included patients undergoing CRC surgery and investigated postoperative complications and QoL side effects were found. Meta-analyses using random-effects model were performed on data from 11 studies to calculate the effects of probiotics/synbiotics on common CRC resection postoperative side effects and complications. Perioperative probiotics/synbiotics administration was associated with lower infection incidence (odds ratio [OR] = 0.34, P < 0.001), lower diarrheal incidence (OR = 0.38, P < 0.001), faster return to normal gut function (mean difference [MD] −0.66 days, P < 0.001), shorter postoperative antibiotics use (MD −0.64 days, P < 0.001), lower incidence of septicemia (OR = 0.31, P < 0.001), and shorter length of hospital stay (MD −0.41 days, P = 0.110). The results support the hypothesis that short-term perioperative administration of probiotics/synbiotics, which are easy to administer, have few side-effects, and are low cost compared with alternatives, might help to alleviate gastrointestinal symptoms and postoperative complications among CRC patients.
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7
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Tang G, Zhang L. Update on Strategies of Probiotics for the Prevention and Treatment of Colorectal Cancer. Nutr Cancer 2020; 74:27-38. [PMID: 33356609 DOI: 10.1080/01635581.2020.1865420] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In recent years, with the further research on probiotics, probiotics may become an indispensable part in the prevention and treatment of colorectal cancer (CRC) in the future. As one of the most common cancer, the incidence of CRC is still rising in developing countries. Nowadays, there are lacking in prevention methods with low side effect. Surgery and chemotherapy, as the main treatment of CRC, bring many complications and affect the quality of life of patients. Probiotics has provided new ideas to solve these problems. Probiotics have anti-inflammatory, immune-enhancing, tumor-suppressing and other beneficial effects. Probiotics may provide some safe and effective prevention strategies for CRC. In addition, probiotics can also reduce the complications of surgery and chemotherapy, and improve the effectiveness of chemotherapy. Target administration with probiotics or probiotics cooperated with TRAIL to treat CRC. This article aims to review the mechanisms of probiotics for the prevention and treatment of CRC, as well as specific ways to use probiotics, in order to provide more new strategies for the prevention and treatment of CRC in the future, and reduce the incidence of and improve the quality of life of patients.
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Affiliation(s)
- Gang Tang
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
| | - Linyu Zhang
- Department of Clinical Medicine, Chongqing Medical University, Chongqing, China
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8
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Farshi Radvar F, Mohammad-Zadeh M, Mahdavi R, Andersen V, Nasirimotlagh B, Faramarzi E, Lotfi Yagin N. Effect of synbiotic supplementation on matrix metalloproteinase enzymes, quality of life and dietary intake and weight changes in rectal cancer patients undergoing neoadjuvant chemoradiotherapy. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2020. [DOI: 10.3233/mnm-200413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND: Probiotic/synbiotic has the important role of in altering intestinal bacteria, reducing inflammation and improvement of intestinal diseases. OBJECTIVE: We aimed to investigate the effect of synbiotic supplementation on matrix metalloproteinase (MMP) enzymes, hs-CRP, quality of life, dietary intake and weight changes in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (CRT). METHODS: In this study, 46 rectal cancer patients were recruited. Patients were allocated to the synbiotic (n = 23) group or placebo groups (n = 23) receiving 2 synbiotic or placebo capsules for six weeks. Anthropometric measurements, quality of life, dietary intakes, and serum levels of MMP-2, MMP-9, and hs-CRP were compared before and after intervention with the use of statistical tests. RESULTS: The mean energy, carbohydrate, and protein intake of patients increased in the synbiotic group, while in the placebo group, post intervention, significant reduction was noticed in these parameters (P < 0.05). Synbiotic supplementation caused improvement in global health status, symptom scale scores and scores of functional scale. At the end of intervention, the elevation in hs-CRP, MMP-2, and MMP-9 levels in the placebo group was approximately two and four times higher than the synbiotic group respectively. CONCLUSION: According to our results, synbiotic supplementation may be helpful in cancer patients undergoing CRT. However, further studies must consider synbiotic as a new complementary treatment.
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Affiliation(s)
| | - Mohammad Mohammad-Zadeh
- Radiotherapy Department Shahid Madani University hospital Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Mahdavi
- Nutrition Research Centre of Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vibeke Andersen
- Organ Center, Hospital of Southern Jutland, 6200 Aabenraa, Denmark
| | - Behnam Nasirimotlagh
- Radiotherapy Department Shahid Madani University Hospital Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elnaz Faramarzi
- Liver & Gastrointestinal Diseases Research Centre of Tabriz University of Medical Sciences. Tabriz, Iran
| | - Neda Lotfi Yagin
- Nutrition Research Centre of Tabriz University of Medical Sciences. Tabriz, Iran
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9
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The effects of probiotics on reducing the colorectal cancer surgery complications: A periodic review during 2007–2017. Clin Nutr 2020; 39:2358-2367. [DOI: 10.1016/j.clnu.2019.11.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 10/09/2019] [Accepted: 11/04/2019] [Indexed: 02/01/2023]
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10
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Krebs B, Horvat M, Golle A, Krznaric Ž, Papeš D, Augustin G, Arslani N, Potrč S. A Randomized Clinical Trial of Synbiotic Treatment before Colorectal Cancer Surgery. Am Surg 2020. [DOI: 10.1177/000313481307901202] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Bojan Krebs
- Department of Abdominal Surgery University Clinical Center Maribor, Slovenia
| | - Matjaž Horvat
- Department of Abdominal Surgery University Clinical Center Maribor, Slovenia
| | | | - Željko Krznaric
- Department of Gastroenterology Clinical Hospital Center Zagreb, Croatia
| | - Dino Papeš
- Department of Surgery Clinical Hospital Center Zagreb, Croatia
| | - Goran Augustin
- Department of Surgery Clinical Hospital Center Zagreb, Croatia
| | - Nuhi Arslani
- Department of Abdominal Surgery University Clinical Center Maribor, Slovenia
| | - Stojan Potrč
- Department of Abdominal Surgery University Clinical Center Maribor, Slovenia
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11
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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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12
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Efficacy of Using Probiotics with Antagonistic Activity against Pathogens of Wound Infections: An Integrative Review of Literature. BIOMED RESEARCH INTERNATIONAL 2019; 2019:7585486. [PMID: 31915703 PMCID: PMC6930797 DOI: 10.1155/2019/7585486] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/03/2019] [Indexed: 02/06/2023]
Abstract
The skin and its microbiota serve as physical barriers to prevent invasion of pathogens. Skin damage can be a consequence of illness, surgery, and burns. The most effective wound management strategy is to prevent infections, promote healing, and prevent excess scarring. It is well established that probiotics can aid in skin healing by stimulating the production of immune cells, and they also exhibit antagonistic effects against pathogens via competitive exclusion of pathogens. Our aim was to conduct a review of recent literature on the efficacy of using probiotics against pathogens that cause wound infections. In this integrative review, we searched through the literature published in the international following databases: PubMed, ScienceDirect, Web of Science, and Scopus using the search terms “probiotic” AND “wound infection.” During a comprehensive review and critique of the selected research, fourteen in vitro studies, 8 animal studies, and 19 clinical studies were found. Two of these in vitro studies also included animal studies, yielding a total of 39 articles for inclusion in the review. The most commonly used probiotics for all studies were well-known strains of the species Lactobacillus plantarum, Lactobacillus casei, Lactobacillus acidophilus, and Lactobacillus rhamnosus. All in vitro studies showed successful inhibition of chosen skin or wound pathogens by the selected probiotics. Within the animal studies on mice, rats, and rabbits, probiotics showed strong opportunities for counteracting wound infections. Most clinical studies showed slight or statistically significant lower incidence of surgical site infections, foot ulcer infection, or burn infections for patients using probiotics. Several of these studies also indicated a statistically significant wound healing effect for the probiotic groups. This review indicates that exogenous and oral application of probiotics has shown reduction in wound infections, especially when used as an adjuvant to antibiotic therapy, and therefore the potential use of probiotics in this field remains worthy of further studies, perhaps focused more on typical skin inhabitants as next-generation probiotics with high potential.
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13
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Saito Y, Hinoi T, Adachi T, Miguchi M, Niitsu H, Kochi M, Sada H, Sotomaru Y, Sakamoto N, Sentani K, Oue N, Yasui W, Tashiro H, Ohdan H. Synbiotics suppress colitis-induced tumorigenesis in a colon-specific cancer mouse model. PLoS One 2019; 14:e0216393. [PMID: 31242213 PMCID: PMC6594584 DOI: 10.1371/journal.pone.0216393] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/19/2019] [Indexed: 02/07/2023] Open
Abstract
Although synbiotics may be effective in maintaining remission of inflammatory bowel disease, their anticarcinogenic effects are still debated. To address this issue, we evaluated the effects of synbiotics, probiotics, and prebiotics on tumorigenesis using a CDX2P-Cre; Apc+/flox mouse model harboring a colon-specific Apc knock out, which develops adenoma and adenocarcinoma of the colon. Dextran sodium sulfate (DSS)-administration promoted colonic tumor development in CDX2P-Cre; Apc+/flox mice, and these tumors were associated with loss of Apc heterozygosity, as confirmed by observation of well-differentiated adenocarcinomas with β-catenin accumulation in tumor cell cytoplasm. Synbiotics-treatment suppressed dextran sodium sulfate-induced colitis in CDX2P-Cre; Apc+/flox mice, thereby reducing mortality, and inhibited tumorigenesis accelerated by DSS-administration. Conversely, neither probiotics nor prebiotics had any effect on inflammation and tumorigenesis. Lactobacillus casei and Bifidobacterium breve were detected in the fecal microbiota of probiotics-treated mice. Synbiotics-treatment suppressed DSS-induced expression of IL-6, STAT-3, COX-2, and TNF-α gene transcripts in normal colonic epithelium, indicating the possibility of suppressing tumor development. Importantly, these genes may be potential therapeutic targets in inflammation-associated colon cancer.
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Affiliation(s)
- Yasufumi Saito
- Department of Gastroenterological and Transplant Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Takao Hinoi
- Department of Gastroenterological and Transplant Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Clinical and Molecular Genetics, Hiroshima University Hospital, Hiroshima, Japan
- Department of Surgery, Division of Molecular Oncology, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
- * E-mail:
| | - Tomohiro Adachi
- Department of Gastroenterological and Transplant Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masashi Miguchi
- Department of Gastroenterological and Transplant Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hiroaki Niitsu
- Department of Gastroenterological and Transplant Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
- Vanderbilt University Medical Center, GI medicine, Nashville, Tennessee, United States of America
| | - Masatoshi Kochi
- Department of Gastroenterological and Transplant Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Haruki Sada
- Department of Gastroenterological and Transplant Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yusuke Sotomaru
- Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima, Japan
| | - Naoya Sakamoto
- Department of Molecular Pathology, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan
| | - Kazuhiro Sentani
- Department of Molecular Pathology, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan
| | - Naohide Oue
- Department of Molecular Pathology, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan
| | - Wataru Yasui
- Department of Molecular Pathology, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan
| | - Hirotaka Tashiro
- Department of Gastroenterological and Transplant Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Surgery, Division of Molecular Oncology, Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima, Japan
| | - Hideki Ohdan
- Department of Gastroenterological and Transplant Surgery, Division of Medicine, Biomedical Sciences Major, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
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Anderson SW, Bazzell AF, Dains JE. An Integrative Review on the Effect of Prebiotics, Probiotics, and Synbiotics on Infection After Colorectal Cancer Surgery. AORN J 2018; 107:237-248. [DOI: 10.1002/aorn.12033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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15
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Yang Y, Xia Y, Chen H, Hong L, Feng J, Yang J, Yang Z, Shi C, Wu W, Gao R, Wei Q, Qin H, Ma Y. The effect of perioperative probiotics treatment for colorectal cancer: short-term outcomes of a randomized controlled trial. Oncotarget 2016; 7:8432-40. [PMID: 26824990 PMCID: PMC4885004 DOI: 10.18632/oncotarget.7045] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 01/13/2016] [Indexed: 12/14/2022] Open
Abstract
This study was designed to mainly evaluate the anti-infective effects of perioperative probiotic treatment in patients receiving confined colorectal cancer (CRC) respective surgery. From November 2011 to September 2012, a total of 60 patients diagnosed with CRC were randomly assigned to receive probiotic (n = 30) or placebo (n = 30) treatment. The operative and post-operative clinical results including intestinal cleanliness, days to first - flatus, defecation, fluid diet, solid diet, duration of pyrexia, average heart rate, length of intraperitoneal drainage, length of antibiotic therapy, blood index changes, rate of infectious and non-infectious complications, postoperative hospital stay, and mortality were investigated. The patient demographics were not significantly different (p > 0.05) between the probiotic treated and the placebo groups. The days to first flatus (3.63 versus 3.27, p = 0.0274) and the days to first defecation (4.53 versus 3.87, p = 0.0268) were significantly improved in the probiotic treated patients. The incidence of diarrhea was significantly lower (p = 0.0352) in probiotics group (26.67%, 8/30) compared to the placebo group (53.33%, 16/30). There were no statistical differences (p > 0.05) in other infectious and non-infectious complication rates including wound infection, pneumonia, urinary tract infection, anastomotic leakage, and abdominal distension. In conclusion, for those patients undergoing confined CRC resection, perioperative probiotic administration significantly influenced the recovery of bowel function, and such improvement may be of important clinical significance in reducing the short-term infectious complications such as bacteremia.
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Affiliation(s)
- Yongzhi Yang
- Department of GI Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Yang Xia
- Department of Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Hongqi Chen
- Department of Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Leiming Hong
- Department of GI Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Junlan Feng
- Department of Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Jun Yang
- Department of Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - Zhe Yang
- Department of GI Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Chenzhang Shi
- Department of GI Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Wen Wu
- Department of GI Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Renyuan Gao
- Department of GI Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Qing Wei
- Department of Pathology, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Huanlong Qin
- Department of GI Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
| | - Yanlei Ma
- Department of GI Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, China
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Gallo A, Passaro G, Gasbarrini A, Landolfi R, Montalto M. Modulation of microbiota as treatment for intestinal inflammatory disorders: An uptodate. World J Gastroenterol 2016; 22:7186-202. [PMID: 27621567 PMCID: PMC4997632 DOI: 10.3748/wjg.v22.i32.7186] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Revised: 06/23/2016] [Accepted: 08/01/2016] [Indexed: 02/06/2023] Open
Abstract
Alterations of intestinal microflora may significantly contribute to the pathogenesis of different inflammatory and autoimmune disorders. There is emerging interest on the role of selective modulation of microflora in inducing benefits in inflammatory intestinal disorders, by as probiotics, prebiotics, synbiotics, antibiotics, and fecal microbiota transplantation (FMT). To summarize recent evidences on microflora modulation in main intestinal inflammatory disorders, PubMed was searched using terms microbiota, intestinal flora, probiotics, prebiotics, fecal transplantation. More than three hundred articles published up to 2015 were selected and reviewed. Randomized placebo-controlled trials and meta-analysis were firstly included, mainly for probiotics. A meta-analysis was not performed because of the heterogeneity of these studies. Most of relevant data derived from studies on probiotics, reporting some efficacy in ulcerative colitis and in pouchitis, while disappointing results are available for Crohn's disease. Probiotic supplementation may significantly reduce rates of rotavirus diarrhea. Efficacy of probiotics in NSAID enteropathy and irritable bowel syndrome is still controversial. Finally, FMT has been recently recognized as an efficacious treatment for recurrent Clostridium difficile infection. Modulation of intestinal flora represents a very interesting therapeutic target, although it still deserves some doubts and limitations. Future studies should be encouraged to provide new understanding about its therapeutical role.
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Mizuta M, Endo I, Yamamoto S, Inokawa H, Kubo M, Udaka T, Sogabe O, Maeda H, Shirakawa K, Okazaki E, Odamaki T, Abe F, Xiao JZ. Perioperative supplementation with bifidobacteria improves postoperative nutritional recovery, inflammatory response, and fecal microbiota in patients undergoing colorectal surgery: a prospective, randomized clinical trial. BIOSCIENCE OF MICROBIOTA FOOD AND HEALTH 2015; 35:77-87. [PMID: 27200261 PMCID: PMC4858881 DOI: 10.12938/bmfh.2015-017] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 11/09/2015] [Indexed: 01/04/2023]
Abstract
The use of probiotics has been widely documented to benefit human health, but their clinical value in
surgical patients remains unclear. The present study investigated the effect of perioperative oral
administration of probiotic bifidobacteria to patients undergoing colorectal surgery. Sixty patients
undergoing colorectal resection were randomized to two groups prior to resection. One group (n=31) received a
probiotic supplement, Bifidobacterium longum BB536, preoperatively for 7–14 days and
postoperatively for 14 days, while the other group (n=29) received no intervention as a control. The
occurrences of postoperative infectious complications were recorded. Blood and fecal samples were collected
before and after surgery. No significant difference was found in the incidence of postoperative infectious
complications and duration of hospital stay between the two groups. In comparison to the control group, the
probiotic group tended to have higher postoperative levels of erythrocytes, hemoglobin, lymphocytes, total
protein, and albumin and lower levels of high sensitive C-reactive proteins. Postoperatively, the proportions
of fecal bacteria changed significantly; Actinobacteria increased in the probiotic group, Bacteroidetes and
Proteobacteria increased in the control group, and Firmicutes decreased in both groups. Significant
correlations were found between the proportions of fecal bacteria and blood parameters; Actinobacteria
correlated negatively with blood inflammatory parameters, while Bacteroidetes and Proteobacteria correlated
positively with blood inflammatory parameters. In the subgroup of patients who received preoperative
chemoradiotherapy treatment, the duration of hospital stay was significantly shortened upon probiotic
intervention. These results suggest that perioperative oral administration of bifidobacteria may contribute to
a balanced intestinal microbiota and attenuated postoperative inflammatory responses, which may subsequently
promote a healthy recovery after colorectal resection.
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Affiliation(s)
- Minoru Mizuta
- Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan
| | - Izuru Endo
- Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan
| | | | | | - Masatoshi Kubo
- Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan
| | | | - Osanori Sogabe
- Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan
| | - Hiroya Maeda
- Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan
| | | | | | - Toshitaka Odamaki
- Next Generation Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama City, Kanagawa 252-8583, Japan
| | - Fumiaki Abe
- Food Ingredients and Technology Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama City, Kanagawa 252-8583, Japan
| | - Jin-Zhong Xiao
- Next Generation Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama City, Kanagawa 252-8583, Japan
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Lytvyn L, Quach K, Banfield L, Johnston BC, Mertz D. Probiotics and synbiotics for the prevention of postoperative infections following abdominal surgery: a systematic review and meta-analysis of randomized controlled trials. J Hosp Infect 2015; 92:130-9. [PMID: 26601607 DOI: 10.1016/j.jhin.2015.08.028] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Accepted: 08/14/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Postoperative infections, particularly surgical site infections (SSIs), cause significant morbidity and mortality. Probiotics or synbiotics are a potential prevention strategy. AIM To evaluate the efficacy of probiotics/synbiotics for reducing postoperative infection risk following abdominal surgery. METHODS We searched AMED, Central, CINAHL, Embase, Medline, and grey literature for randomized controlled trials of elective abdominal surgery patients administered probiotics or synbiotics compared to placebo or standard care. Primary outcome was SSIs. Secondary outcomes were adverse events, respiratory tract infections (RTIs), urinary tract infections (UTIs), combined infections, length of hospital stay, and mortality. Using random-effects meta-analyses, we estimated the relative risk (RR) or mean difference (MD) and 95% confidence interval (CI). Tests were performed for heterogeneity, subgroup and sensitivity analyses were conducted, and the overall evidence quality was graded. FINDINGS We identified 20 trials (N = 1374 participants) reporting postoperative infections. Probiotics/synbiotics reduced SSIs (RR: 0.63; 95% CI: 0.41-0.98; N = 15 studies), UTIs (RR: 0.29; 95% CI: 0.15-0.57; N = 11), and combined infections (RR: 0.49; 95% CI: 0.35-0.70; N = 18). There was no difference between groups for adverse events (RR: 0.89; 95% CI: 0.61-1.30; N = 6), RTIs (RR: 0.60; 95% CI: 0.36-1.00; N = 14), length of stay (MD: -1.19; 95% CI: -2.94 to 0.56; N = 12), or mortality (RR: 1.20; 95% CI: 0.58-2.48; N = 15). CONCLUSION Our review suggests that probiotics/synbiotics reduce SSIs and UTIs from abdominal surgeries compared to placebo or standard of care, without evidence of safety risk. Overall study quality was low, owing mostly to imprecision (few patients and events, or wide CIs); thus larger multi-centered trials are needed to further assess the certainty in this estimate.
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Affiliation(s)
- L Lytvyn
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Systematic Overviews through Advancing Research Technology, Child Health Evaluative Sciences, The Research Institute, The Hospital For Sick Children, Toronto, Canada
| | - K Quach
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
| | - L Banfield
- Health Sciences Library, McMaster University, Hamilton, Canada
| | - B C Johnston
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Systematic Overviews through Advancing Research Technology, Child Health Evaluative Sciences, The Research Institute, The Hospital For Sick Children, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Department of Anaesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Canada
| | - D Mertz
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada; Department of Medicine, McMaster University, Hamilton, Canada; Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada; Michael G. DeGroote Institute for Infectious Diseases Research, McMaster University, Hamilton, Canada.
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Efficacy of perioperative synbiotics treatment for the prevention of surgical site infection after laparoscopic colorectal surgery: a randomized controlled trial. Surg Today 2015; 46:479-90. [PMID: 25933911 DOI: 10.1007/s00595-015-1178-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 04/13/2015] [Indexed: 02/07/2023]
Abstract
PURPOSE The aim of this study was to assess the effect of perioperative oral administration of synbiotics on the surgical outcome in patients undergoing laparoscopic colorectal resection. METHODS In this single-center randomized, controlled trial, patients scheduled to undergo elective laparoscopic colorectal surgery were eligible to participate and randomly assigned to a synbiotics group or a control group. The primary study outcome was the development of infectious complications, particularly surgical site infection (SSI), within 30 days of surgery. RESULTS In this study, 379 patients were enrolled and randomly assigned (173 to the synbiotics group and 206 to the control group), of whom 362 patients (168 to the synbiotics group and 194 to the control group) were eligible for this study. SSI occurred in 29 (17.3%) patients in the synbiotics group and 44 (22.7%) patients in the control group (OR: 0.761, 95% CI 0.50-1.16; p = 0.20). Overall, the rate of postoperative complications, including anastomotic leakage, did not differ significantly between the two groups. Synbiotics treatment reversed the changes in fecal bacteria and organic acids after surgery and suppressed the increases in potentially pathogenic species, such as Clostridium difficile. CONCLUSION The efficacy of perioperative administration of synbiotics was not validated as a treatment for reducing the incidence of infectious complications after laparoscopic colorectal resection. However, the microbial imbalance, in addition to the reduction in organic acids, could be improved by perioperative synbiotics treatment.
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Serban DE. Gastrointestinal cancers: influence of gut microbiota, probiotics and prebiotics. Cancer Lett 2014; 345:258-70. [PMID: 23981580 DOI: 10.1016/j.canlet.2013.08.013] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 08/08/2013] [Accepted: 08/13/2013] [Indexed: 02/07/2023]
Abstract
Cancers of the gastrointestinal (GI) tract continue to represent a major health problem, despite progress in therapy. Gut microbiota is a key element related to the genesis of GI cancers, countless papers addressing this burning issue across the world. We provide an updated knowledge of the involvement of gut microbiota in GI tumorigenesis, including its underlying mechanisms. We present also a comprehensive review of the evidence from animal and clinical studies using probiotics and/or prebiotics in the prevention and/or therapy of GI tumours, of GI cancer therapy-related toxicity and of post-operative complications. We summarize the anticarcinogenic mechanisms of these biotherapeutics from in vitro, animal and clinical interventions. More research is required to reveal the interactions of microflora with genetic, epigenetic and immunologic factors, diet and age, before any firm conclusion be drawn. Well-designed, randomized, double blind, placebo-controlled human studies using probiotics and/or prebiotics, with adequate follow-up are necessary in order to formulate directions for prevention and therapy.
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Affiliation(s)
- Daniela Elena Serban
- "Iuliu Hatieganu" University of Medicine and Pharmacy, Second Pediatric Clinic, Emergency Children's Hospital, Cluj-Napoca, Romania.
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Diet and nutrition in cancer survivorship and palliative care. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:917647. [PMID: 24288570 PMCID: PMC3832963 DOI: 10.1155/2013/917647] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 09/07/2013] [Accepted: 09/18/2013] [Indexed: 02/07/2023]
Abstract
The primary goal of palliative cancer care is typically to relieve suffering and improve quality of life. Most approaches to diet in this setting have focused only on eating as many calories as possible to avoid cachexia. However, as the concept of palliative care has evolved to include all aspects of cancer survivorship and not just end of life care, there is an increasing need to thoughtfully consider diet and nutrition approaches that can impact not only quality of life but overall health outcomes and perhaps even positively affect cancer recurrence and progression. In this regard, there has been a recent emphasis in the literature on nutrition and cancer as an important factor in both quality of life and in the pathophysiology of cancer. Hence, the primary purpose of this paper is to review the current data on diet and nutrition as it pertains to a wide range of cancer patients in the palliative care setting.
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