Effects of Probiotics for the Prevention and Treatment of Radiation-induced Diarrhea

Fuccio, Lorenzo; Guido, A.; Eusebi, Leonardo Henry; Laterza, Liboria; Grilli, Diego; Cennamo, Vincenzo; Ceroni, Liza; Barbieri, Enza; Bazzoli, Franco

doi:10.1097/mcg.0b013e3181a1f59c

Cited by 56 publications

(41 citation statements)

References 46 publications

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“…The main limitation of the primary outcome was influenced by various factors, which may affect the robustness of the conclusion and further confuse the clinical practice. Due to the difference of patients, treatment protocols, onset of intake as well as dosage, time, administration route and duration of delivery, species and strains of probiotics, it is difficult to compare our result with other studies [3, 13, 15, 17, 18, 41]. Consequently, based on current evidence, it may be uncertain to give a precise guidance on how to use probiotics to prevent the radiation-induced diarrhea.…”

Section: Discussionmentioning

confidence: 89%

“…Moreover, inflammation can amplify endothelial dysfunction and increase the levels of cytokines and growth factors, such as transforming growth factor b (TGF-b), thus delaying the process of re-epithelialisation [34]. Radiation should also be responsible for the reduction of intestinal motility and bile acid reabsorption [14, 18, 43–45]. The last but not the least, radiation severely impaired intestinal micro villi, contributing to decrease enzymatic activity and total gut transit time [13, 46–53].…”

Section: Discussionmentioning

confidence: 99%

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Probiotics for prevention of radiation-induced diarrhea: A meta-analysis of randomized controlled trials

Liu

Yan

et al. 2017

PLoS ONE

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BackgroundRadiotherapy is commonly used for abdominal or pelvic cancer, and patients receiving radiotherapy have a high risk developing to an acute radiation-induced diarrhea. Several previous studies have discussed the effect of probiotics on prevention of radiation-induced diarrhea, but the results are still inconsistent.ObjectiveWe performed a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of probiotic supplementation for prevention the radiation-induced diarrhea.MethodsRelevant RCTs studies assessing the effect of probiotic supplementation on clinical outcomes compared with placebo were searched in PubMed, EMBASE, and the Cochrane Library databases (up to March 30 2016). Heterogeneity was assessed with I2 and H2, and publication bias was evaluated using sensitive analysis.ResultsSix trials, a total of 917 participants (490 participants received prophylactic probiotics and 427 participants received placebo), were included in this meta-analysis. Compared with placebo, probiotics were associated with a lower incidence of radiation-induced diarrhea (RR: 0.55; 95% CI: 0.34–0.88; P = 0.01; I2: 87%; 95% CI: 75%-94%; H2: 2.8; 95% CI: 2.0–4.0). However, there is no significant difference in the anti-diarrheal medication use (RR: 0.68; 95% CI: 0.40–1.14; P = 0.14) or bristol scale on stool form (RR: 0.64; 95% CI: 0.35–1.17; P = 0.14).ConclusionProbiotics may be beneficial to prevent radiation-induced diarrhea in patients who suffered from abdominal or pelvic cancers during radiotherapy period.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Probiotics for prevention of radiation-induced diarrhea: A meta-analysis of randomized controlled trials

Liu

Yan

et al. 2017

PLoS ONE

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“…Radiation-induced diarrhea is a common side effect of RT and grossly impairs quality of life. The prophylactic use of different products such as smectite, sucralfate, octreotide, and probiotics has been reported without recommendation for prevention of radiation-induced diarrhea (34)(35)(36)(37)(38). Selenium supplementation yielded significant prevention of diarrhea and thus improved the quality of life in the SG.…”

Section: Discussionmentioning

confidence: 97%

Multicenter, Phase 3 Trial Comparing Selenium Supplementation With Observation in Gynecologic Radiation Oncology

Muecke

Schomburg

Glatzel³

et al. 2010

International Journal of Radiation Oncology*Biology*Physics

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“…Our results suggest that the reduction of colonic microbial signaling or its modulation might protect the colon from the damaging effects of radiation. Promising results with probiotics in the prevention of radiation proctitis 40, 41 suggest that this paradigm may be valid.…”

Section: Discussionmentioning

confidence: 99%

Suppression of radiation-induced DNA double-strand break repair by MyD88 is accompanied by apoptosis and crypt loss in mouse colon

Lai

Egan

2013

Oncogenesis

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Intestinal microbes promote the injurious effects of radiation on those tissues. However, the molecular factors mediating this effect are largely unknown. In this work, we explored the effects of orally administered antibiotics and MyD88, a key adapter molecule in toll-like receptor signaling, on molecular and cellular responses of mouse colon to radiation. Results show that oral antibiotics lowered radiation-induced colonic damage by protecting epithelial cells against radiation-induced apoptosis, leading to increased survival of crypts. MyD88 deficiency partially phenocopied the effects of oral antibiotics on apoptosis and crypt survival, suggesting that colonic microbes exert their injurious effects in part via that molecule. Analysis of DNA double-strand breaks, the primary genotoxic lesions induced by radiation, showed that their early induction in mouse colon was unaffected by MyD88. However, MyD88 deficiency resulted in the later disappearance of DNA double-strand breaks. Loss of DNA double-strand breaks was accompanied by the evidence of increased activation of both the non-homologous end-joining and homologous recombination pathways of DNA repair in MyD88-deficient mice. These results show that colonic microbes and MyD88 regulate DNA double-strand break repair in irradiated mouse colon, effects which exert significant control over radiation-induced apoptosis and crypt survival.

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Effects of Probiotics for the Prevention and Treatment of Radiation-induced Diarrhea

Cited by 56 publications

References 46 publications

Probiotics for prevention of radiation-induced diarrhea: A meta-analysis of randomized controlled trials

Probiotics for prevention of radiation-induced diarrhea: A meta-analysis of randomized controlled trials

Multicenter, Phase 3 Trial Comparing Selenium Supplementation With Observation in Gynecologic Radiation Oncology

Suppression of radiation-induced DNA double-strand break repair by MyD88 is accompanied by apoptosis and crypt loss in mouse colon

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