Gut microbiome alterations in ICU patients with enteral nutrition-related diarrhea

Ni, Wei‐Wei; Jiao, Xinwei; Zou, Huihuang; Jing, Mengjuan; Xia, Ming; Zhu, Shichao; Li, Liming

doi:10.3389/fmicb.2022.1051687

Cited by 3 publications

(2 citation statements)

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“…Diarrhea is the most common symptom of enteral feeding intolerance in critically ill patients during enteral nutrition, with an incidence of 30.8%. Diarrhea in critically ill patients will reduce the absorption of nutrients and secondary water, cause electrolyte balance disorders and skin and mucous membrane damage, and increase the risk of infection and death ( 25 ). In addition, it will also affect the psychological state of patients and increase the workload of nursing ( 26 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical effects and safety of semi-solid feeds in tube-fed patients: a meta-analysis and systematic review

Feng,

Xiang,

2024

Front. Nutr.

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BackgroundEnteral nutrition is a very important form of treatment for critically ill patients. This meta-analysis aimed to evaluate the clinical effects and safety of semi-solid feeds in tube-fed patients.MethodsTwo researchers searched PubMed, clinical trials, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Weipu databases for randomized controlled trials (RCTs) on the clinical effects and safety of semi-solid feeds in tube-fed patients until 10 October 2023. The quality evaluation tool recommended by the Cochrane Library was used to evaluate the quality of included RCTs. RevMan 5.4 software was used for data analysis.ResultsA total of eight RCTs involving 823 tube-fed patients were included in this meta-analysis. A synthesized outcome indicated that semi-solid feeds reduced the incidence of diarrhea (RR = 0.32, 95%CI:0.20–0.50, P < 0.001), vomiting (RR = 0.31, 95%CI:0.15–0.64, P = 0.002), abdominal distension (RR = 0.41, 95%CI:0.22–0.76, P = 0.005), length of intensive care unit (ICU) stay (MD = −3.61, 95%CI: −6.74 to −0.48, P = 0.02), and length of hospital stay (MD = −7.14, 95%CI: −10.31 to −3.97, P < 0.01) in tube-fed patients. Enteric feeding had no effect on the 30-day mortality (RR = 0.55, 95%CI: 0.19−1.56, P = 0.26). No publication bias was detected by the Egger's test results (all P > 0.05).ConclusionSemi-solid feeds are beneficial in reducing the incidence of diarrhea, abdominal distension, vomiting, and hospital stay. More high-quality studies are needed in the future to verify the effects of semi-solid feeds on mortality.

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Section: Discussionmentioning

confidence: 99%

Clinical effects and safety of semi-solid feeds in tube-fed patients: a meta-analysis and systematic review

Feng,

Xiang,

2024

Front. Nutr.

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“…On the one hand, the prognostic effects of enteral and parenteral nutritional support status could simply be the result of its correlation with higher malnutrition risk in extensively pre-treated R/M HNSCC patients. However, non-oral nutritional support could also affect ICI response through other mechanisms, as enteral and parenteral nutrition can affect the gut microbiome [ 44 , 45 ]. Given the link between the microbiome and immunotherapy response [ 41 , 42 ], further investigation on the effects of nutritional support on survival in RM/HNSCC patients receiving ICI is warranted.…”

Section: Discussionmentioning

confidence: 99%

The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer

et al. 2023

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Malnutrition is a frequent comorbidity in head and neck cancer patients and has been shown to impair immunotherapy response in other cancer types. The geriatric nutritional risk index (GNRI) assesses malnutrition using the patient’s ideal weight, actual weight, and serum albumin. The aim of this study was to evaluate the prognostic relevance of malnutrition as determined by the GNRI for the response to immunotherapy in recurrent and/or metastatic head and neck squamous cell carcinoma (R/M HNSCC). A total of 162 patients with R/M HNSCC who received immune checkpoint inhibitors were included. The associations between the GNRI and progression-free survival (PFS), overall survival (OS), and the disease control rate (DCR) were computed. Univariable analysis showed worse PFS for GNRI ≤ 98 (p < 0.001), ECOG performance status (PS) ≥ 2 (p = 0.012), and enteral (p = 0.009) and parenteral (p = 0.015) nutritional supplementation, and worse OS for GNRI < 92 (p < 0.001), ECOG PS ≥ 2 (p < 0.001), and enteral (p = 0.008) and parenteral (p = 0.023) nutritional supplementation. In our multivariable model, GNRI ≤ 98 (p = 0.012) and ECOG PS ≥ 2 (p = 0.025) were independent prognostic factors for PFS. For OS, GNRI < 92 (p < 0.001) and ECOG PS ≥ 2 (p < 0.001) were independent prognostic factors. A GNRI ≤ 98 was significantly associated with a lower DCR compared to a GNRI > 98 (p = 0.001). In conclusion, our findings suggest that the GNRI may be an effective predictor for response to immunotherapy in R/M HNSCC.

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Effects of oral liquiritigenin inoculation on gut microbiota and gene expression in intestinal and extraintestinal tissues of mice

Suo,

Yu,

Shi

et al. 2024

Front. Microbiomes

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IntroductionLiquiritigenin (LQ), a natural flavonoid found in traditional Chinese medicine and often administered orally, holds potential to affect both the gut and its microbiota, that potentially mediating or influencing its biological and pharmacological effects. However, the effects of LQ on gut microbiota composition and intestinal function remain poorly understood. In this study, we aimed to explore the impact of LQ on gut microbiota and gene expression in both intestinal and extraintestinal tissues.MethodsWe orally inoculated six-week-old SPF C57BL/6 mice with either LQ (a concentration of 4 mg/ml diluted in dimethylsulfoxide, (DMSO)) or DMSO, and administered daily for a duration of 2 weeks. At the end of the experimental period, all mice were euthanized. Fresh fecal samples, as well as samples from the intestine, lung, and liver, were collected for subsequent microbiota analysis, RNA-seq, or histochemical and immunohistochemical (IHC) staining.ResultsFindings show that LQ alters gut microbiota composition, enhancing microbial correlations in the colon but causing some dysbiosis, evidenced by increased pathobionts, decreased beneficial bifidobacteria, and reduced microbiota diversity. Gene expression analysis reveals LQ upregulates mucosal immune response genes and antiinfection genes in both the intestine and lung, with histology confirming increased Paneth cells and antimicrobial peptides in the intestine. Additionally, LQ affects tissue-specific gene expression, triggering hypersensitivity genes in the colon, downregulating metabolic genes in the small intestine, and reducing cell motility and adhesion genes in the lung.DiscussionThese results suggest LQ’s potential to modulate common mucosal immunity but also highlight possible risks of gut dysbiosis and hypersensitivity, particularly in vulnerable individuals. Our study, while informative about the effects of LQ on gut health, lacks direct evidence on whether changes in gut microbiota and gene expression caused by LQ impact inflammatory diseases or are causally linked. Future research should investigate this through fecal microbiota transplantation to explore the causal relationships and LQ’s potential effects on immune responses and disease outcomes in relevant models.

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Gut microbiome alterations in ICU patients with enteral nutrition-related diarrhea

Cited by 3 publications

References 60 publications

Clinical effects and safety of semi-solid feeds in tube-fed patients: a meta-analysis and systematic review

Clinical effects and safety of semi-solid feeds in tube-fed patients: a meta-analysis and systematic review

The Geriatric Nutritional Risk Index (GNRI) as a Prognostic Biomarker for Immune Checkpoint Inhibitor Response in Recurrent and/or Metastatic Head and Neck Cancer

Effects of oral liquiritigenin inoculation on gut microbiota and gene expression in intestinal and extraintestinal tissues of mice

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