Postoperative Probiotics Administration Attenuates Gastrointestinal Complications and Gut Microbiota Dysbiosis Caused by Chemotherapy in Colorectal Cancer Patients

Abstract

The current study aims to evaluate the potential roles of taking probiotics postoperatively in attenuating the gastrointestinal complications and disturbed gut microbiota in colorectal cancer (CRC) patients undergoing chemotherapy. One hundred eligible CRC patients who were treated with radical surgery and needed to receive chemotherapy were recruited. Half of them were randomly assigned to the Probio group to take a probiotic combination from post-operation to the end of the first chemotherapeutic course. The other half of patients taking placebo instead were classified as the Placebo group. Gastrointestinal complications such as nausea, acid reflux, abdominal pain, abdominal distention, constipation, and diarrhea were recorded during chemotherapy. Fecal samples were collected preoperatively and after the first cycle of postoperative chemotherapy for 16S rRNA high-throughput sequencing and short-chain fatty acids (SCFAs) analysis. Results showed that probiotics administration could effectively reduce chemotherapy-induced gastrointestinal complications, particularly in diarrhea (p < 0.01). Additionally, chemotherapy also reduced the bacterial diversity indexes of the gut microbiota in CRC patients, which could be significantly increased by taking probiotics. Moreover, this chemotherapy caused significant changes in the composition of the gut microbiota, as indicated by decreased phylum levels of Firmicutes and increased Bacteroidetes, Proteobacteria, and Verrucomicrobia. In particular, several bacterial genera such as Akkermansia and Clostridium were significantly increased, while Prevotella, Lactobacillus, and Roseburia were decreased (p < 0.05). However, probiotic administration could effectively restore these taxa changes both at the phylum and genus levels, and mildly increase the genus levels of Bifidobacterium, Streptococcus, and Blautia. Furthermore, probiotics could also promote the production of SCFAs, particularly increasing acetate, butyrate, and propionate (p < 0.0001). These results support the beneficial effects of the probiotic interventions as novel alternative or complementary strategies in chemoprevention.

Black chokeberry (Aronia melanocarpa L.) polyphenols attenuate obesity-induced colonic inflammation by regulating gut microbiota and the TLR4/NF-κB signaling pathway in high fat diet-fed rats

“…65 Besides, Blautia could also promote the production of SCFAs, particularly by increasing butyrate level in colorectal cancer patients after postoperative probiotics administration. 68 In our study, Bacteroides was positively correlated with acetic acid and isobutyric acid and negatively correlated with isovaleric acid. Blautia was positively correlated with butyric acid.…”

Oral compound probiotic supplements can improve the quality of life for patients with lung cancer during chemotherapy: A randomized placebo‐controlled study

“…Jiang et al found that a probiotic combination ( Bifidobacterium longum , Lactobacillus lactis , and Enterococcus faecium ) can ameliorate the severity of oral mucositis via gut microbiota modulation for nasopharyngeal carcinoma patients who were undergoing concurrent radiochemotherapy 28 . Probiotic combinations containing Bifidobacterium infants , Lactobacillus acidophilus , Enterococcus faecalis , and Bacillus cereus have also been shown to be effective in attenuating chemotherapy‐related gastrointestinal complications, especially diarrhea for colorectal cancer patients who were undergoing postoperative chemotherapy 22 . As for lung cancer patients receiving platinum‐based doublet chemotherapy, Clostridium butyricum can relieve chemotherapy‐related diarrhea 25 .…”

“…After one cycle of chemotherapy and compound probiotic supplement/placebo treatment, the scores of the two groups (group BP-1 vs. group C) showed a statistically significant difference in the following dimensions: overall quality of life (75.45 ± 15.46 vs. 61.55 ± 19.12, p = 0.001), pain (6.76 ± 13.87 vs. 17.75 ± 25.68, p = 0.021), nausea and vomiting (4.05 ± 9.13 vs. 22 2a).…”

“…Emerging evidence favors the strategy of gut microbiota regulation for ameliorating chemotherapy‐related adverse events 17 . In particular, the feasibility of probiotic supplementation to ameliorate chemotherapy‐related adverse effects has been demonstrated in preclinical and clinical studies 18–25 . Nevertheless, whether administering compound probiotics can relieve chemotherapy‐related adverse events for lung patients undergoing platinum‐based doublet chemotherapy is rarely reported.…”

Integrated gut microbiome and metabolome analysis reveals the inhibition effect of Lactobacillus plantarum CBT against colorectal cancer

“…4 Recently, the role of probiotics in CRC has attracted widespread attention. 5 Lactobacillus plantarum ( L. plantarum ) is a probiotic strain that is commonly found in the vagina and gastrointestinal tract and commonly encountered in dairy products. 6 Previous investigations have indicated that L. plantarum exhibits anti-inflammatory properties by inhibiting proinflammatory cytokines and bolstering the integrity and function of the intestinal epithelial barrier.…”