Table_8_Clostridium butyricum potentially improves inflammation and immunity through alteration of the microbiota and metabolism of gastric cancer patients after gastrectomy.xlsx

BackgroundGastrectomy is the most effective treatment to improve the clinical survival rate of patients with gastric cancer. However, the pathophysiological changes caused by gastrectomy have seriously affected the postoperative recovery.MethodsIn the present trial, Ataining (containing C. butyricum, CGMCC0313.1) was applied in patients after gastrectomy to investigate the effect of C. butyricum on the early postoperative recovery by monitoring the inflammatory immune response with blood indicators, detecting the gut microbiota with high-throughput sequencing, and analyzing the short-chain fatty acids (SCFAs) with targeted metabolomics. This study is registered with the number ChiCTR2000040915.ResultsOur outcomes revealed that C. butyricum had significantly reduced the number of Leucocyte (P < 0.001), the percentage of Neutrophil (P < 0.001), the expression of IL-1β (P < 0.01), IL-6 (P < 0.05), and TNF-α (P < 0.01), while markedly enhanced the immunity indexes (immunoglobulin and lymphocyte) (P < 0.05) and nutrition indexes (albumin and total protein) (P < 0.05). In addition, the use of the C. butyricum greatly enriched the relative abundance of beneficial bacteria Bacteroides, Faecalibacterium and Gemmiger, while the abundance of pathogenic Streptococcus, Desulfovibrio and Actinomyces were markedly decreased at genus level. We also observed significant up-regulation of SCFAs, including acetic acid, propionic acid, butyric acid and isobutyric acid, after C. butyricum administration in patients receiving gastrectomy.ConclusionTherefore, evidence supported that oral administration of C. butyricum after gastrectomy can reduce early postoperative inflammation, enhance immune ability, restore intestinal microbiota eubiosis, increase intestinal SCFAs, reduce the occurrence of postoperative complications, and ultimately promote the early recovery of the patient.Clinical trial registrationhttp://www.chictr.org.cn/, identifier (ChiCTR2000040915).

背景：胃切除术是提高胃癌患者临床生存率的最为有效的治疗方法。然而，胃切除术引发的病理生理变化严重影响了患者的术后恢复。方法：在本项研究中，我们应用了含有双歧杆菌（C. butyricum，CGMCC0313.1）的制剂于胃切除术后的患者中，旨在通过监测血液指标中的炎症免疫反应、高通量测序检测肠道菌群以及靶向代谢组学分析短链脂肪酸（SCFAs）来探讨双歧杆菌对早期术后恢复的影响。本研究已注册于ChiCTR2000040915编号。结果：我们的研究结果表明，双歧杆菌显著降低了白细胞（P < 0.001）、中性粒细胞百分比（P < 0.001）、IL-1β（P < 0.01）、IL-6（P < 0.05）和TNF-α（P < 0.01）的表达，同时显著提高了免疫指标（免疫球蛋白和淋巴细胞）（P < 0.05）和营养指标（白蛋白和总蛋白）（P < 0.05）。此外，使用双歧杆菌显著丰富了有益菌类如拟杆菌属、粪肠球菌属和梭菌属的相对丰度，而在属水平上，病原菌如链球菌属、脱硫弧菌属和放线菌属的丰度明显降低。我们还观察到在行胃切除术的患者中，给予双歧杆菌后显著上调了包括乙酸、丙酸、丁酸和异丁酸在内的短链脂肪酸。结论：因此，证据表明，胃切除术后的口服双歧杆菌可以减轻早期术后炎症，增强免疫能力，恢复肠道菌群生态平衡，增加肠道短链脂肪酸，减少术后并发症的发生，并最终促进患者的早期恢复。临床试验注册：http://www.chictr.org.cn/，标识符（ChiCTR2000040915）。