Ann Surg Treat Res.  2021 Nov;101(5):281-290. 10.4174/astr.2021.101.5.281.

The effect of probiotics supplementation in postoperative cancer patients: a prospective pilot study

Affiliations
  • 1Cancer Genomic Research Institute, Immunology Laboratory, Seoul Song Do Colorectal Hospital, Seoul, Korea
  • 2Ildong Bioscience, Pyeongtaek, Korea
  • 3Cancer Immune Clinic, Seoul Song Do Colorectal Hospital, Seoul, Korea
  • 4Department of Surgery, Pelvic Floor Center, Seoul Song Do Colorectal Hospital, Seoul, Korea
  • 5Department of Pathology, Seoul Song Do Colorectal Hospital, Seoul, Korea

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.

Keyword

Cancer patients; Gut microbiota; Postoperative; Probiotics; Quality of life

Figure

  • Fig. 1 Alpha diversity. Boxplots of alpha diversity metrics; (A) Chao1, (B) Shannon index, and (C) Simpson index. Red bars and points indicate before group values; blue bars and points indicate after group values. Significance was assessed by means of paired Wilcoxon test. Group I, the group before ingestion of probiotics; group II, the group after ingestion of probiotics.

  • Fig. 2 Microbial comparison for beta diversity. Beta diversity based on (A) the weighted UniFrac distance, (B) the unweighted UniFrac distance, (C) Bray-Curtis distance, and (D) Jaccard distance were compared with principal coordinates analysis for the 2 groups. The groups were compared using the P-value of the permutational multivariate analysis of variance method.

  • Fig. 3 Gut microbiota composition at the (A) phylum, (B) genus, and (C) species level for the 2 groups. *P < 0.05.

  • Fig. 4 The linear discriminant analysis effect size (LEfSe) analysis of gut microbiota between the 2 groups. (A) Cladogram generated by LEfSe indicating differences at phylum, class, family and genus levels between the 2 groups. Each successive circle represents a phylogenetic level. Regions in red indicate taxa enriched in before group affected while regions in green indicate taxa enriched in after group. Differing taxa are listed on the right side of the cladogram. (B) Bar graphs showing linear discriminant analysis (LDA) scores. Horizontal bars represent the effect size for each taxon. The length of the bar represents the log10 transformed LDA score, indicated by vertical dotted lines. Significance determined using default parameters (P < 0.05 by Kruskal-Wallis test and LDA score > 2). The name of the taxon level is abbreviated as p, phylum; c, class; g, genus; and s, species.


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