S.C. Dietetica e Nutrizione Clinica, AOU Città della Salute e della Scienza di Torino, 10126 Torino, Italy.
Multimodal Laboratory Medicine Research Area, Unit of Human Microbiome, Bambino Gesù Children's Hospital, IRCCS, 00165 Rome, Italy.
Nutrients. 2020 Dec 29;13(1):87. doi: 10.3390/nu13010087.
Long-term enteral nutrition (LTEN) can induce gut microbiota (GM) dysbiosis and gastrointestinal related symptoms, such as constipation or diarrhoea. To date, the treatment of constipation is based on the use of laxatives and prebiotics. Only recently have probiotics and synbiotics been considered, the latter modulating the GM and regulating intestinal functions. This randomized open-label intervention study evaluated the effects of synbiotic treatment on the GM profile, its functional activity and on intestinal functions in long-term home EN (LTHEN) patients. Twenty LTHEN patients were recruited to take enteral formula plus one sachet/day of synbiotic (intervention group, IG) or enteral formula (control group, CG) for four months and evaluated for constipation, stool consistency, and GM and metabolite profiles. In IG patients, statistically significant reduction of constipation and increase of stool consistency were observed after four months (T), compared to CG subjects. GM ecology analyses revealed a decrease in the microbial diversity of both IC and CG groups. Biodiversity increased at T for 5/11 IG patients and was identified as the biomarker correlated to the richness increase. Moreover, the increase of short chain fatty acids and the reduction of harmful molecules have been correlated to synbiotic administration. Synbiotics improve constipation symptoms and influences growth in LTHEN patients.
长期肠内营养(LTEN)可引起肠道微生物群(GM)失调和胃肠道相关症状,如便秘或腹泻。迄今为止,便秘的治疗方法基于泻药和益生元的使用。最近才开始考虑使用益生菌和合生剂,后者调节 GM 并调节肠道功能。这项随机开放标签干预研究评估了合生剂治疗对 GM 谱、其功能活性以及对长期家庭肠内营养(LTHEN)患者肠道功能的影响。招募了 20 名 LTHEN 患者,每天服用肠内配方加 1 包合生剂(干预组,IG)或肠内配方(对照组,CG),持续四个月,并评估便秘、粪便稠度以及 GM 和代谢物谱。在 IG 患者中,与 CG 组相比,四个月后(T)时,便秘明显减少,粪便稠度增加。GM 生态分析显示 IC 和 CG 两组的微生物多样性均下降。生物多样性在 T 时增加了 5/11 的 IG 患者,并被鉴定为与丰富度增加相关的生物标志物。此外,短链脂肪酸的增加和有害分子的减少与合生剂的给药有关。合生剂可改善 LTHEN 患者的便秘症状并影响 GM 的生长。