Fuyuki Akiko, Higurashi Takuma, Kessoku Takaomi, Ashikari Keiichi, Yoshihara Tsutomu, Misawa Noboru, Iwaki Michihiro, Kobayashi Takashi, Ohkubo Hidenori, Yoneda Masato, Usuda Haruki, Wada Koichiro, Nakajima Atsushi
Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, 3-9 Fuku-ura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
Department of Pharmacology, Shimane University Faculty of Medicine, 89-1 Enyacho, Izumo, Shimane 693-0021, Japan.
Biosci Microbiota Food Health. 2021;40(2):105-114. doi: 10.12938/bmfh.2020-073. Epub 2021 Jan 19.
Chronic constipation is a functional disorder that decreases a patient's quality of life (QOL). Because dysbiosis has been associated with constipation, we aimed to investigate the efficacy of G9-1 (BBG9-1) in improving QOL in patients with constipation. This was a prospective, single-center, non-blinded, single-arm feasibility trial. A total of 31 patients with constipation and decreased QOL received BBG9-1 treatment for 8 weeks, followed by a 2-week washout period. The primary endpoint was change in the overall Japanese version of the patient assessment of constipation of QOL (JPAC-QOL) score after probiotic administration relative to that at baseline. Secondary endpoints included changes in gut microbiota, stool consistency, frequency of bowel movement, degree of straining, sensation of incomplete evacuation, and frequency of rescue drug use. The overall JPAC-QOL scores and frequency of bowel movement significantly improved after BBG9-1 administration from those at baseline (p<0.01 and p<0.01, respectively). There were no statistically significant changes in other clinical symptoms. Subset analysis revealed that patients with initial Bristol Stool Form Scale stool types of <4 had improvements in stool consistency, a significant increase in the frequency of bowel movements, and a significant alleviation in the degree of straining, following BBG9-1 administration. At the genus and species levels, and were significantly increased. Functional analysis showed that butanoate metabolism increased significantly, whereas methane metabolism decreased significantly. We concluded that BBG9-1 is safe and improves QOL in patients with constipation. The underlying improvements may be due to changes in stool consistency.
慢性便秘是一种降低患者生活质量(QOL)的功能性疾病。由于肠道菌群失调与便秘有关,我们旨在研究G9-1(BBG9-1)对改善便秘患者生活质量的疗效。这是一项前瞻性、单中心、非盲、单臂可行性试验。共有31例便秘且生活质量下降的患者接受了BBG9-1治疗8周,随后有2周的洗脱期。主要终点是益生菌给药后便秘患者生活质量评估(JPAC-QOL)日语版总分相对于基线时的变化。次要终点包括肠道微生物群的变化、粪便稠度、排便频率、用力程度、排便不尽感以及急救药物使用频率。服用BBG9-1后,JPAC-QOL总分和排便频率相对于基线时均显著改善(分别为p<0.01和p<0.01)。其他临床症状无统计学显著变化。亚组分析显示,初始布里斯托大便分类法大便类型<4的患者在服用BBG9-1后,粪便稠度得到改善,排便频率显著增加,用力程度显著减轻。在属水平和种水平上,[具体属名]和[具体种名]显著增加。功能分析表明,丁酸盐代谢显著增加,而甲烷代谢显著降低。我们得出结论,BBG9-1对便秘患者安全且能改善生活质量。潜在的改善可能归因于粪便稠度的变化。