随机临床试验：益生菌减轻甲状腺切除术后接受放射性碘治疗前甲状腺癌患者的口腔-肠道微生物群失调及甲状腺激素撤药相关并发症。

Randomized Clinical Trial: Probiotics Alleviated Oral-Gut Microbiota Dysbiosis and Thyroid Hormone Withdrawal-Related Complications in Thyroid Cancer Patients Before Radioiodine Therapy Following Thyroidectomy.

作者信息

Lin Baiqiang, Zhao Fuya, Liu Yang, Wu Xin, Feng Jing, Jin Xiangren, Yan Wei, Guo Xiao, Shi Shang, Li Zhiyong, Liu Lujia, Chen Hongye, Wang Haoran, Wang Shuang, Lu Yu, Wei Yunwei

机构信息

Department of Oncology and Laparoscopy Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, China.

Department of Pancreatic and Gastrointestinal Surgery Division, HwaMei Hospital, University of Chinese Academy of Science, Ningbo, China.

出版信息

Front Endocrinol (Lausanne). 2022 Mar 8;13:834674. doi: 10.3389/fendo.2022.834674. eCollection 2022.

BACKGROUND

Thyroid hormone withdrawal (THW) in postoperative thyroid cancer patients who need always accompanied by complications (e.g., dyslipidemia and constipation). At present, there are no effective and safe means to alleviate these complications.

PURPOSE

We aimed to assess the oral-gut microbiota profiles in THW patients then investigate whether probiotics could alleviating alleviate THW related complications and investigate whether these therapeutic effects were associated with the oral-gut microbiota state.

METHODS

Fifty eligible thyroid carcinoma patients undergoing thyroidectomy were randomly assigned to receive probiotics or placebo during THW. Complications were assessed through validated questionnaires and plasma lipid indicators. The complex probiotics preparation was composed of , , , and .

RESULTS

Probiotics alleviated lack of energy, constipation, weight gain, and dry mouth and decreased the levels of fecal/serum LPS and plasma lipid indicators (total cholesterol, triglycerides, low-density lipoprotein, and apolipoprotein A) (P < 0.05). Gut and oral microbial diversity were significantly decreased after THW, while an increased microbial dysbiosis index (MDI) was observed. Probiotics distinctly restored the gut and oral microbial diversity. Increased , , and , while decreased , , , and in the gut were found after probiotics intervention. Lack of energy, constipation, weight gain, and dyslipidemia were seen to be related to the above microbiota. In addition, probiotics reduced oral , , , and , which were positively correlated with the occurrence of dry mouth.

CONCLUSION

Probiotics reduce the incidence of complications in patients after THW, which may be related to modifying the oral and gut microbiota.

CLINICAL TRIAL REGISTRATION

[https://clinicaltrials.gov/], identifier America Clinical Trial Registry NCT03574051.

背景

术后甲状腺癌患者的甲状腺激素撤减（THW）常伴有并发症（如血脂异常和便秘）。目前，尚无有效且安全的方法来缓解这些并发症。

目的

我们旨在评估THW患者的口腔-肠道微生物群谱，然后研究益生菌是否能减轻THW相关并发症，并研究这些治疗效果是否与口腔-肠道微生物群状态相关。

方法

50例符合条件的接受甲状腺切除术的甲状腺癌患者在THW期间被随机分配接受益生菌或安慰剂。通过经过验证的问卷和血脂指标评估并发症。复合益生菌制剂由[具体成分]组成。

结果

益生菌减轻了乏力、便秘、体重增加和口干，并降低了粪便/血清脂多糖水平和血脂指标（总胆固醇、甘油三酯、低密度脂蛋白和载脂蛋白A）（P<0.05）。THW后肠道和口腔微生物多样性显著降低，同时观察到微生物失调指数（MDI）增加。益生菌明显恢复了肠道和口腔微生物多样性。益生菌干预后，肠道中[具体微生物]增加，而[具体微生物]减少。乏力、便秘、体重增加和血脂异常与上述微生物群有关。此外，益生菌减少了口腔中的[具体微生物]，这些微生物与口干的发生呈正相关。