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LRa05 根除率的疗效和安全性评价:一项随机、双盲、安慰剂对照试验。

Evaluation of efficacy and safety of LRa05 in the eradication of : a randomized, double-blind, placebo-controlled trial.

机构信息

Department of Gastroenterology, Jinshan Hospital, Fudan University, Shanghai, China.

Department of General Practice, Shihua Community Health Service Center in Jinshan District, Shanghai, China.

出版信息

Front Immunol. 2024 Aug 21;15:1450414. doi: 10.3389/fimmu.2024.1450414. eCollection 2024.

Abstract

AIM

This study aims to evaluate the efficacy of LRa05 supplementation in enhancing () eradication rate and alleviating the gastrointestinal side effects associated with bismuth quadruple therapy.

METHODS

-positive patients were randomized to receive levofloxacin-based bismuth quadruple therapy combined either probiotic LRa05 or a placebo for two weeks, followed by LRa05 (1 × 10 CFU) or maltodextrin for the next two weeks. infection was detected by C breath test pre- and post-treatment. Blood and stool samples were collected at week 0 and week 4 for routine and biochemical analysis, and serum inflammatory markers. Gastrointestinal symptoms were evaluated using the gastrointestinal symptom rating scale (GSRS). Intestinal microbiota was analyzed using 16S rRNA sequencing. The research was listed under the Chinese Clinical Trial Registry (ChiCTR2300072220), and written informed consent was obtained from all participants.

RESULTS

The LRa05 group exhibited a trend toward higher eradication rates (86.11%) compared to the placebo group (82.86%), though the difference was not statistically significant. Significant reductions in neutrophil count, alanine aminotransferase, aspartate aminotransferase, pepsinogen I, interleukin-6 (IL-6), tumor necrosis factor α (TNF-α) ( < 0.05) suggest that LRa05 supplementation may mitigate inflammation, enhance liver function, and potential aid in early cancer prevention. GSRS symptom scores showed that LRa05 alleviated abdominal pain, acid reflux, bloating, and diarrhea, enhancing patient compliance. Furthermore, 16S rRNA sequencing showed that LRa05 countered the antibiotic-induced disruption of gut microbiota diversity, primarily by increasing beneficial bacteria.

CONCLUSION

Although LRa05 did not significantly improve the success rate of eradication therapy, it has the potential to improve liver function and reduced levels of inflammatory markers such as IL-6 and TNF-α in the body, regulating the inflammatory response. In addition, it played a positive role in alleviating the adverse symptoms and gut microbiota disturbances caused by eradication therapy, providing a possible way to improve the overall health of patients and demonstrating promising clinical potential.

CLINICAL TRIAL REGISTRATION

http://www.chictr.org.cn, identifier ChiCTR2300072220.

摘要

目的

本研究旨在评估 LRa05 补充剂在提高()根除率和缓解铋四联疗法相关胃肠道副作用方面的疗效。

方法

将幽门螺杆菌阳性患者随机分为接受左氧氟沙星为基础的铋四联疗法联合益生菌 LRa05 或安慰剂治疗 2 周,然后再接受 LRa05(1×10 CFU)或麦芽糊精治疗 2 周。治疗前后通过 C 呼吸试验检测感染情况。在第 0 周和第 4 周采集血和粪便样本进行常规和生化分析以及血清炎症标志物检测。采用胃肠道症状评分量表(GSRS)评估胃肠道症状。采用 16S rRNA 测序分析肠道微生物群。该研究在中国临床试验注册中心(ChiCTR2300072220)进行登记,并获得所有参与者的书面知情同意。

结果

LRa05 组的()根除率(86.11%)有升高趋势,但与安慰剂组(82.86%)相比差异无统计学意义。中性粒细胞计数、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、胃蛋白酶原 I、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)显著降低(<0.05),提示 LRa05 补充剂可能减轻炎症、改善肝功能,并有助于早期预防癌症。GSRS 症状评分显示,LRa05 缓解了腹痛、胃酸反流、腹胀和腹泻,提高了患者的依从性。此外,16S rRNA 测序显示,LRa05 对抗生素引起的肠道微生物多样性破坏具有拮抗作用,主要通过增加有益菌来实现。

结论

虽然 LRa05 并未显著提高()根除治疗的成功率,但它有可能改善肝功能,降低体内白细胞介素-6 和肿瘤坏死因子-α等炎症标志物的水平,调节炎症反应。此外,它在缓解根除治疗引起的不良反应和肠道微生物群紊乱方面发挥了积极作用,为改善患者整体健康提供了一种可能的途径,具有广阔的临床应用前景。

临床试验注册

http://www.chictr.org.cn,标识符 ChiCTR2300072220。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ccf4/11371625/9aecb767740e/fimmu-15-1450414-g001.jpg

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