Zhao Zicen, Wu Yuxuan, Leng Yufang, Chang Liya, Wang Yu, Li Dongbin, Xing Yang
The First Clinical Medical College, Lanzhou University, Lanzhou, China.
Clinical Medicine Department, Fenyang College of Shanxi Medical University, Fenyang, China.
Front Med (Lausanne). 2025 May 22;12:1546650. doi: 10.3389/fmed.2025.1546650. eCollection 2025.
Intestinal ischemia-reperfusion injury (IRI) is a common complication of intestinal surgery and carries the risk of patient death. The treatment of intestinal IRI is an important direction of current research. This study aimed to analyze animal experiments and thus investigate the effects of probiotics administration on intestinal IRI and its mechanisms.
We included a total of 12 studies from 5 databases (PubMed, Web of Science, Cochrane, Embase, and Scopus), incorporating outcome metrics including Chiu's score, levels of malondialdehyde (MDA), myeloperoxidase (MPO) tumor necrosis factor-alpha (TNF-), IL-6, IL-1β, occludin, zonula occludens-1 (ZO-1), FITC-dextran and intestinal bacteria (Lactobacillus, Bacteroides and Bifidobacteria). Statistical analysis was performed using Review Manager 5.3.
We found that probiotic-added animals had less intestinal damage after IRI compared to controls, as evidenced by a more intact intestinal barrier [occludin (2.83, 95% CI: 1.46 to 4.20, < 0.0001), ZO-1 (3.30, 95% CI: 1.58 to 5.01, = 0.0002) and FITC-dextran (-3.83, 95% CI: -5.83 to -2.29, < 0.0001)], lower Chiu score (-1.83, 95% CI: -2.47 to -1.20, < 0.0001), fewer inflammatory factors [IL-6 (-2.19, 95% CI: -3.98 to -0.39, = 0.02), TNF- (-2.24, 95% CI: -4.15 to -0.33, = 0.02)], and lower levels of oxidative stress [MDA (-2.46, 95% CI: -4.62 to -0.30, = 0.03), MPO (-0.97, 95% CI: -1.77 to -0.17; = 0.02)]. In addition, probiotic supplementation increased the relative abundance of Lactobacillus (0.90, 95% CI: 0.33 to 1.48, = 0.002) and Bacteroides (0.81, 95% CI: 0.14 to 1.49, = 0.02), thus maintaining the stability of the gut microbiota.
In conclusion, the mechanisms by which probiotic therapy attenuates intestinal IRI may be related to decreased levels of inflammation and oxidative stress, increased probiotic abundance, and increased expression of tight junction (TJ) proteins.
肠缺血再灌注损伤（IRI）是肠道手术常见的并发症，存在患者死亡风险。肠IRI的治疗是当前研究的重要方向。本研究旨在分析动物实验，从而探究给予益生菌对肠IRI的影响及其机制。
我们从5个数据库（PubMed、Web of Science、Cochrane、Embase和Scopus）共纳入12项研究，纳入的结局指标包括Chiu评分、丙二醛（MDA）水平、髓过氧化物酶（MPO）、肿瘤坏死因子-α（TNF-）、白细胞介素-6（IL-6）、白细胞介素-1β（IL-1β）、闭合蛋白、紧密连接蛋白-1（ZO-1）、异硫氰酸荧光素标记右旋糖酐（FITC-右旋糖酐）和肠道细菌（乳酸杆菌、拟杆菌和双歧杆菌）。使用RevMan 5.3进行统计分析。
我们发现，与对照组相比，给予益生菌的动物在IRI后肠道损伤较轻，表现为肠道屏障更完整[闭合蛋白（2.83，95%置信区间：1.46至4.20，P<0.0001）、ZO-1（3.30，95%置信区间：1.58至5.01，P=0.0002）和FITC-右旋糖酐（-3.83，95%置信区间：-5.83至-2.29，P<0.0001）]，Chiu评分更低（-1.83，95%置信区间：-2.47至-1.20，P<0.0001），炎症因子更少[IL-6（-2.19，95%置信区间：-3.98至-0.39，P=0.02）、TNF-（-2.24，95%置信区间：-4.15至-0.33，P=0.02）]，氧化应激水平更低[MDA（-2.46，95%置信区间：-4.62至-0.30，P=0.03）、MPO（-0.97，95%置信区间：-1.77至-0.17；P=0.02）]。此外，补充益生菌增加了乳酸杆菌（0.90，95%置信区间：0.33至1.48，P=0.002）和拟杆菌（0.81，95%置信区间：0.14至1.49，P=0.02）的相对丰度，从而维持了肠道微生物群的稳定性。
总之，益生菌疗法减轻肠IRI的机制可能与炎症和氧化应激水平降低、益生菌丰度增加以及紧密连接（TJ）蛋白表达增加有关。
