肠内免疫营养对结直肠癌和胃癌患者术前肠道微生物群的影响——随机临床试验的初步结果

The impact of enteral immunonutrition on gut microbiota in colorectal cancer and gastric cancer patients in the preoperative period-preliminary results of randomized clinical trial.

作者信息

Kaźmierczak-Siedlecka Karolina, Stachowska Ewa, Kucharski Robert, Wiśniewski Piotr, Ulasiński Paweł, Stańczak Michał, Makarewicz Wojciech, Skonieczna-Żydecka Karolina, Kalinowski Leszek

机构信息

Department of Medical Laboratory Diagnostics - Fahrenheit Biobank BBMRI.pl, Medical University of Gdansk, Gdańsk, Poland.

Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, Szczecin, Poland.

出版信息

Front Immunol. 2025 Aug 7;16:1606187. doi: 10.3389/fimmu.2025.1606187. eCollection 2025.

DOI:10.3389/fimmu.2025.1606187

PMID:40852731

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12367513/

Abstract

INTRODUCTION

Immunonutrition is a part of nutritional interventions in gastrointestinal cancer patients. It seems to be especially important in the preoperative period to reduce, among others, surgery-related complications. The relation between the immune system and gut microbiota has been previously analyzed. However, the influence of immunonutrients on the composition of gut microbiota is still unclear. Therefore, the aim of this study was to assess the impact of enteral immunonutrition on gut microbiota in gastric/colorectal cancer patients in the preoperative period.

PATIENTS AND METHODS

This study included 14 patients ( = 9 colorectal cancer, = 5 gastric cancer) allocated to receive immunonutrition or standard products by 7 days prior to the surgery. Randomization was performed using a random number generator. The stool samples were collected at day 0 and after 7 days of consuming the study products. Therefore, gut microbiota analysis was conducted at the beginning and after 7 days (follow-up). The analysis consists of alpha diversity analysis, taxonomic data processing, beta diversity analysis, and differential abundance analysis.

RESULTS

Statistical analysis did not indicate any significant differences ( > 0.05) between the two dietary groups for any of the alpha diversity indices. Microbial community compositions were largely similar between the immunodiet and standard nutridrink groups. Differential abundance analysis (DAA) using the Wilcoxon test identified several taxa with nominal -values <0.05, suggesting potential differences in abundance between groups. However, none of these findings remained statistically significant. The taxa with nominal significance included , , , , , , , and [] group.

CONCLUSIONS

The analysis of gut microbiota in the context of immunonutrition is a new area in oncology. In the current study, despite some initial microbial alterations, it was not finally confirmed that immunonutrition has a beneficial effect on gut microbiota in gastric and colorectal cancer patients in the preoperative period. However, the small sample size is one of the study's limitations.

摘要

引言

免疫营养是胃肠道癌症患者营养干预的一部分。在术前阶段，它似乎对于减少手术相关并发症等方面尤为重要。免疫系统与肠道微生物群之间的关系此前已得到分析。然而，免疫营养物质对肠道微生物群组成的影响仍不明确。因此，本研究的目的是评估术前肠内免疫营养对胃癌/结直肠癌患者肠道微生物群的影响。

患者与方法

本研究纳入了14例患者（9例结直肠癌患者，5例胃癌患者），在手术前7天被分配接受免疫营养或标准产品。使用随机数生成器进行随机分组。在第0天以及食用研究产品7天后采集粪便样本。因此，在开始时和7天后（随访）进行肠道微生物群分析。分析包括α多样性分析、分类数据处理、β多样性分析和差异丰度分析。

结果

统计分析表明，两个饮食组在任何α多样性指数方面均未显示出任何显著差异（P>0.05）。免疫饮食组和标准营养饮料组之间的微生物群落组成在很大程度上相似。使用Wilcoxon检验的差异丰度分析（DAA）确定了几个名义P值<0.05的分类群，表明两组之间丰度可能存在差异。然而，这些发现均未保持统计学显著性。具有名义显著性的分类群包括[具体分类群名称未完整给出]。