Nutrition Research and Practice

The Korean Nutrition Society (한국영양학회)
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Effect of preoperative immunonutrition on fecal microbiota in colon cancer patients: a secondary analysis of a randomized controlled trial

  • Soo Young Lee (Department of Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School) ;
  • Jaram Lee (Department of Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School) ;
  • Hyeong-min Park (Department of Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School) ;
  • Chang Hyun Kim (Department of Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School) ;
  • Hyeong Rok Kim (Department of Surgery, Chonnam National University Hwasun Hospital and Chonnam National University Medical School)
  • Received : 2022.07.08
  • Accepted : 2022.11.15
  • Published : 2023.06.01
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Abstract

BACKGROUND/OBJECTIVES: This study aimed to evaluate the effect of preoperative immunonutrition on the composition of fecal microbiota following a colon cancer surgery. MATERIALS/METHODS: This study was a secondary analysis of a randomized controlled trial assessing the impact of preoperative immunonutrition on the postoperative outcomes of colon cancer surgery. Patients with primary colon cancer were enrolled and randomly assigned to receive additional preoperative immunonutrition or a normal diet alone. Oral nutritional supplementation (400 mL/day) with arginine and ω-3 fatty acids were administered to patients in the immunonutrition group for 7 days prior to surgery. Thirty-two fecal samples were collected from 16 patients in each group, and the composition of fecal microbiota was compared between the 2 groups. RESULTS: At the phylum level, no significant difference was observed in the composition of microbiota between the 2 groups (Firmicutes, 69.1% vs. 67.5%, P = 0.624; Bacteroidetes, 19.3% vs. 18.1%, P = 0.663; Actinobacteria, 6.7% vs. 10.6%, P = 0.080). The Firmicutes/Bacteroidetes ratio (4.43 ± 2.32 vs. 4.55 ± 2.51, P = 0.897) was also similar between the 2 groups. At the genus level, the proportions of beneficial bacteria such as Faecalibacterium spp. (8.1% vs. 6.4%, P = 0.328) and Prevotella spp. (6.9% vs. 4.8%, P = 0.331) were higher, while that of Clostridium spp. was lower (0.5% vs. 1.2%, P = 0.121) in the immunonutrition group, but the difference was not significant. CONCLUSIONS: Immunonutrition showed no significant association with the composition of fecal microbiota. The relationship between immunonutrition and the fecal microbiota should be investigated further in large-scale studies.

Keywords

Acknowledgement

This study was supported by Chonnam National University Hwasun Hospital, Institute for Biomedical Science (grant numbers: HCRI19014 and HCRI20043).

References

  1. Cresci GA, Bawden E. Gut microbiome: what we do and don't know. Nutr Clin Pract 2015;30:734-46.  https://doi.org/10.1177/0884533615609899
  2. Guyton K, Alverdy JC. The gut microbiota and gastrointestinal surgery. Nat Rev Gastroenterol Hepatol 2017;14:43-54.  https://doi.org/10.1038/nrgastro.2016.139
  3. Agnes A, Puccioni C, D'Ugo D, Gasbarrini A, Biondi A, Persiani R. The gut microbiota and colorectal surgery outcomes: facts or hype? A narrative review. BMC Surg 2021;21:83. 
  4. Koliarakis I, Athanasakis E, Sgantzos M, Mariolis-Sapsakos T, Xynos E, Chrysos E, Souglakos J, Tsiaoussis J. Intestinal microbiota in colorectal cancer surgery. Cancers (Basel) 2020;12:3011. 
  5. Tourelle KM, Boutin S, Weigand MA, Schmitt FC. The association of gut microbiota and complications in gastrointestinal-cancer therapies. Biomedicines 2021;9:1305. 
  6. Keskey R, Papazian E, Lam A, Toni T, Hyoju S, Thewissen R, Zaborin A, Zaborina O, Alverdy JC. Defining microbiome readiness for surgery: dietary prehabilitation and stool biomarkers as predictive tools to improve outcome. Ann Surg 2022;276:e361-9  https://doi.org/10.1097/SLA.0000000000004578
  7. Darbandi A, Mirshekar M, Shariati A, Moghadam MT, Lohrasbi V, Asadolahi P, Talebi M. The effects of probiotics on reducing the colorectal cancer surgery complications: a periodic review during 2007-2017. Clin Nutr 2020;39:2358-67.  https://doi.org/10.1016/j.clnu.2019.11.008
  8. Liu PC, Yan YK, Ma YJ, Wang XW, Geng J, Wang MC, Wei FX, Zhang YW, Xu XD, Zhang YC. Probiotics reduce postoperative infections in patients undergoing colorectal surgery: a systematic review and metaanalysis. Gastroenterol Res Pract 2017;2017:6029075. 
  9. Weimann A. Influence of nutritional status on postoperative outcome in patients with colorectal cancer - the emerging role of the microbiome. Innov Surg Sci 2017;3:55-64.  https://doi.org/10.1515/iss-2017-0039
  10. Lee SY, Lee J, Park HM, Kim CH, Kim HR. Impact of preoperative immunonutrition on the outcomes of colon cancer surgery: results from a randomized controlled trial. Ann Surg. Forthcoming 2021. 
  11. Probst P, Ohmann S, Klaiber U, Huttner FJ, Billeter AT, Ulrich A, Buchler MW, Diener MK. Meta-analysis of immunonutrition in major abdominal surgery. Br J Surg 2017;104:1594-608.  https://doi.org/10.1002/bjs.10659
  12. Fukatsu K. Role of nutrition in gastroenterological surgery. Ann Gastroenterol Surg 2019;3:160-8.  https://doi.org/10.1002/ags3.12237
  13. Lee SY, Yeom SS, Kim CH, Kim HR. Effect of preoperative immunonutrition on outcomes of colon cancer surgery: study protocol for a randomized controlled trial. Trials 2020;21:628. 
  14. Lee SY, Jung MR, Kim CH, Kim YJ, Kim HR. Nutritional risk screening score is an independent predictive factor of anastomotic leakage after rectal cancer surgery. Eur J Clin Nutr 2018;72:489-95.  https://doi.org/10.1038/s41430-018-0112-3
  15. Leylabadlo HE, Ghotaslou R, Feizabadi MM, Farajnia S, Moaddab SY, Ganbarov K, Khodadadi E, Tanomand A, Sheykhsaran E, Yousefi B, et al. The critical role of Faecalibacterium prausnitzii in human health: an overview. Microb Pathog 2020;149:104344. 
  16. Ferreira-Halder CV, Faria AV, Andrade SS. Action and function of Faecalibacterium prausnitzii in health and disease. Best Pract Res Clin Gastroenterol 2017;31:643-8.  https://doi.org/10.1016/j.bpg.2017.09.011
  17. Lapiere A, Geiger M, Robert V, Demarquay C, Auger S, Chadi S, Benadjaoud M, Fernandes G, Milliat F, Langella P, et al. Prophylactic Faecalibacterium prausnitzii treatment prevents the acute breakdown of colonic epithelial barrier in a preclinical model of pelvic radiation disease. Gut Microbes 2020;12:1-15.  https://doi.org/10.1080/19490976.2020.1812867
  18. Damle RN, Cherng NB, Flahive JM, Davids JS, Maykel JA, Sturrock PR, Sweeney WB, Alavi K. Clostridium difficile infection after colorectal surgery: a rare but costly complication. J Gastrointest Surg 2014;18:1804-11. https://doi.org/10.1007/s11605-014-2600-7
  19. Lee J, Yeom SS, Lee SY, Kim CH, Kim HR, Kim YJ. The diagnostic delay and treatment outcome of Clostridium difficile infection in the patients who underwent rectal surgery. Korean J Clin Oncol 2019;15:34-9.  https://doi.org/10.14216/kjco.19007
  20. Merra G, Noce A, Marrone G, Cintoni M, Tarsitano MG, Capacci A, De Lorenzo A. Influence of Mediterranean diet on human gut microbiota. Nutrients 2020;13:7. 
  21. Yang Q, Liang Q, Balakrishnan B, Belobrajdic DP, Feng QJ, Zhang W. Role of dietary nutrients in the modulation of gut microbiota: a narrative review. Nutrients 2020;12:381. 
  22. Moreno-Perez D, Bressa C, Bailen M, Hamed-Bousdar S, Naclerio F, Carmona M, Perez M, GonzalezSoltero R, Montalvo-Lominchar MG, Carabana C, et al. Effect of a protein supplement on the gut microbiota of endurance athletes: a randomized, controlled, double-blind pilot study. Nutrients 2018;10:337. 
  23. Schmitt FC, Schneider M, Mathejczyk W, Weigand MA, Figueiredo JC, Li CI, Shibata D, Siegel EM, Toriola AT, Ulrich CM, et al. Postoperative complications are associated with long-term changes in the gut microbiota following colorectal cancer surgery. Life (Basel) 2021;11:246. 
  24. van Praagh JB, de Goffau MC, Bakker IS, van Goor H, Harmsen HJ, Olinga P, Havenga K. Mucus microbiome of anastomotic tissue during surgery has predictive value for colorectal anastomotic leakage. Ann Surg 2019;269:911-6. https://doi.org/10.1097/SLA.0000000000002651