甲状腺激素停药(THW)在术后甲状腺癌患者中需要始终伴有并发症(例如,血脂异常和便秘)。目前,没有有效和安全的方法来缓解这些并发症。
我们旨在评估THW患者的口腔-肠道菌群分布,然后研究益生菌是否可以缓解THW相关并发症,并研究这些治疗效果是否与口腔-肠道菌群状态相关。
50名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。通过有效的问卷和血浆脂质指标评估并发症。复合益生菌制剂由婴儿双歧杆菌组成,嗜酸乳杆菌,粪肠球菌,和蜡状芽孢杆菌.
益生菌缓解了能量不足,便秘,体重增加,和口干,降低粪便/血清LPS和血浆脂质指标(总胆固醇,甘油三酯,低密度脂蛋白,载脂蛋白A)(P<0.05)。肠道和口腔微生物多样性在THW后显著下降,同时观察到微生物菌群失调指数(MDI)增加。益生菌明显恢复了肠道和口腔微生物的多样性。增加了Holdemanella,肠球菌,和coprococcus_2,而减少了梭杆菌,真细菌-反刍动物-群,益生菌干预后,在肠道中发现了反刍动物_1和Parasutterylla。缺乏能源,便秘,体重增加,血脂异常与上述微生物群有关。此外,益生菌减少口服Prevotella_9,嗜血杆菌,梭杆菌,还有Lautropia,与口干的发生呈正相关。
益生菌可降低THW后患者并发症的发生率,这可能与改变口腔和肠道微生物群有关。
[https://clinicaltrials.gov/],标识符美国临床试验注册NCT03574051。
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.
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.
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 Bifidobacterium infantis, Lactobacillus acidophilus, Enterococcus faecalis, and Bacillus cereus.
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 Holdemanella, Enterococcus, and Coprococcus_2, while decreased Fusobacterium, Eubacterium_ruminantium_group, Ruminococcus_1, and Parasutterella 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 Prevotella_9, Haemophilus, Fusobacterium, and Lautropia, which were positively correlated with the occurrence of dry mouth.
Probiotics reduce the incidence of complications in patients after THW, which may be related to modifying the oral and gut microbiota.
[https://clinicaltrials.gov/], identifier America Clinical
Trial Registry NCT03574051.