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Effect of synbiotic supplementation on immune parameters and gut microbiota in healthy adults: a double-blind randomized controlled trial.
Li, X, Hu, S, Yin, J, Peng, X, King, L, Li, L, Xu, Z, Zhou, L, Peng, Z, Ze, X, et al
Gut microbes. 2023;15(2):2247025
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The gut microbiota is involved in regulating immunity and synbiotics, that is combinations of pro- and prebiotics, may therefore modulate immunity via the gut microbiota. The aim of this randomised, double-blind, placebo-controlled trial was to evaluate the immune-modulatory effects of a synbiotic supplement (containing Bifidobacterium lactis HN019, Lactobacillus rhamnosus HN001 and fructo-oligosaccharide) in healthy adults. Outcome measures included C-reactive protein (CRP, an inflammatory marker), various pro- and anti-inflammatory cytokines, stool and salivary secretory IgA (sIgA), leukocytes, microbial stool analysis and occurrence, duration, and severity of upper respiratory tract infections (URTI). Compared to the control group, a significant reduction in the inflammatory markers CRP and interferon-gamma and an increase in the anti-inflammatory interleukin-10 and stool sIgA were observed in the supplementation group. There were no differences in types of leukocytes or URTIs between groups. Significant favourable changes in microbiome analysis were observed in the supplemented group which correlated with the observed improvements in inflammatory markers. These changes were dependent on the baseline composition of the microbiome. No adverse events were reported. The authors conclude that the data show that synbiotics are of benefit to healthy adults and support the concept of personalised supplementation.
Abstract
Synbiotics are increasingly used by the general population to boost immunity. However, there is limited evidence concerning the immunomodulatory effects of synbiotics in healthy individuals. Therefore, we conducted a double-blind, randomized, placebo-controlled study in 106 healthy adults. Participants were randomly assigned to receive either synbiotics (containing Bifidobacterium lactis HN019 1.5 × 108 CFU/d, Lactobacillus rhamnosus HN001 7.5 × 107 CFU/d, and fructooligosaccharide 500 mg/d) or placebo for 8 weeks. Immune parameters and gut microbiota composition were measured at baseline, mid, and end of the study. Compared to the placebo group, participants receiving synbiotic supplementation exhibited greater reductions in plasma C-reactive protein (P = 0.088) and interferon-gamma (P = 0.008), along with larger increases in plasma interleukin (IL)-10 (P = 0.008) and stool secretory IgA (sIgA) (P = 0.014). Additionally, synbiotic supplementation led to an enrichment of beneficial bacteria (Clostridium_sensu_stricto_1, Lactobacillus, Bifidobacterium, and Collinsella) and several functional pathways related to amino acids and short-chain fatty acids biosynthesis, whereas reduced potential pro-inflammatory Parabacteroides compared to baseline. Importantly, alternations in anti-inflammatory markers (IL-10 and sIgA) were significantly correlated with microbial variations triggered by synbiotic supplementation. Stratification of participants into two enterotypes based on pre-treatment Prevotella-to-Bacteroides (P/B) ratio revealed a more favorable effect of synbiotic supplements in individuals with a higher P/B ratio. In conclusion, this study suggested the beneficial effects of synbiotic supplementation on immune parameters, which were correlated with synbiotics-induced microbial changes and modified by microbial enterotypes. These findings provided direct evidence supporting the personalized supplementation of synbiotics for immunomodulation.
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Effect of a multichannel oral irrigator on periodontal health and the oral microbiome.
Kim, JM, Yoo, SY, An, JS, Woo, JJ, Cho, YD, Park, HE, Karm, MH
Scientific reports. 2023;13(1):12043
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Oral biofilms are the primary cause of dental caries and periodontal diseases. This RCT looked at the effect of a multichannel oral irrigator (MCOI) (a new oral hygiene device which injects clean water onto the teeth at an angle of 45°) on periodontal health in 29 healthy participants randomly divided into two groups. Saliva samples were analysed in the MCOI group and the control group and changes in the oral microbiota investigated with a focus on gingival inflammation. It was assumed that water irrigation using this new device may lower the accumulation of oral biofilms. However, the effectiveness of this new device in decreasing dental plaque was not determined because the MCOI group showed accumulation of plaque in the oral cavity and increased levels of opportunistic pathogens called Captocytopaga species involved in periodontal disease. Streptococcus species also showed an increase in the MCOI group and other bacteria were reduced. The authors agree that these conflicting trends imply the need for a longitudinal study over a longer period as three days was too short to assess gingival status change, let alone detect any changes to the periodontal state. Overall the oral microbiome and oral hygiene is important and relevant to health as certain patients with low dexterity such as the elderly and those with disabilities may struggle with thorough plaque removal so assisted devices to clean the oral cavity are needed. Furthermore this can also apply to patients with Alzheimer disease, dementia and autism.
Abstract
Oral biofilms or dental plaques are one of the major etiological factors for diverse oral diseases. We aimed to evaluate the effect of a multichannel oral irrigator (MCOI) on periodontal health in 29 participants randomly divided into two groups: the MCOI group and the control group. To evaluate the effect of the MCOI on periodontal health, the modified Quigley Hein Plaque Index (PI), Mühlemann-Son Sulcus Bleeding Index (SBI), bleeding on probing (BOP), and swelling were evaluated and compared before and after MCOI use for 3 days. Although PI and SBI showed statistically significant increases in the control group, the MCOI group showed no significant changes in either parameter. Moreover, the percentage of BOP was significantly lower in the MCOI group. Saliva samples were analyzed by 16s rRNA amplicon sequencing to investigate changes in the oral microbiome. Sequencing results showed that Porphyromonas spp. were significantly increased in the control group, whereas no significant change was detected in the MCOI group. Using the MCOI, enriched populations and functional pathways were detected in pioneer species comprising non-mutans streptococci. These findings provide evidence of the effectiveness of the MCOI in maintaining periodontal health and a healthy microbial ecology in the oral cavity.
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Randomized Clinical Trial: Probiotics Alleviated Oral-Gut Microbiota Dysbiosis and Thyroid Hormone Withdrawal-Related Complications in Thyroid Cancer Patients Before Radioiodine Therapy Following Thyroidectomy.
Lin, B, Zhao, F, Liu, Y, Wu, X, Feng, J, Jin, X, Yan, W, Guo, X, Shi, S, Li, Z, et al
Frontiers in endocrinology. 2022;13:834674
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The occurrence of thyroid cancer has increased in recent years. Part of the treatment for this disease is removal of the thyroid gland and then the administration of radioactive iodine. To help aid the uptake of radioactive iodine, individuals may need to withdraw from their thyroid hormone therapy, known as thyroid hormone withdrawal (THW). This is however accompanied by side effects such as fatigue, constipation, and weight gain, all of which have been hypothesised to be due to gut microbiota dysbiosis. This randomised control trial aimed to determine any gut and oral microbiota signatures in 50 individuals who have undergone THW because of thyroid cancer and to see if probiotics have any beneficial effects. The results showed that gut and oral microbiota diversity was decreased after THW. Upon the administration of probiotics, diversity was restored, energy and blood lipid levels were improved, and weight gain and a dry mouth were alleviated. It was concluded that probiotics reduce the occurrence of side effects following THW, which may be related to the modification of oral and gut microbiota diversity. This study could be used by healthcare professionals to understand that probiotics may be of benefit to improve the side effects associated with THW in individuals with thyroid cancer.
Abstract
BACKGROUND 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. PURPOSE 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. METHODS 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. RESULTS 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. CONCLUSION Probiotics reduce the incidence of complications in patients after THW, which may be related to modifying the oral and gut microbiota. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/], identifier America Clinical Trial Registry NCT03574051.
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A pilot, open labelled, randomised controlled trial of hypertonic saline nasal irrigation and gargling for the common cold.
Ramalingam, S, Graham, C, Dove, J, Morrice, L, Sheikh, A
Scientific reports. 2019;9(1):1015
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The common cold is a viral upper respiratory tract infection which affects adults and children worldwide, often multiple times a year. A large number of viruses cause these infections, making targeted antiviral treatment impractical. This small, randomised, controlled pilot trial (not blinded) of 68 adults aimed to assess the impact of salt-water nasal washing and throat gargling as many times as required (on average 3 times a day for 5 days) within 48 hours of symptom on-set on study recruitment and retention, as well as acceptability, symptom duration and viral shedding. The researchers found that nasal irrigation and gargling with a saline solution was acceptable to study participants. Illness duration was shortened by 1.9 days in the intervention arm, with significant reductions in the duration of runny nose, blocked nose, sneezing, cough and hoarseness of voice. The average quality of life score was also higher in the intervention arm, although this failed to reach significance. Viral shedding was higher in the intervention arm, with over the counter medication use 36% lower. There was also a lower rate of infection spread within households for the intervention arm. The authors call for a larger, placebo controlled trial to confirm these findings. Nutrition Practitioners supporting immunity in relation to the common cold virus may want to discuss the use of saline nasal irrigation with their clients as a simple measure to reduce symptoms and spread.
Abstract
There are no antivirals to treat viral upper respiratory tract infection (URTI). Since numerous viruses cause URTI, antiviral therapy is impractical. As we have evidence of chloride-ion dependent innate antiviral response in epithelial cells, we conducted a pilot, non-blinded, randomised controlled trial of hypertonic saline nasal irrigation and gargling (HSNIG) vs standard care on healthy adults within 48 hours of URTI onset to assess recruitment (primary outcome). Acceptability, symptom duration and viral shedding were secondary outcomes. Participants maintained a symptom diary until well for two days or a maximum of 14 days and collected 5 sequential mid-turbinate swabs to measure viral shedding. The intervention arm prepared hypertonic saline and performed HSNIG. We recruited 68 participants (2.6 participants/week; November 2014-March 2015). A participant declined after randomisation. Another was on antibiotics and hence removed (Intervention:32, Control:34). Follow up data was available from 61 (Intervention:30, Control:31). 87% found HSNIG acceptable, 93% thought HSNIG made a difference to their symptoms. In the intervention arm, duration of illness was lower by 1.9 days (p = 0.01), over-the-counter medications (OTCM) use by 36% (p = 0.004), transmission within household contacts by 35% (p = 0.006) and viral shedding by ≥0.5 log10/day (p = 0.04). We hence need a larger trial to confirm our findings.
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Profiling of lung microbiota in the patients with obstructive sleep apnea.
Lu, D, Yao, X, Abulimiti, A, Cai, L, Zhou, L, Hong, J, Li, N
Medicine. 2018;97(26):e11175
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Obstructive sleep apnoea is a disease of lower airways of the lungs. Numerous studies have reported that various commensal bacteria such as Streptococcus, Veillonella, Prevotella, and Actinomyces are predominant in healthy human lungs. Therefore the current study was designed to analyse and assess the lower airway microbiota in patients with Obstructive sleep apnoea (OSA) and compared it to that of control group (who did not have OSA but had other lung disease). Sleep apnoea was examined with a sleep diagnostic device and data were analysed with Profusion PSG software. The study was conducted in China and total number of subjects who took part in the study was 19. On comparison between the two groups revealed that, Fusobacteria species of bacteria was higher in OSA patients whilst firmicutes species was significantly less. The result from the study indicated that lung microbiota in OSA patients were different from those of control group(non OSA )patients and maybe manipulation of the microbiota could be considered as an intervention to increase airway immunity and decrease susceptibility to airway infections. Though the authors concluded that more studies are needed before these findings and interventions can be confirmed.
Abstract
Lung microbiota may affect innate immunity and treatment consequence in the obstructive sleep apnea (OSA) patients. Bronchoalveolar lavage fluid (BALF) was obtained from 11 OSA patients and 8 patients with other lung diseases as control, and used for lung microbiota profiling by PCR amplification and sequencing of the microbial samples. It was demonstrated that phyla of Firmicutes, Fusobacteria, and Bacteriodetes were relatively abundant in the lung microbiota. Alpha-diversity comparison between OSA and control group revealed that Proteobacteria and Fusobacteria were significantly higher in OSA patients (0.3863 ± 0.0631 and 0.0682 ± 0.0159, respectively) than that in control group (0.119 ± 0.074 and 0.0006 ± 0.0187, respectively, P < .05 for both phyla). In contrast, Firmicutes was significantly less in OSA patients (0.1371 ± 0.0394) compared with that in the control group (0.384 ± 0.046, P < .05). Comparison within a group (ß-diversity) indicated that the top 5 phyla in the OSA lung were Proteobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and Acidobacteria, while the top 5 phyla in the control group were Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria, and Acidobacteria. These findings indicated that lung microbiota in OSA is distinct from that of non-OSA patients. Manipulation of the microbiota may be an alternative strategy to augment airway immunity and to reduce susceptibility to airway infection.