治疗前禁食能否缓解化疗引起的胃肠粘膜炎?
创作:szx 审核:szx 2020年09月14日
  • 大鼠接受48小时的禁食或不禁食处理后,利用亚致死剂量(45mg/kg)的甲氨蝶呤治疗以诱导胃肠道粘膜炎;
  • 治疗前禁食可减缓肠道上皮细胞的增殖速度,显著降低体重、体脂、肌肉质量及体液,并增加肠道菌群的多样性及丰富度;
  • 与之前的研究报道不一致的是,治疗前禁食并未显著增加肠道菌群中的乳杆菌属丰度,且无法缓解甲氨蝶呤诱导的胃肠道粘膜炎。
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szx
先前的一项研究表明,限制饮食摄入可通过调节菌群(增加乳杆菌属的丰度)以预防甲氨蝶呤诱导的死亡。Gut Microbes上发表的一项最新研究,发现预先禁食并无法缓解甲氨蝶呤诱导的大鼠胃肠道粘膜炎,且无法增加肠道菌群中的乳杆菌属丰度。
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Gut Microbes [IF:7.74]

Pre-therapy fasting slows epithelial turnover and modulates the microbiota but fails to mitigate methotrexate-induced gastrointestinal mucositis

治疗前禁食减缓上皮更新并调节菌群,但无法缓解甲氨蝶呤诱导的胃肠道粘膜炎

10.1080/19490976.2020.1809332

2020-08-26, Article

Abstract & Authors:展开

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Background: Recent findings by Tang et al. (2020) show dietary restriction (30%, 2 weeks) prevents methotrexate-induced mortality by modulation of the microbiota, specifically the expansion of Lactobacillus. While fundamentally insightful, upscaling this schedule is a major obstacle to clinical uptake. Here, we evaluate a safe and clinically achievable schedule of pre-therapy fasting for 48 h on microbiota composition, body composition and intestinal proliferation, and assess its impact on the severity of methotrexate-induced gastrointestinal mucositis using a validated preclinical rat model.
Methods: Age- and weight-matched male Wistar rats were treated with a sublethal dose of 45 mg/kg methotrexate with or without pre-therapy fasting. The impact of acute fasting on epithelial proliferation, body composition and the microbiota was assessed using plasma citrulline, Ki67 immunohistochemistry, miniSpec and 16S rRNA sequencing. The severity of gastrointestinal mucositis was evaluated using plasma citrulline and body weight.
Results: Whilst pre-therapy fasting slowed epithelial proliferation and increased microbial diversity and richness, it also induced significant weight loss and was unable to attenuate the severity of mucositis in both age- and weight-matched groups. In contrast to Tang et al., we saw no expansion of Lactobacillus following acute fasting.
Conclusions: Our findings suggest that the beneficial effects of acute fasting are masked by the detrimental effects on body weight and composition and lacking influence on Lactobacillus. Future studies should consider alternative fasting schedules or aim to induce comparable microbial and mucosal manipulation without compromising body composition using clinically feasible methods of dietary or microbial intervention.

First Authors:
H R Wardill

Correspondence Authors:
H R Wardill

All Authors:
H R Wardill,A R da Silva Ferreira,S Lichtenberg Cloo,R Havinga,H J M Harmsen,W P Vermeij,W J E Tissing

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