Nutr Res Pract.  2023 Jun;17(3):475-486. 10.4162/nrp.2023.17.3.475.

Effect of preoperative immunonutrition on fecal microbiota in colon cancer patients: a secondary analysis of a randomized controlled trial

• Lee SY
• Lee J
• Park Hm
• Kim CH
• Kim HR

• KMID: 2542844
• DOI: http://doi.org/10.4162/nrp.2023.17.3.475

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. Thirtytwo 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.

Keyword

Nutrition therapy; microbiota; colonic neoplasms

Figure

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  Fig. 1 CONSORT flow diagram.

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  Fig. 2 Alpha diversity analysis of immunonutrition and control groups. Within-sample diversity measured by observed OTUs (A), Chao1 richness (B), and Shannon (C) and Simpson (D) indices.OUT, operational taxonomic unit.

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  Fig. 3 PCoA 2D plots of beta diversity analysis between immunonutrition and control groups. Between-sample dissimilarities were measured by Bray-Curtis (A) and generalized UniFrac (B) distences. Permutational multivariate analysis of variance was performed to analyse statistical significance.

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  Fig. 4 Relative abundance of bacterial 16S rRNA in the fecal samples of patients in the immunonutrition and control groups at the phylum level. The legend on the right side shows the 6 most abundant phyla arranged in the order of frequency.

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  Fig. 5 Stacked bar graphs of the relative abundance of bacterial 16S rRNA from the fecal samples of patients in the immunonutrition (I1–16) and control (C1–16) groups at the phylum level.

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  Fig. 6 Stacked bar graphs of the relative abundance of bacterial 16S rRNA from the fecal samples of patients in the immunonutrition (I1–16) and control (C1–16) groups at the genus level. The legend on the inferior side represents the 25 most abundant genera arranged in order of frequency.

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