Effects of prebiotics on immunological indicators and intestinal microbiota structure in perioperative colorectal cancer patients

Abstract Objective The aim of the present study was to investigate the effects of prebiotics(containing fructo-oligosaccharides, xylo-oligosaccharides, polydextrose and resistant dextrin) intake on immune function and intestinal microbiota structure in perioperative patients with colorectal cancer(CRC). Methods A randomized, double-blind, no-treatment parallel control clinical trial involving 140 perioperative patients (90 males and 50 females, aged 40-75 years) with CRC was performed. Patients were randomly divided into two groups: an intervention group (prebiotic group, n = 70) that received prebiotic supplementation of 30g/day for 7 days, and a control group (non-prebiotic group, n = 70) that received no prebiotic supplementation. The nutritional and immunological indices were evaluated for both groups before and after operation and analyzed against baseline values. Moreover, fecal samples were collected from 40 patients randomly chosen from the two groups to study intestinal microbiota which was analyzed by sequencing the V3-V4 region of 16S ribosomal DNA(16S rDNA) using the Illumina Miseq (PE 2 × 300bp) platform. Results Oral intake of prebiotics showed significant effects on immunological indices in both the pre- and post operation periods, but the patterns of effects were different. In the preoperative period, prebiotics increased serum levels of immunoglobulin G (IgG)(P=0.02), immunoglobulin M(IgM) (P=0.00) and transferrin (TRF)(P=0.027) (all P P > 0.05). At the genus level, prebiotics increased the abundance of Bifidobacterium(P=0.017) and Enterococcus(P=0.02) (both P Bacteroides(P=0.04) in the preoperative period (all P Bacteroides(P=0.04) was decreased, but the abundance of Enterococcus(P=0.00), Bacillus(P=0.01), Lactococcus(P=0.00), and Streptococcus(P=0.037) increased in the non-prebiotic group (all p Enterococcus(P=0.56), Lactococcus(P=0.07) and Streptococcus(P=0.56) due to prebiotic intervention in this period (all P >0.05). The abundance of Escherichia-Shigella was increased after prebiotic intake in the postoperative period (P=0.014, P Conclusion Prebiotic intake is recommended to improve serum immunologic indicators in patients with CRC 7 days before operation. Prebiotics improved the abundance of 4 commensal microbiota containing opportunistic pathogens in patients with CRC. Surgical stress decreased the abundance of most intestinal microbiota in the intestinal tract but increased the abundance of some opportunistic pathogens and commensal microbiota. Bacteroides is a relevant bacterial species for further research on the mechanism of prebiotics.