Probiotics in Mitigating Adverse Effects of Intestinal Resection and Chemotherapy: A Meta-analysis

Salvatore Furnari; Pio Maria Furneri; Virginia Fuochi

doi:10.2174/0126666499314634241028103336

ISSN: 2666-6499
E-ISSN: 2666-6502

Probiotics in Mitigating Adverse Effects of Intestinal Resection and Chemotherapy: A Meta-analysis
Authors: Salvatore Furnari¹, Pio Maria Furneri^1,2 and Virginia Fuochi^1,2
View Affiliations Hide Affiliations

¹ Department of Biomedical and Biotechnological Sciences, University of Catania, Via S. Sofia, 97, Catania, 95123, Italy; ² Center of Excellence for the Acceleration of Harm Reduction (CoEHAR), University of Catania, Via S. Sofia, 97, Catania, 95123, Italy
Source: Current Probiotics, Volume 1, Issue 1, Jan 2024, E26666499314634
DOI: https://doi.org/10.2174/0126666499314634241028103336
- Received: 22 Mar 2024
- Accepted: 18 Sep 2024
- Available online: 11 Dec 2024

Abstract

Introduction

Colorectal cancer (CRC) imposes a significant burden on global healthcare systems, particularly in Europe, where it ranks among the most diagnosed cancers and leading causes of cancer-related deaths. With an estimated 50,000 deaths attributed to CRC in 2023 alone, a pressing need for innovative approaches to prevention, early detection, and treatment is evident. While chemotherapy and surgical resection remain crucial therapeutic strategies, they often entail significant adverse effects, such as chemotherapy-induced diarrhea and post-surgical complications.

Methods

Recent research underscores the role of the microbiota in modulating these side effects, with dysbiosis associated with increased risks. Probiotics, known for their ability to restore microbial balance, have emerged as a promising adjunctive therapy for mitigating treatment-related complications in CRC patients. However, the efficacy of probiotics remains debated, necessitating a meta-analysis to provide a comprehensive assessment. Hence, this study aimed to evaluate the efficacy of probiotics in reducing complications in CRC patients undergoing chemotherapy and intestinal surgery. For this purpose, thirteen randomized controlled trials (RCTs) meeting strict inclusion criteria were included in the meta-analysis.

Results

Probiotic administration was associated with significant reductions in postoperative infections, including surgical site infections (SSI), pneumonia, urinary tract infections (UTI), and central line infections, showing a Risk Ratio (RR) of 0.74 with a Confidence Interval (CI) of 95%. Moreover, probiotics demonstrated efficacy in mitigating chemotherapy-induced diarrhea and post-surgical complications, such as anastomosis loosening and abdominal disorders, with an RR of 0.35 and 0.74, respectively, with a CI of 95%. While promising, further research is needed to optimize probiotic interventions and address potential interactions with concurrent therapies. Integrating probiotics into perioperative care protocols presents a convincing opportunity to enhance surgical outcomes and improve patient prognosis following CRC resection.

Conclusion

Future randomized controlled trials should focus on identifying optimal probiotic strains, dosages, and administration timing to maximize therapeutic benefits.

Article metrics loading...

/content/journals/probiot/10.2174/0126666499314634241028103336

2024-12-11

2025-11-07

From This Site

/content/journals/probiot/10.2174/0126666499314634241028103336

dcterms_title,dcterms_subject,pub_keyword

-contentType:Contributor -contentType:Concept -contentType:Institution

10

5

Full text loading...

References

XiY. XuP. Global colorectal cancer burden in 2020 and projections to 2040.Transl. Oncol.2021141010117410.1016/j.tranon.2021.10117434243011
[Google Scholar]
SawickiT. RuszkowskaM. DanielewiczA. NiedźwiedzkaE. ArłukowiczT. PrzybyłowiczK.E. A review of colorectal cancer in terms of epidemiology, risk factors, development, symptoms and diagnosis.Cancers2021139202510.3390/cancers1309202533922197
[Google Scholar]
SiegelR.L. WagleN.S. CercekA. SmithR.A. JemalA. Colorectal cancer statistics.CA Cancer J. Clin.202373323325410.3322/caac.2177236856579
[Google Scholar]
RentschM. SchiergensT. KhandogaA. WernerJ. Surgery for colorectal cancer - trends, developments, and future perspectives.Visc. Med.201632318419110.1159/00044649027493946
[Google Scholar]
ArredondoJ. MartínezP. BaixauliJ. Analysis of surgical complications of primary tumor resection after neoadjuvant treatment in stage IV colon cancer.J. Gastrointest. Oncol.20145214815324772343
[Google Scholar]
DamatoA. GhidiniM. DottoriniL. Chemotherapy duration for various indications in colorectal cancer: A review.Curr. Oncol. Rep.202325434135210.1007/s11912‑023‑01378‑536781622
[Google Scholar]
SteinA. VoigtW. JordanK. Review: Chemotherapy-induced diarrhea: Pathophysiology, frequency and guideline-based management.Ther. Adv. Med. Oncol.201021516310.1177/175883400935516421789126
[Google Scholar]
BenedekZ. CoroșM.F. The impact of sarcopenia on the postoperative outcome in colorectal cancer surgery.Med. Pharm. Rep.2023961202710.15386/mpr‑248336818326
[Google Scholar]
TsalikidisC. MitsalaA. MentonisV.I. Predictive factors for anastomotic leakage following colorectal cancer surgery: Where are we and where are we going?Curr. Oncol.20233033111313710.3390/curroncol3003023636975449
[Google Scholar]
RebersekM. Gut microbiome and its role in colorectal cancer.BMC Cancer2021211132510.1186/s12885‑021‑09054‑234895176
[Google Scholar]
QuaglioA.E.V. GrilloT.G. OliveiraE.C.S.D. StasiL.C.D. SassakiL.Y. Gut microbiota, inflammatory bowel disease and colorectal cancer.World J. Gastroenterol.202228304053406010.3748/wjg.v28.i30.405336157114
[Google Scholar]
WongS.H. YuJ. Gut microbiota in colorectal cancer: Mechanisms of action and clinical applications.Nat. Rev. Gastroenterol. Hepatol.2019161169070410.1038/s41575‑019‑0209‑831554963
[Google Scholar]
FeiZ. LijuanY. XiY. Gut microbiome associated with chemotherapy-induced diarrhea from the CapeOX regimen as adjuvant chemotherapy in resected stage III colorectal cancer.Gut Pathog.20191111810.1186/s13099‑019‑0299‑431168325
[Google Scholar]
KawasakiY. KakimotoK. TanakaY. Relationship between chemotherapy-induced diarrhea and intestinal microbiome composition.Digestion2023104535736910.1159/00052828237231829
[Google Scholar]
WeiL. WenX.S. XianC.J. Chemotherapy-induced intestinal microbiota dysbiosis impairs mucosal homeostasis by modulating toll-like receptor signaling pathways.Int. J. Mol. Sci.20212217947410.3390/ijms2217947434502383
[Google Scholar]
ShiY. CuiH. WangF. Role of gut microbiota in postoperative complications and prognosis of gastrointestinal surgery: A narrative review.Medicine (Baltimore)202210129e2982610.1097/MD.000000000002982635866808
[Google Scholar]
StivalaA. CarotaG. FuochiV. FurneriP.M. Lactobacillus rhamnosus AD3 as a promising alternative for probiotic products.Biomolecules20211119410.3390/biom1101009433450875
[Google Scholar]
Maldonado GaldeanoC. CazorlaS.I. Lemme DumitJ.M. VélezE. PerdigónG. Beneficial effects of probiotic consumption on the immune system.Ann. Nutr. Metab.201974211512410.1159/00049642630673668
[Google Scholar]
LiuY. WangJ. WuC. Modulation of gut microbiota and immune system by probiotics, pre-biotics, and post-biotics.Front. Nutr.2022863489710.3389/fnut.2021.63489735047537
[Google Scholar]
WangX. ZhangP. ZhangX. Probiotics regulate gut microbiota: An effective method to improve immunity.Molecules20212619607610.3390/molecules2619607634641619
[Google Scholar]
ZhangJ.W. DuP. YangB-R. GaoJ. FangW.J. YingC.M. Preoperative probiotics decrease postoperative infectious complications of colorectal cancer.Am. J. Med. Sci.2012343319920510.1097/MAJ.0b013e31823aace622197980
[Google Scholar]
BajramagicS. HodzicE. MulabdicA. HoljanS. SmajlovicS. RovcaninA. Usage of probiotics and its clinical significance at surgically treated patients sufferig from colorectal carcinoma.Med. Arh.201973531632010.5455/medarh.2019.73.316‑32031819304
[Google Scholar]
DeliaP. SansottaG. DonatoV. Use of probiotics for prevention of radiation-induced diarrhea.World J. Gastroenterol.200713691291510.3748/wjg.v13.i6.91217352022
[Google Scholar]
FleschA.T. TonialS.T. ContuP.D.C. DaminD.C. Perioperative synbiotics administration decreases postoperative infections in patients with colorectal cancer: A randomized, double-blind clinical trial.Rev. Col. Bras. Cir.201744656757310.1590/0100‑6991201700600429267553
[Google Scholar]
PolakowskiC.B. KatoM. PretiV.B. SchieferdeckerM.E.M. Ligocki CamposA.C. Impact of the preoperative use of synbiotics in colorectal cancer patients: A prospective, randomized, double-blind, placebo-controlled study.Nutrition201958404610.1016/j.nut.2018.06.00430278428
[Google Scholar]
KotzampassiK. StavrouG. DamorakiG. A Four‐probiotics regimen reduces postoperative complications after colorectal surgery: A randomized, double‐blind, placebo‐controlled study.World J. Surg.201539112776278310.1007/s00268‑015‑3071‑z25894405
[Google Scholar]
MegoM. ChovanecJ. Vochyanova-AndrezalovaI. Prevention of irinotecan induced diarrhea by probiotics: A randomized double blind, placebo controlled pilot study.Complement. Ther. Med.201523335636210.1016/j.ctim.2015.03.00826051570
[Google Scholar]
ÖsterlundP. RuotsalainenT. KorpelaR. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study.Br. J. Cancer20079781028103410.1038/sj.bjc.660399017895895
[Google Scholar]
SadahiroS. SuzukiT. TanakaA. Comparison between oral antibiotics and probiotics as bowel preparation for elective colon cancer surgery to prevent infection: Prospective randomized trial.Surgery2014155349350310.1016/j.surg.2013.06.00224524389
[Google Scholar]
TanC.K. SaidS. RajandramR. WangZ. RoslaniA.C. ChinK.F. Pre‐surgical administration of microbial cell preparation in colorectal cancer patients: A randomized controlled trial.World J. Surg.20164081985199210.1007/s00268‑016‑3499‑927098538
[Google Scholar]
GolkhalkhaliB. RajandramR. PalianyA.S. Strain‐specific probiotic (microbial cell preparation) and omega‐3 fatty acid in modulating quality of life and inflammatory markers in colorectal cancer patients: A randomized controlled trial.Asia Pac. J. Clin. Oncol.201814317919110.1111/ajco.1275828857425
[Google Scholar]
ZaharuddinL. MokhtarN.M. Muhammad NawawiK.N. Raja AliR.A. A randomized double-blind placebo-controlled trial of probiotics in post-surgical colorectal cancer.BMC Gastroenterol.201919113110.1186/s12876‑019‑1047‑431340751
[Google Scholar]
GianottiL. MorelliL. GalbiatiF. A randomized double-blind trial on perioperative administration of probiotics in colorectal cancer patients.World J. Gastroenterol.201016216717510.3748/wjg.v16.i2.16720066735
[Google Scholar]
IshikawaH. AkedoI. OtaniT. Randomized trial of dietary fiber and Lactobacillus casei administration for prevention of colorectal tumors.Int. J. Cancer2005116576276710.1002/ijc.2111515828052
[Google Scholar]
HuangF. LiS. ChenW. Postoperative probiotics administration attenuates gastrointestinal complications and gut microbiota dysbiosis caused by chemotherapy in colorectal cancer patients.Nutrients202315235610.3390/nu1502035636678227
[Google Scholar]
LiuZ. QinH. YangZ. Randomised clinical trial: The effects of perioperative probiotic treatment on barrier function and post‐operative infectious complications in colorectal cancer surgery – a double‐blind study.Aliment. Pharmacol. Ther.2011331506310.1111/j.1365‑2036.2010.04492.x21083585
[Google Scholar]
LiuZ. LiC. HuangM. Positive regulatory effects of perioperative probiotic treatment on postoperative liver complications after colorectal liver metastases surgery: A double-center and double-blind randomized clinical trial.BMC Gastroenterol.20151513410.1186/s12876‑015‑0260‑z25881090
[Google Scholar]
NiuW. LiZ. LiZ. A prospective and randomized control study on effects of thymalfasin for injection on perioperative immune function and long-term prognosis of patients with colorectal cancer.Biotechnol. Genet. Eng. Rev.2023•••11310.1080/02648725.2023.221697237248723
[Google Scholar]
PakH. MaghsoudiL.H. SoltanianA. GholamiF. Surgical complications in colorectal cancer patients.Ann. Med. Surg. (Lond.)202055131810.1016/j.amsu.2020.04.02432435475
[Google Scholar]
Hernandez DominguezO. YilmazS. SteeleS.R. StageI.V. Stage IV colorectal cancer management and treatment.J. Clin. Med.2023125207210.3390/jcm1205207236902858
[Google Scholar]
AltintasM.M. KayaS. KocaogluA.E. MulkutF. Does preoperative anaemia have an effect on the perioperative period in colorectal cancer surgery?Niger. J. Clin. Pract.20222571102110610.4103/njcp.njcp_1664_2135859472
[Google Scholar]
GheybiK. BuckleyE. VitryA. RoderD. Occurrence of comorbidity with colorectal cancer and variations by age and stage at diagnosis.Cancer Epidemiol.20228010224610.1016/j.canep.2022.10224636067574
[Google Scholar]
KoliarakisI. AthanasakisE. SgantzosM. Intestinal microbiota in colorectal cancer surgery.Cancers20201210301110.3390/cancers1210301133081401
[Google Scholar]
HanC. ChenW. YeX.L. Risk factors analysis of surgical site infections in postoperative colorectal cancer: A nine-year retrospective study.BMC Surg.202323132010.1186/s12893‑023‑02231‑z37872509
[Google Scholar]
AntonicV. StojadinovicA. KesterK.E. Significance of infectious agents in colorectal cancer development.J. Cancer20134322724010.7150/jca.583523459622
[Google Scholar]
HuangW.K. ChangJ.W.C. SeeL.C. Higher rate of colorectal cancer among patients with pyogenic liver abscess with Klebsiella pneumoniae than those without: An 11‐year follow‐up study.Colorectal Dis.20121412e794e80110.1111/j.1463‑1318.2012.03174.x22776247
[Google Scholar]
RegenbogenS.E. ReadT.E. RobertsP.L. MarcelloP.W. SchoetzD.J. RicciardiR. Urinary tract infection after colon and rectal resections: More common than predicted by risk-adjustment models.J. Am. Coll. Surg.2011213678479210.1016/j.jamcollsurg.2011.08.01321945417
[Google Scholar]
AnthonyT. MurrayB.W. Sum-PingJ.T. Evaluating an evidence-based bundle for preventing surgical site infection: A randomized trial.Arch. Surg.2011146326326910.1001/archsurg.2010.24921079110
[Google Scholar]
DholeS. MahakalkarC. KshirsagarS. BhargavaA. Antibiotic prophylaxis in surgery: Current insights and future directions for surgical site infection prevention.Cureus20231510e4785810.7759/cureus.4785838021553
[Google Scholar]
ShahT. BalochZ. ShahZ. CuiX. XiaX. The intestinal microbiota: Impacts of antibiotics therapy, colonization resistance, and diseases.Int. J. Mol. Sci.20212212659710.3390/ijms2212659734202945
[Google Scholar]
JointF.A.O. Probiotics in food: Health and nutritional properties and guidelines for evaluation.FAO Food Nutr. Pap.20068556
[Google Scholar]
HillC. GuarnerF. ReidG. The International Scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic.Nat. Rev. Gastroenterol. Hepatol.201411850651410.1038/nrgastro.2014.6624912386
[Google Scholar]
SahaU.B. SarojS.D. Lactic acid bacteria: Prominent player in the fight against human pathogens.Expert Rev. Anti Infect. Ther.202220111435145310.1080/14787210.2022.212876536154442
[Google Scholar]
BerschK.L. DeMeesterK.E. ZaganiR. Bacterial peptidoglycan fragments differentially regulate innate immune signaling.ACS Cent. Sci.20217468869610.1021/acscentsci.1c0020034056099
[Google Scholar]
PiccioniA. CicchinelliS. VallettaF. Gut microbiota and autoimmune diseases: A charming real world together with probiotics.Curr. Med. Chem.202229183147315910.2174/092986732866621092216191334551690
[Google Scholar]
GershuniV.M. FriedmanE.S. The microbiome-host interaction as a potential driver of anastomotic leak.Curr. Gastroenterol. Rep.2019211410.1007/s11894‑019‑0668‑730684121
[Google Scholar]
TzikosG. TsalkatidouD. StavrouG. A four-probiotic regime to reduce surgical site infections in multi-trauma patients.Nutrients20221413262010.3390/nu1413262035807801
[Google Scholar]
AbdulahD.M. SulaimanS.J. AhmedZ.W. Effect of probiotics plus zinc supplementation on clinical outcomes of infants and children with acute infectious diarrhea: A randomized controlled trial.Clin. Exp. Pediatr.202467420321210.3345/cep.2023.0134038374706
[Google Scholar]
MerensteinD. TanT. Herbin SmithK. Exploratory pilot studies to demonstrate mechanisms of preventing antibiotic-associated diarrhea and the role for probiotics.Ann. Fam. Med.2024213
[Google Scholar]
SausaM. FucarinoA. PaladinoL. Probiotics as potential therapeutic agents: Safeguarding skeletal muscle against alcohol-induced damage through the gut–liver–muscle axis.Biomedicines202412238210.3390/biomedicines1202038238397983
[Google Scholar]
BanothD. WaliM.H. BekovaK. The role of oral probiotics in alleviating inflammation, symptom relief, and postoperative recurrence and their side effects in adults with Crohn’s disease: A systematic review.Cureus20231512e5090110.7759/cureus.5090138259373
[Google Scholar]
FuochiV. SpampinatoM. DistefanoA. Soluble peptidoglycan fragments produced by Limosilactobacillus fermentum with antiproliferative activity are suitable for potential therapeutic development: A preliminary report.Front. Mol. Biosci.202310108252610.3389/fmolb.2023.108252636876040
[Google Scholar]
SaffarK.N. LarypoorM. TorbatiM.B. Analyzing of colorectal cancerrelated genes and microRNAs expression profiles in response to probiotics Lactobacillus acidophilus and Saccharomyces cerevisiae in colon cancer cell lines.Mol. Biol. Rep.202451112210.1007/s11033‑023‑09008‑w38227272
[Google Scholar]
BuduO. MiocA. SoicaC. Lactiplantibacillus plantarum induces apoptosis in melanoma and breast cancer cells.Microorganisms202412118210.3390/microorganisms1201018238258008
[Google Scholar]
Ruiz-SánchezC. Escudero-LópezB. Fernández-PachónM.S. Evaluation of the efficacy of probiotics as treatment in irritable bowel syndrome.Endocrinol. Diabetes Nutr. (Engl. Ed.)2024711193010.1016/j.endien.2024.01.00338331656
[Google Scholar]
AngX.Y. RoslanN.S. AhmadN. Lactobacillus probiotics restore vaginal and gut microbiota of pregnant women with vaginal candidiasis.Benef. Microbes202314542143110.1163/18762891‑2022010338350486
[Google Scholar]
FuochiV. VoltiG. FurneriP. Probiotic Properties of Lactobacillus fermentum strains isolated from human oral samples and description of their antibacterial activity.Curr. Pharm. Biotechnol.201718213814910.2174/138920101766616122915353028034294
[Google Scholar]
GanL. WangY. HuangS. Therapeutic evaluation of Bifidobacterium animalis subsp. lactis MH-02 as an adjunctive treatment in patients with reflux esophagitis: A randomized, double-blind, placebo-controlled trial.Nutrients202416334210.3390/nu1603034238337627
[Google Scholar]
ZhangQ. LiG. ZhaoW. Efficacy of Bifidobacterium animalis subsp. lactis BL-99 in the treatment of functional dyspepsia: A randomized placebo-controlled clinical trial.Nat. Commun.202415122710.1038/s41467‑023‑44292‑x38172093
[Google Scholar]
SarlinS. KoskelaU. HonkilaM. Streptococcus salivarius probiotics to prevent acute otitis media in children.JAMA Netw. Open2023611e234060810.1001/jamanetworkopen.2023.4060837917062
[Google Scholar]
AmitayE.L. CarrP.R. GiesA. LaetschD.C. BrennerH. Probiotic/Synbiotic treatment and postoperative complications in colorectal cancer patients: Systematic review and meta-analysis of randomized controlled trials.Clin. Transl. Gastroenterol.20201112e0026810.14309/ctg.000000000000026833512803
[Google Scholar]
AnS. KimK. KimM.H. JungJ.H. KimY. Perioperative probiotics application for preventing postoperative complications in patients with colorectal cancer: A systematic review and meta-analysis.Medicina (Kaunas)20225811164410.3390/medicina5811164436422183
[Google Scholar]
ChenY. QiA. TengD. Probiotics and synbiotics for preventing postoperative infectious complications in colorectal cancer patients: A systematic review and meta-analysis.Tech. Coloproctol.202226642543610.1007/s10151‑022‑02585‑135348943
[Google Scholar]
DanisR. MegoM. AntonovaM. Orally administered probiotics in the prevention of chemotherapy (± Radiotherapy)-induced gastrointestinal toxicity: A systematic review with meta-analysis of randomized trials.Integr. Cancer Ther.2022•••2110.1177/1534735422114430936567453
[Google Scholar]
OuyangX. LiQ. ShiM. Probiotics for preventing postoperative infection in colorectal cancer patients: A systematic review and meta-analysis.Int. J. Colorectal Dis.201934345946910.1007/s00384‑018‑3214‑430539265
[Google Scholar]
ZengJ. JiY. LiangB. The effect of pro/synbiotics on postoperative infections in colorectal cancer patients: A systematic review and meta-analysis.Complement. Ther. Clin. Pract.20214310137010.1016/j.ctcp.2021.10137033894576
[Google Scholar]
KinrossJ.M. MarkarS. KarthikesalingamA. A meta-analysis of probiotic and synbiotic use in elective surgery: Does nutrition modulation of the gut microbiome improve clinical outcome?JPEN J. Parenter. Enteral Nutr.201337224325310.1177/014860711245230622750803
[Google Scholar]
ChowdhuryA.H. AdiamahA. KushairiA. LoboD.N. Response to the comment on “Perioperative probiotics or synbiotics in adults undergoing elective abdominal surgery: A systematic review and meta-analysis of randomized controlled trials”.Ann. Surg.20212746e676e67710.1097/SLA.000000000000375931895712
[Google Scholar]
ChowdhuryA.H. AdiamahA. KushairiA. Perioperative probiotics or synbiotics in adults undergoing elective abdominal surgery.Ann. Surg.202027161036104710.1097/SLA.000000000000358131469748
[Google Scholar]
MoreiraM.M. CarriçoM. CapelasM.L. The impact of pre-, pro- and synbiotics supplementation in colorectal cancer treatment: A systematic review.Front. Oncol.202414139596610.3389/fonc.2024.139596638807764
[Google Scholar]
WuX.D. WuD. LiuY. HuangW. Comment on “Perioperative probiotics or synbiotics in adults undergoing elective abdominal surgery.Ann. Surg.20212746e675e67610.1097/SLA.000000000000376231895710
[Google Scholar]
McFarlandL.V. EvansC.T. GoldsteinE.J.C. Strain-Specificity and disease-specificity of probiotic efficacy: A systematic review and meta-analysis.Front. Med. (Lausanne)2018512410.3389/fmed.2018.0012429868585
[Google Scholar]
MinS. ThanN. ShinY.C. Live probiotic bacteria administered in a pathomimetic leaky gut chip ameliorate impaired epithelial barrier and mucosal inflammation.Sci. Rep.20221212264110.1038/s41598‑022‑27300‑w36587177
[Google Scholar]
BatistaV.L. De JesusL.C.L. TavaresL.M. Paraprobiotics and postbiotics of Lactobacillus delbrueckii CIDCA 133 Mitigate 5-FU-induced intestinal inflammation.Microorganisms2022107141810.3390/microorganisms1007141835889136
[Google Scholar]
GaoZ. GuoB. GaoR. ZhuQ. WuW. QinH. Probiotics modify human intestinal mucosa-associated microbiota in patients with colorectal cancer.Mol. Med. Rep.20151246119612710.3892/mmr.2015.412426238090
[Google Scholar]
RafterJ. Probiotics and colon cancer.Best Pract. Res. Clin. Gastroenterol.200317584985910.1016/S1521‑6918(03)00056‑814507593
[Google Scholar]
RafterJ. The effects of probiotics on colon cancer development.Nutr. Res. Rev.200417227728410.1079/NRR20048419079931
[Google Scholar]
Azcárate-PerilM.A. SikesM. Bruno-BárcenaJ.M. The intestinal microbiota, gastrointestinal environment and colorectal cancer: A putative role for probiotics in prevention of colorectal cancer?Am. J. Physiol. Gastrointest. Liver Physiol.20113013G401G42410.1152/ajpgi.00110.201121700901
[Google Scholar]
HanM. WangK. SunL. LiuW. DongW. Prevention of ventilator-associated pneumonia with probiotics: An overview of systematic reviews.Front. Microbiol.202415134527810.3389/fmicb.2024.134527838426068
[Google Scholar]
JirilloE. PalmirottaR. ColellaM. SantacroceL. A bird’s-eye view of the pathophysiologic role of the human urobiota in health and disease: Can we modulate it?Pathophysiology2024311526710.3390/pathophysiology3101000538390942
[Google Scholar]
SalazarA.M. NeugentM.L. De NiscoN.J. MysorekarI.U. Gut-bladder axis enters the stage: Implication for recurrent urinary tract infections.Cell Host Microbe20223081066106910.1016/j.chom.2022.07.00835952642
[Google Scholar]
YangH.J. KimD.S. LeeK.W. KimY.H. The urinary microbiome; Axis crosstalk and short-chain fatty acid.Diagnostics20221212311910.3390/diagnostics1212311936553126
[Google Scholar]