Distinct effects of TU-100 (daikenchuto) on long-lasting dysbiosis in the small intestine in patients with colorectal cancer and inflammatory bowel disease.

Abstract

The profile of the human small intestinal microbiota remains to be uncovered primarily due to sampling difficulties. Ileostomy provides the intestinal luminal contents as ileostomy effluents (IE) that offer opportunity for performing extensive analyses of nutrients, gastrointestinal fluids, metabolites, and microbiome. In the present study, we evaluated changes in the microbiome, pH, and bacterial short-chain fatty acids (SCFAs) in IE obtained from patients who had undergone ileostomy following surgical resection of colon cancer and inflammatory bowel disease (IBD). We enrolled 11 patients who varied in the duration of ileostomy from 3 days to >5 years after surgery and had no inflammation in the small intestine. The analyses suggested that IE from patients previously having IBD had less diversity and greater intraday and interday fluctuations, and increased pH and decreased levels of propionic acid and acetic acid than those in IE from patients previously having cancer. Furthermore, correlation analysis suggested a possible effect of the intestinal microbiome on luminal pH, presumably via SCFA production. The present study suggested that inflammation in the colon may induce long-term dysbiosis in the small intestine even after removal of diseased parts of the colon. Moreover, pharmaceutical-grade Japanese traditional medicine daikenchuto (TU-100) was found to have beneficial effects on postoperative bowel dysfunction and the human small intestinal microbiota. Taken together, these results suggest the necessity of a direct remedy for dysbiosis and the treatment of gastrointestinal lesions to achieve favorable outcomes for chronic gastrointestinal disorders.

• Authors: Toru Kono, Taku Maejima, Yusuke Ono, Takahiro Ito, Shigeru Furukawa, Mitsue Nishiyama, Masahiro Yamamoto, Ayumu Sugitani, Hidenori Karasaki, Yusuke Mizukami, Atsuo Maemoto
• Journal: Gene (Gene) Vol. 820 Pg. 146266 (Apr 30 2022) ISSN: 1879-0038 [Electronic] Netherlands
• PMID: 35134471 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Elsevier B.V. All rights reserved.

Chemical References

• Fatty Acids, Volatile
• Plant Extracts
• dai-kenchu-to

Topics

• Adult
• Aged
• Aged, 80 and over
• Colorectal Neoplasms (metabolism)
• Dysbiosis (drug therapy, metabolism)
• Fatty Acids, Volatile (metabolism)
• Female
• Gastrointestinal Microbiome (drug effects)
• Humans
• Hydrogen-Ion Concentration (drug effects)
• Ileostomy
• Inflammatory Bowel Diseases (metabolism)
• Intestine, Small (microbiology)
• Male
• Middle Aged
• Panax
• Plant Extracts (pharmacology)
• Young Adult
• Zanthoxylum
• Zingiberaceae