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a new treatment for morbid obesity by using gut microbiome after metabolic surgery

Research Project

Project/Area Number 21K08595
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Review Section Basic Section 55010:General surgery and pediatric surgery-related
Research InstitutionThe University of Tokushima

Principal Investigator

KASHIHARA Hideya  徳島大学, 病院, 特任准教授 (10548738)

Co-Investigator(Kenkyū-buntansha) 徳永 卓哉  徳島大学, 病院, 助教 (30448328)
西 正暁  徳島大学, 病院, 助教 (70464344)
高須 千絵  徳島大学, 大学院医歯薬学研究部(医学域), 講師 (70582823)
吉川 幸造  徳島大学, 大学院医歯薬学研究部(医学域), 特任教授 (80448331)
Project Period (FY) 2021-04-01 – 2024-03-31
Project Status Completed (Fiscal Year 2023)
Budget Amount *help
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2023: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2022: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2021: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
KeywordsMetabolic surgery / DJB / 2型糖尿病 / NASH / 腸内細菌叢 / 肝発癌抑制 / Bariatric surgeery / gut microbiota / インスリン抵抗性 / 炎症性サイトカイン / 腸管透過性 / 肝発癌 / metabolic surgery / 便移植
Outline of Research at the Start

これまでに我々は、ラットDJBモデルを用い肥満症に対する外科治療は2型糖尿病・非アルコール性脂肪肝炎(NASH)改善効果を有し、その効果には腸内細菌叢Gut microbiomeの変化や胆汁酸が関与することを報告した。近年、この腸内細菌叢の変化は二次胆汁酸の低下やNKT細胞を増加させ、肝発癌抑制にも寄与することが報告されている。本研究ではMetabolic surgeryの腸内細菌叢を肥満・糖尿病ラットに移植することで、糖尿病やNASH改善とともに長期的には肝発癌予防も得られるかを検証する。またそこから得られた結果をもとに、ある特定の菌種をラットに経口摂取させ同様の変化が得られるかを検討する。

Outline of Final Research Achievements

In this study, we attempted to verify whether obesity, diabetes, and non-alcoholic steatohepatitis could be improved by using the intestinal microbiota after bariatric surgery, as well as the prevention of liver carcinogenesis. Obese diabetic rats were divided into a bariatric surgery group and a laparotomy-only group, and were given postoperative hepatocarcinogenic inducers, and specimens were collected 6 weeks after surgery. As a result, there was no difference in blood sugar between the two groups, but body weight decreased in the bariatric surgery group. Regarding liver tumor formation, no macroscopic tumor formation was observed in either group, but liver precancerous markers were lower in the bariatric surgery group. There were no differences in genetic changes involved in hepatocarcinogenesis, and there were no significant changes in the intestinal flora between the two groups. Therefore, although it was suggested that bariatric surgery may have an inhibitory effect on liver

Academic Significance and Societal Importance of the Research Achievements

本研究ではMetabolic surgeryによる腸内細菌叢・胆汁酸組成の変化、腸管炎症抑制、透過性低下に着目しインスリン抵抗性・NASH改善、肝発癌抑制効果を検討した。これまで不明とされていたMetabolic surgeryの肝発癌抑制効果を詳細に検討した報告は他に類を見ず、極めて斬新で、今後の肥満や肥満関連疾患に対する治療の一助となり得る。これが判明した際には内科的治療では改善できなかった肥満・2型糖尿病・NASHやそれらに関連する疾患、発癌に対する治療アプローチが一変する可能性があり、またこれまで肥満外科治療適応外とされてきた症例に対しても新たな治療オプションが提示できるかもしれない。

Report

(4 results)
  • 2023 Annual Research Report   Final Research Report ( PDF )
  • 2022 Research-status Report
  • 2021 Research-status Report
  • Research Products

    (30 results)

All 2023 2022 2021

All Journal Article (13 results) (of which Peer Reviewed: 13 results,  Open Access: 1 results) Presentation (17 results)

  • [Journal Article] Effect of duodenal-jejunal bypass on diabetes in the early postoperative period.2023

    • Author(s)
      Okikawa S, Kashihara H, Shimada M, Yoshikawa K, Tokunaga T, Nishi M, Takasu C, Wada Y, Yoshimoto T
    • Journal Title

      Sci Rep.

      Volume: 13 Issue: 1 Pages: 1856-1856

    • DOI

      10.1038/s41598-023-28923-3

    • Related Report
      2023 Annual Research Report 2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Usefulness of Diagnostic Staging Laparoscopy for Advanced Gastric Cancer.2023

    • Author(s)
      Yoshikawa K, Shimada M, Higashijima J, Tokunaga T, Nishi M, Takasu C, Kashihara H, Eto S, Yoshimoto T.
    • Journal Title

      Am Surg.

      Volume: 89 Issue: 4 Pages: 685-690

    • DOI

      10.1177/00031348211038554

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Surgical Outcomes of Gastrectomy in Hemodialysis Patients with Gastric Cancer.2023

    • Author(s)
      Yoshimoto T, Yoshikawa K, Nakao T, Tokunaga T, Nishi M, Takasu C, Kashihara H, Wada Y, Noma T, Shimada M.
    • Journal Title

      Am Surg.

      Volume: 89 Issue: 12 Pages: 6328-6330

    • DOI

      10.1177/00031348231173970

    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Prognostic impact of frailty after gastrectomy in elderly gastric cancer patients2023

    • Author(s)
      Nishi M, Wada Y, Yoshikawa K, Takasu C, Tokunaga T, Nakao T, Kashihara H, Yamada S, Yoshimoto T, Shimada M.
    • Journal Title

      The Journal of Medical Investigation

      Volume: 70 Issue: 3.4 Pages: 423-429

    • DOI

      10.2152/jmi.70.423

    • ISSN
      1343-1420, 1349-6867
    • Related Report
      2023 Annual Research Report
    • Peer Reviewed
  • [Journal Article] Visualization of the pelvic nerves using magnetic resonance imaging for rectal cancer surgery.2023

    • Author(s)
      Nakao T, Shimada M, Yoshikawa K, Tokunaga T, Nishi M, Kashihara H, Takasu C, Wada Y, Yoshimoto T.
    • Journal Title

      Surg Endosc.

      Volume: 37 Issue: 6 Pages: 4315-4320

    • DOI

      10.1007/s00464-022-09771-0

    • Related Report
      2023 Annual Research Report 2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Transanal lateral lymph node dissection with intraoperative hologram support in low rectal cancer2023

    • Author(s)
      Tokunaga Takuya、Sugimoto Maki、Saito Yu、Kashihara Hideya、Yoshikawa Kozo、Nakao Toshihiro、Nishi Masaaki、Takasu Chie、Wada Yuma、Waki Yuhei、Yoshimoto Toshiaki、Noma Takayuki、Shimada Mitsuo
    • Journal Title

      Surgical Endoscopy

      Volume: 37 Issue: 7 Pages: 5414

    • DOI

      10.1007/s00464-023-09977-w

    • URL

      https://localhost/en/publications/ef3e6716-11b3-46c7-84fd-949ca652c096

    • Related Report
      2023 Annual Research Report 2022 Research-status Report
    • Peer Reviewed / Open Access
  • [Journal Article] Stapler insertion angle toward the esophagus reduces the incidence of early postoperative Roux stasis syndrome after distal gastrectomy in minimally invasive surgery.2023

    • Author(s)
      Yoshikawa K, Shimada M, Tokunaga T, Nakao T, Nishi M, Takasu C, Kashihara H, Wada Y, Yoshimoto T.
    • Journal Title

      BMC Surg.

      Volume: 23 Issue: 1 Pages: 54-54

    • DOI

      10.1186/s12893-023-01954-3

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] Propensity Score-Matched Analysis of the Short- and Long-Term Outcomes of Robotic Versus Laparoscopic Gastrectomy for Gastric Cancer.2022

    • Author(s)
      Nishi M, Shimada M, Yoshikawa K, Takasu C, Wada Y, Tokunaga T, Nakao T, Kashihara H, Yoshimoto T, Yamashita S.
    • Journal Title

      Ann Surg Oncol.

      Volume: 29 Issue: 6 Pages: 3887-3895

    • DOI

      10.1245/s10434-021-11203-7

    • Related Report
      2022 Research-status Report
    • Peer Reviewed
  • [Journal Article] The influence and countermeasure of obesity in laparoscopic colorectal resection.2021

    • Author(s)
      Kashihara H, Shimada M, Yoshikawa K, Higashijima J, Tokunaga T, Nishi M, Takasu C, Yoshimoto T.
    • Journal Title

      Ann Gastroenterol Surg

      Volume: 5 Pages: 677-682

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Pre-operative Weight Loss Program for Obese Patients Undergoing Laparoscopic Gastrectomy.2021

    • Author(s)
      Kashihara H, Shimada M, Yoshikawa K, Higashijima J, Tokunaga T, Nishi M, Takasu C, Yoshimoto T.
    • Journal Title

      J Med Invest

      Volume: 68 Pages: 165-169

    • NAID

      130008038413

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] The role of the immunoescape in colorectal cancer liver metastasis.2021

    • Author(s)
      Takasu C, Yamashita S, Morine Y, Yoshikawa K, Tokunaga T, Nishi M, Kashihara H, Yoshimoto T, Shimada M.
    • Journal Title

      PLoS One

      Volume: 16

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] A Transabdominal Robotic Purse-String Suture Technique for Transanal Total Mesorectal Excision.2021

    • Author(s)
      Tokunaga T, Kashihara H, Higashijima J, Yoshikawa K, Nishi M, Takasu C, Eto S, Yoshimoto T, Shimada M.
    • Journal Title

      J Laparoendosc Adv Surg Tech A

      Volume: 31 Pages: 937-941

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Journal Article] Effect of TU-100 on Peyer's patches in a bacterial translocation rat model.2021

    • Author(s)
      Takasu C, Miyazaki K, Yoshikawa K, Nishi M, Tokunaga T, Kashihara H, Yoshimoto T, Ogawa H, Morine Y, Shimada M.
    • Journal Title

      Ann Gastroenterol Surg

      Volume: 5 Pages: 683-691

    • Related Report
      2021 Research-status Report
    • Peer Reviewed
  • [Presentation] 腸脳相関からみたMetabolic surgeryの術後早期血糖抑制効果2023

    • Author(s)
      柏原秀也, 島田光生, 吉川幸造, 徳永卓哉, 中尾寿宏, 西正暁, 髙須千絵, 和田佑馬, 良元俊昭
    • Organizer
      第123回日本外科学会定期学術集会
    • Related Report
      2023 Annual Research Report
  • [Presentation] 腹腔鏡下スリーブ状胃切除術後長期効果に影響を及ぼす因子に関する検討2023

    • Author(s)
      柏原秀也, 島田光生, 吉川幸造, 徳永卓哉, 中尾寿宏, 西正暁, 髙須千絵, 和田佑馬, 良元俊昭
    • Organizer
      第78回日本消化器外科学会総会
    • Related Report
      2023 Annual Research Report
  • [Presentation] 他臓器浸潤を伴う直腸癌に対する経肛門アプローチの有用性2023

    • Author(s)
      柏原秀也, 徳永卓哉, 島田光生, 吉川幸造, 中尾寿宏, 西正暁, 髙須千絵, 和田佑馬, 良元俊昭
    • Organizer
      第61回日本癌治療学会学術集会
    • Related Report
      2023 Annual Research Report
  • [Presentation] 右側結腸癌に対するロボット支援下手術の可能性ー腹腔鏡手術との比較からー2023

    • Author(s)
      柏原秀也, 島田光生, 吉川幸造, 徳永卓哉, 中尾寿宏, 西正暁, 髙須千絵, 和田佑馬, 良元俊昭
    • Organizer
      第85回日本臨床外科学会総会
    • Related Report
      2023 Annual Research Report
  • [Presentation] 非アルコール性脂肪肝炎に対する減量・代謝改善手術の意義2023

    • Author(s)
      柏原秀也, 島田光生, 吉川幸造, 徳永卓哉, 中尾寿宏, 西正暁, 髙須千絵, 和田佑馬, 良元俊昭
    • Organizer
      第36回日本内視鏡外科学会総会
    • Related Report
      2023 Annual Research Report
  • [Presentation] 直腸癌に対するTaTME併用ロボット支援下直腸切除術の有用性 - TaTME併用腹腔鏡下直腸切除術との比較から -2022

    • Author(s)
      柏原秀也, 島田光生, 吉川幸造, 徳永卓哉, 中尾寿宏, 西正暁, 高須千絵, 和田佑馬, 良元俊昭
    • Organizer
      第122回日本外科学会定期学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] Duodenal-jejunal bypassの術後早期血糖抑制効果に関する基礎的研究2022

    • Author(s)
      柏原秀也, 沖川昌平, 島田光生
    • Organizer
      第108回日本消化器病学会
    • Related Report
      2022 Research-status Report
  • [Presentation] 腹腔鏡下スリーブ状胃切除術後長期効果に影響を及ぼす因子に関する検討2022

    • Author(s)
      柏原秀也, 島田光生, 吉川幸造, 徳永卓哉, 中尾寿宏, 西正暁, 髙須千絵, 和田佑馬, 良元俊昭, 山下祥子
    • Organizer
      第77回日本消化器外科学会総会
    • Related Report
      2022 Research-status Report
  • [Presentation] 下部直腸癌に対するTaTME併用ロボット支援下直腸切除術(Hybrid robotic surgery)の有用性2022

    • Author(s)
      柏原秀也, 徳永卓哉, 島田光生, 吉川幸造, 中尾寿宏, 西正暁, 髙須千絵, 和田佑馬, 良元俊昭
    • Organizer
      第77回日本大腸肛門病学会学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] 下部直腸癌に対するTaTME併用ロボット支援下直腸切除術の有用性2022

    • Author(s)
      柏原秀也, 島田光生, 吉川幸造, 徳永卓哉, 中尾寿宏, 西正暁, 髙須千絵, 和田佑馬, 良元俊昭
    • Organizer
      第60回日本癌治療学会学術集会
    • Related Report
      2022 Research-status Report
  • [Presentation] 低位直腸癌に対するTaTME併用ロボット支援下直腸切除術の有用性2022

    • Author(s)
      柏原秀也, 徳永卓哉, 島田光生
    • Organizer
      JDDW 2022
    • Related Report
      2022 Research-status Report
  • [Presentation] Usefulness of preoperative NLR as a predictive marker of DM remission in sleeve gastrectomy2021

    • Author(s)
      柏原秀也
    • Organizer
      第33回日本内視鏡外科学会
    • Related Report
      2021 Research-status Report
  • [Presentation] NASHに対する新たな治療アプローチとしてのmetabolic surgeryの可能性2021

    • Author(s)
      柏原秀也
    • Organizer
      第121回日本外科学会定期学術集会
    • Related Report
      2021 Research-status Report
  • [Presentation] TaTME併用ロボット支援直腸切除術の有用性2021

    • Author(s)
      柏原秀也
    • Organizer
      第76回日本消化器外科学会総会
    • Related Report
      2021 Research-status Report
  • [Presentation] 腹腔鏡下胃・大腸癌手術における多職種介入術前減量プログラムの有用性2021

    • Author(s)
      柏原秀也
    • Organizer
      第59回日本癌治療学会学術集会
    • Related Report
      2021 Research-status Report
  • [Presentation] 経肛門的内視鏡下直腸間膜切除術TaTME併用による安全なロボット支援下直腸切除術の導入2021

    • Author(s)
      柏原秀也
    • Organizer
      第83回日本臨床外科学会総会
    • Related Report
      2021 Research-status Report
  • [Presentation] NASHに対する新たな治療アプローチとしての腹腔鏡下スリーブ状胃切除術2021

    • Author(s)
      柏原秀也
    • Organizer
      第34回日本内視鏡外科学会総会
    • Related Report
      2021 Research-status Report

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Published: 2021-04-28   Modified: 2025-01-30  

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