2023 Fiscal Year Final Research Report
Clinical application of intestinal immunity stimulation by administering synbiotics to the atrophied intestine of the anal side of ileostomy.
| Project/Area Number |
19K20203
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 59040:Nutrition science and health science-related
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| Research Institution | National Defense Medical College |
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Principal Investigator |
Okamoto Koichi 防衛医科大学校(医学教育部医学科進学課程及び専門課程、動物実験施設、共同利用研究施設、病院並びに防衛, 外科学講座, 講師 (20783517)
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| Project Period (FY) |
2019-04-01 – 2024-03-31
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| Keywords | シンバイオティクス / プロバイオティクス / 人工肛門閉鎖 / 萎縮腸管 / バクテリアルトランスロケーション |
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| Outline of Final Research Achievements |
A randomized controlled trial examined the effect of administering synbiotics to the atrophic anal side of ileostomy with double orifices before stoma closure. The treatment group showed a significant improvement in morphological atrophy and an increase in the number of mature immune cells. In a comprehensive analysis of the intestinal flora, the UniFrac distance between the oral side flora and the anal side flora (OA distance) in the treatment group was significantly smaller than the OA distance in the non-treatment group, and the UniFrac distance between the anal side flora (AA distance) between the treatment group and the non-treatment group was significantly smaller than the AA distance in the non-treatment group. In an examination of bacterial DNA in the blood after surgery, Escherichia coli was found in two cases and Enterococcus faecalis in one case in the non-treatment group, but none in the treatment group.
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| Free Research Field |
消化器外科
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| Academic Significance and Societal Importance of the Research Achievements |
ヒトにおいて、①シンバイオティクス投与前後の腸管を採取し、萎縮腸管に対するシンバイオティクスによる形態学的かつ免疫学的に有意な萎縮改善効果を確認できたこと、②便や腸液の通過しない腸管内の細菌叢の解明と、シンバイオティクス投与により有意な変化を明らかにしたこと、③人工肛門閉鎖後にBacterial translocationが発生し、シンバイオティクス投与によるその予防効果が窺えたこと、以上が本研究の学術的意義となる。また、日常診療において、人工肛門閉鎖は一般的に行われる手術であり、本成果を参考にした安全な人工肛門閉鎖が他施設でも普及すれば、多くの患者への還元と共に医療費削減にも貢献できる。
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