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Background

Oxidative stress (OS) plays a crucial role in colorectal cancer (CRC) progression. Lactobacillus has been proposed as a potential modulator of OS. This randomised controlled trial aimed to evaluate the effects of Lactobacillus supplementation on OS markers and its related signalling pathways in CRC patients after surgery.

Methods

A total of 76 CRC patients were enrolled and randomised into two groups: the study group (n=39) received Lactobacillus supplementation, while the control group (n=37) received a placebo. The intervention lasted for six months following surgery. Serum levels of catalase (CAT), glutathione (GSH), oxidised glutathione (GSSG), 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG), and F2-isoprostanes (F2-IsoPs) were measured. In addition, the nuclear factor erythroid 2-related factor 2/Kelch-like ECH-associated protein 1 (NRF2/KEAP1), p38 mitogen-activated protein kinase (MAPK), and c-Jun N-terminal kinase (JNK) signalling pathways were assessed via western blot analysis.

Results

Following Lactobacillus supplementation, serum carcinoembryonic antigen (CEA) levels significantly decreased, whereas carbohydrate antigen 19-9 (CA19-9) levels remained unchanged. OS marker analysis demonstrated increased CAT, GSH, and F2-IsoPs levels and decreased GSSG and 8-oxodG levels in the study group compared to the control group. Western blot results revealed that NRF2, ASK1, MKK3, p-p38, and MKK4 protein levels were significantly reduced after Lactobacillus intervention, while KEAP1 and p-JNK remained unchanged.

Conclusions

Oral administration of Lactobacillus for six months reduced OS marker levels and inhibited NRF2/KEAP1, p38 MAPK, and JNK signalling pathways in CRC patients after surgery. These findings suggest that Lactobacillus may contribute to CRC management by modulating oxidative stress.

Research Insights

SupplementHealth OutcomeEffect TypeEffect Size
Lactobacillus amylovorusReduced CEA LevelsBeneficial
Small
Lactobacillus amylovorusReduced Oxidative StressBeneficial
Moderate
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