Effect of synbiotic supplementation on matrix metalloproteinase enzymes, quality of life and dietary intake and weight changes in rectal cancer patients undergoing neoadjuvant chemoradiotherapy

Article type: Research Article

Authors: Farshi Radvar, Fatemeh^a | Mohammad-Zadeh, Mohammad^b | Mahdavi, Reza^c | Andersen, Vibeke^d | Nasirimotlagh, Behnam^e | Faramarzi, Elnaz^{f; *} | Lotfi Yagin, Neda^g

Affiliations: [a] Nutrition Research Centre of Tabriz University of Medical Sciences, Tabriz, Iran | [b] Radiotherapy Department Shahid Madani University hospital Tabriz University of Medical Sciences, Tabriz, Iran | [c] Nutrition Research Centre of Tabriz University of Medical Sciences, Tabriz, Iran | [d] Organ Center, Hospital of Southern Jutland, 6200 Aabenraa, Denmark | [e] Radiotherapy Department Shahid Madani University Hospital Tabriz University of Medical Sciences, Tabriz, Iran | [f] Liver & Gastrointestinal Diseases Research Centre of Tabriz University of Medical Sciences. Tabriz, Iran | [g] Nutrition Research Centre of Tabriz University of Medical Sciences. Tabriz, Iran

Correspondence: [*] Correspondence to: Elnaz Faramarzi: Assistant Professor of Nutrition. Liver & Gastrointestinal Diseases Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran. Tel.: +98 9149110561; Fax: +9833369315; E-mails: [email protected] and [email protected].

Abstract: BACKGROUND:Probiotic/synbiotic has the important role of in altering intestinal bacteria, reducing inflammation and improvement of intestinal diseases. OBJECTIVE:We aimed to investigate the effect of synbiotic supplementation on matrix metalloproteinase (MMP) enzymes, hs-CRP, quality of life, dietary intake and weight changes in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (CRT). METHODS:In this study, 46 rectal cancer patients were recruited. Patients were allocated to the synbiotic (n = 23) group or placebo groups (n = 23) receiving 2 synbiotic or placebo capsules for six weeks. Anthropometric measurements, quality of life, dietary intakes, and serum levels of MMP-2, MMP-9, and hs-CRP were compared before and after intervention with the use of statistical tests. RESULTS:The mean energy, carbohydrate, and protein intake of patients increased in the synbiotic group, while in the placebo group, post intervention, significant reduction was noticed in these parameters (P < 0.05). Synbiotic supplementation caused improvement in global health status, symptom scale scores and scores of functional scale. At the end of intervention, the elevation in hs-CRP, MMP-2, and MMP-9 levels in the placebo group was approximately two and four times higher than the synbiotic group respectively. CONCLUSION:According to our results, synbiotic supplementation may be helpful in cancer patients undergoing CRT. However, further studies must consider synbiotic as a new complementary treatment.

Keywords: Rectal cancer, synbiotic supplementation, preoperative chemoradiotherapy, dietary intake, quality of life

DOI: 10.3233/MNM-200413

Journal: Mediterranean Journal of Nutrition and Metabolism, vol. 13, no. 3, pp. 225-235, 2020