Probiotics with Lactobacillus Casei Reduce Inflammation After Colorectal Cancer Surgery

observational-study PMID: 31340751

Probiotics with Lactobacillus Casei Reduce Inflammation After Colorectal Cancer Surgery

Quick Summary: This study tested a probiotic blend including Lactobacillus casei on colorectal cancer patients right after surgery. The blend safely lowered levels of several inflammation markers in the blood, but it didn't prevent side effects like diarrhea from chemotherapy. These findings suggest probiotics might help calm the body's inflammatory response during recovery.

What The Research Found

Researchers discovered that a mix of beneficial bacteria, including Lactobacillus casei, helped reduce harmful inflammation signals in the body. These signals, called pro-inflammatory cytokines, can make recovery tougher after cancer surgery.

Key results included:
- Lower inflammation markers: In the probiotic group, levels of seven cytokines (TNF-α, IL-6, IL-10, IL-12, IL-17A, IL-17C, and IL-22) dropped significantly compared to before treatment. (Cytokines are like chemical messengers that trigger inflammation; too many can worsen health issues.)
- No change in one marker: Levels of IFN-γ, another immune signal, stayed the same.
- Safety confirmed: No infections from surgery or need for antibiotics in either group.
- No help with diarrhea: Both groups had similar rates of diarrhea caused by chemotherapy, and hospital visits didn't differ.

Overall, the probiotics seemed to tweak the gut environment to dial down inflammation, but they didn't fix common treatment side effects.

Study Details

Who was studied: 52 adults with colorectal cancer, mostly at an advanced stage (about 70% had Duke's C stage, meaning the cancer had spread to nearby lymph nodes). They started the study four weeks after surgery to remove the tumor.
How long: Participants took the treatment for six months, with check-ins to track infections, diarrhea, and hospital stays. Blood tests measured inflammation before and after.
What they took: The probiotic group got a daily dose of 30 billion colony-forming units (CFUs—a measure of live bacteria) from six strains, including Lactobacillus casei subsp. BCMC® 12,313. They took it orally twice a day. The other group got a placebo (fake pill with no bacteria). The blend also included Lactobacillus acidophilus, Lactobacillus lactis, and three Bifidobacterium strains.

This was a high-quality study: randomized (people were randomly assigned to groups), double-blind (neither patients nor doctors knew who got the real thing), and placebo-controlled.

What This Means For You

If you've had colorectal cancer surgery or know someone who has, this research points to probiotics like those with Lactobacillus casei as a safe add-on to help ease inflammation during recovery. Lower inflammation might mean less overall stress on your body, potentially supporting better healing—though more studies are needed to confirm this.

For cancer patients: Talk to your doctor about trying a similar multi-strain probiotic starting a few weeks post-surgery. It won't replace treatments like chemo, but it could complement them by calming immune overreactions.
For gut health seekers: If you're interested in probiotics for general wellness, look for blends with Lactobacillus casei and Bifidobacterium. Start with food sources like yogurt, but check labels for live cultures. Always consult a healthcare pro, especially if you're on meds or have health conditions.
Daily tip: Probiotics are generally safe for most people, but they're not a cure-all. Pair them with a fiber-rich diet to boost gut benefits.

Study Limitations

This research has some hurdles that mean it's not the final word:
- Small group size: Only 52 people were involved, so results might not apply to everyone.
- No direct group comparison: Improvements in inflammation were only checked within the probiotic group (before vs. after), not head-to-head with the placebo group.
- Short timeframe: Six months is a start, but long-term effects on health aren't clear.
- Other gaps: Details like participants' ages or genders weren't shared, and the trial was registered after it began, which could introduce some bias. Plus, it didn't reduce diarrhea, a big chemo side effect.

For stronger proof, we'd need bigger, longer studies. Source: NCT03782428 (PubMed, 2019).

Key Findings

The study found that a probiotic mixture containing Lactobacillus casei subsp. BCMC® 12,313 and five other strains significantly reduced levels of seven pro-inflammatory cytokines (TNF-α, IL-6, IL-10, IL-12, IL-17A, IL-17C, IL-22) in colorectal cancer (CRC) patients four weeks post-surgery. No surgical infections or antibiotic requirements were reported, confirming safety. However, no between-group differences were observed for chemotherapy-induced diarrhea or hospital admissions, and IFN-γ levels remained unchanged.

Study Design

This was a randomized, double-blind, placebo-controlled trial (RCT) conducted in 2019. A total of 52 CRC patients (mean age not specified) were enrolled, with 27 receiving probiotics and 25 placebo. Participants were followed for six months after surgery. The majority (~70%) had Duke’s C-stage cancer, indicating advanced disease.

Dosage & Administration

The probiotic group received 30 billion CFU/day of a mixture containing six strains:
- Lactobacillus acidophilus BCMC® 12,130
- Lactobacillus lactis BCMC® 12,451
- Lactobacillus casei subsp. BCMC® 12,313
- Bifidobacterium longum BCMC® 02120
- Bifidobacterium bifidum BCMC® 02290
- Bifidobacterium infantis BCMC® 02129
Each dose (107 mg of each strain) was administered orally twice daily for six months.

Results & Efficacy

Cytokine levels: Probiotic group showed significant reductions in TNF-α, IL-6, IL-10, IL-12, IL-17A, IL-17C, and IL-22 post-intervention vs. baseline (p < 0.05). Placebo group cytokine changes were not reported.
Safety: No surgical infections or antibiotic use in either group.
Clinical outcomes: No significant differences in diarrhea incidence or hospitalization rates between groups.
IFN-γ: No changes observed in either group.

Limitations

Lack of between-group comparisons: Cytokine reductions were only compared pre- and post-intervention in the probiotic group, not against placebo.
Small sample size: 52 participants limit generalizability and statistical power.
Short duration: Six months may not capture long-term effects.
Retrospective registration: Trial registered after enrollment began (December 2018), increasing bias risk.
No diarrhea prevention: Despite cytokine reductions, probiotics did not reduce chemotherapy-induced diarrhea.
Unspecified baseline demographics: Age, gender, or other confounders not detailed.

Clinical Relevance

This study suggests that a multi-strain probiotic including Lactobacillus casei may safely reduce systemic inflammation in post-surgical CRC patients. However, the lack of between-group cytokine comparisons and failure to mitigate diarrhea highlight the need for larger trials to confirm efficacy. For supplement users, these findings support short-term safety but do not yet justify probiotic use for clinical outcomes like infection or diarrhea prevention. Future research should explore strain-specific effects and correlate cytokine changes with tangible health benefits.

Source: NCT03782428 (PubMed, 2019)