AUTHOR=Lin Baiqiang , Zhao Fuya , Liu Yang , Wu Xin , Feng Jing , Jin Xiangren , Yan Wei , Guo Xiao , Shi Shang , Li Zhiyong , Liu Lujia , Chen Hongye , Wang Haoran , Wang Shuang , Lu Yu , Wei Yunwei 

TITLE=Randomized Clinical Trial: Probiotics Alleviated Oral-Gut Microbiota Dysbiosis and Thyroid Hormone Withdrawal-Related Complications in Thyroid Cancer Patients Before Radioiodine Therapy Following Thyroidectomy

JOURNAL=Frontiers in Endocrinology

VOLUME=13

YEAR=2022

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.834674

DOI=10.3389/fendo.2022.834674

ISSN=1664-2392

ABSTRACT=<sec><title>Background</title><p>Thyroid hormone withdrawal (THW) in postoperative thyroid cancer patients who need always accompanied by complications (e.g., dyslipidemia and constipation). At present, there are no effective and safe means to alleviate these complications.</p></sec><sec><title>Purpose</title><p>We aimed to assess the oral-gut microbiota profiles in THW patients then investigate whether probiotics could alleviating alleviate THW related complications and investigate whether these therapeutic effects were associated with the oral-gut microbiota state.</p></sec><sec><title>Methods</title><p>Fifty eligible thyroid carcinoma patients undergoing thyroidectomy were randomly assigned to receive probiotics or placebo during THW. Complications were assessed through validated questionnaires and plasma lipid indicators. The complex probiotics preparation was composed of <italic>Bifidobacterium infantis</italic>, <italic>Lactobacillus acidophilus</italic>, <italic>Enterococcus faecalis</italic>, and <italic>Bacillus cereus</italic>.</p></sec><sec><title>Results</title><p>Probiotics alleviated lack of energy, constipation, weight gain, and dry mouth and decreased the levels of fecal/serum LPS and plasma lipid indicators (total cholesterol, triglycerides, low-density lipoprotein, and apolipoprotein A) (P &lt; 0.05). Gut and oral microbial diversity were significantly decreased after THW, while an increased microbial dysbiosis index (MDI) was observed. Probiotics distinctly restored the gut and oral microbial diversity. Increased <italic>Holdemanella</italic>, <italic>Enterococcus</italic>, and <italic>Coprococcus_2</italic>, while decreased <italic>Fusobacterium</italic>, <italic>Eubacterium_ruminantium_group</italic>, <italic>Ruminococcus_1</italic>, and <italic>Parasutterella</italic> in the gut were found after probiotics intervention. Lack of energy, constipation, weight gain, and dyslipidemia were seen to be related to the above microbiota. In addition, probiotics reduced oral <italic>Prevotella_9</italic>, <italic>Haemophilus</italic>, <italic>Fusobacterium</italic>, and <italic>Lautropia</italic>, which were positively correlated with the occurrence of dry mouth.</p></sec><sec><title>Conclusion</title><p>Probiotics reduce the incidence of complications in patients after THW, which may be related to modifying the oral and gut microbiota.</p></sec><sec><title>Clinical Trial Registration</title><p>[<uri xlink:href="https://clinicaltrials.gov/" xmlns:xlink="http://www.w3.org/1999/xlink">https://clinicaltrials.gov/</uri>], identifier America Clinical Trial Registry NCT03574051.</p></sec>