The adverse effects of anti-tuberculosis (TB) drugs in the intestines were related to alteration of the intestinal microbiota. However, there was less information about microbial metabolism on the adverse reactions. This study aimed to explore whether Lactobacillus casei could regulate gut microbiota or short-chain fatty acids (SCFAs) disorders to protect intestinal adverse reactions induced by isoniazid (H) and rifampicin (R). Male Wistar rats were given low and high doses of Lactobacillus casei two hours before daily administration of anti-TB drugs. After 42 days, colon tissue and blood were collected for analysis. The feces at two-week and six-week were collected to analyze the microbial composition and the content of SCFAs in colon contents was determined. Supplementation of Lactobacillus casei increased the proportion of intestinal goblet cells induced by H and R (p < 0.05). In addition, HR also reduced the level of mucin-2 (p < 0.05), and supplementation of Lactobacillus casei restored. After two weeks of HR intervention, a decrease in OTUs, diversity index, the abundance of Bacteroides, Akkermansia, and Blautia, and an increase of the abundance of Lacetospiraceae NK4A136 group and Rumencoccus UCG-005, were observed compared with the control group (p all < 0.05). These indices in Lactobacillus casei intervention groups were similar to the HR group. Six-week intervention resulted in a dramatic reduction of Lacetospiraceae NK4A136 group, butyric acid, valeric acid and hexanoic acid, while an increase of Bacteroides and Blautia (p all < 0.05). Pretreatment with Lactobacillus casei significantly increased the content of hexanoic acid compared with HR group (p < 0.05). Lactobacillus casei might prevent intestinal injury induced by anti-tuberculosis drugs by regulating gut microbiota and SCFAs metabolism.
Background Macronutrients play a vital role in liver dysfunction and affect the treatment and prognosis of tuberculosis. This study aimed to clarify the associations between macronutrients intakes or to energy percentages and liver dysfunction in tuberculosis patients. Methods In this cross-sectional study, 2695 active tuberculosis patients aged ≥ 18 years were included based on the data from local tuberculosis clinics in Linyi rural areas, China. Macronutrients intakes and to energy percentages were assessed by the 24-hour dietary recalls. The concentration of alanine transferase (ALT) or aspartate transaminase (AST) greater than 40 U/L was defined liver dysfunction. In addition, restricted cubic spline (RCS) was applied to determine the dose-response relationships. Results Among those who were male, or normal BMI, or consumed energy less than 1646.80 kcal/d, it was suggested both inverse associations between protein (47.30–78.80 g/d) or fat (> 20.30 g/d) intake and the risks of liver dysfunction in all models (all P-trend < 0.05). Moreover, the RCS model showed J-shaped associations between protein, fat intake, the fat or carbohydrate to energy percentages and the odds of liver dysfunction (the cut-off values = 70.69 g/d, 47.50 g/d, 22% and 69%, respectively, and all P-nonlinearity < 0.05). Conclusions An appropriate increase in dietary intakes of protein or fat might reduce liver dysfunction risk. However, intakes of more than 70.69 g/d for protein or 47.50 g/d for fat could increase the risk of liver dysfunction. Our study may provide a novel idea of alleviating liver dysfunction with nutritional improvement.
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