Changes of Intestinal Flora and Its Relationship with Nutritional Status for Patients with Cancer Pain

Abstract

Objective. To study the changes in the intestinal flora and its relationship with nutritional status for patients with cancer pain. Methods. A prospective research method was adopted. One hundred twenty cancer patients with cancer pain were selected as the research objects, who were treated in our hospital from June 2019 to June 2020, and 120 cancer patients without cancer pain were selected as the control group, who were treated in the same period. The differences of the intestinal flora and nutritional status of patients with different severity between the observation group and the control group were compared to analyze the changes of intestinal flora in patients with cancer pain and its correlation with nutritional status. Results. Hemoglobin (HB) ( t = 17.141 , p ≤ 0.001 ), albumin (ALB) ( t = 27.654 , p ≤ 0.001 ), prealbumin (PAB) ( t = 96.192 , p ≤ 0.001 ), and total protein (TP) ( t = 18.781 , p ≤ 0.001 ) in the observation group were significantly lower than those in the control group. There were statistically significant differences in HB ( f = 13.569 , p ≤ 0.001 ), ALB ( f = 22.229 , p ≤ 0.001 ), PAB ( f = 19.521 , p ≤ 0.001 ), and TP ( f = 21.451 , p ≤ 0.001 ) among patients with cancer pain of different severity. Through these two comparisons, their nutritional indicators showed a significant downward trend with the increase in the severity for cancer pain patients; the levels of Lactobacillus ( t = 2.124 , p = 0.035 ), Bifidobacterium ( t = 4.823 , p ≤ 0.001 ), Enterococcus ( t = 3.578 , p ≤ 0.001 ), and Eubacterium ( t = 2.394 , p = 0.017 ) in the observation group were significantly lower than those in the control group. There were statistically significant differences in the levels of Lactobacillus ( f = 20.643 , p ≤ 0.001 ), Bifidobacterium ( f = 19.129 , p ≤ 0.001 ), Enterococcus ( f = 17.408 , p ≤ 0.001 ), and Eubacterium ( f = 22.343 , p ≤ 0.001 ) among patients with cancer pain of different severity. After pairwise comparison, their beneficial intestinal bacteria were significantly lower than those in the control group with the increase in pain in cancer pain patients. Nitric oxide (NO) ( t = 8.418 , p ≤ 0.001 ), galectin-3 ( t = 14.043 , p ≤ 0.001 ), occludin (OCLN) ( t = 47.308 , p ≤ 0.001 ), galectin-1 ( t = 15.298 , p ≤ 0.001 ), zonula occludens protein 1 (ZO-1) ( t = 23.093 , p ≤ 0.001 ), and cingulin ( t = 340.198 , p ≤ 0.001 ) in the observation group were significantly lower than those in the control group. There were statistically significant differences in NO, galectin-3, OCLN, galectin-1, ZO-1, and cingulin for patients with cancer pain of different severity. By comparison, the NO, galectin-3, OCLN, galectin-1, ZO-1, and cingulin of the patients showed a significant downward trend with the aggravation of cancer pain symptoms. Through correlation analysis, the nutritional indicators of patients were positively correlated with intestinal microorganisms and intestinal barrier function. Conclusion. There was a significant correlation between the changes in intestinal flora and nutritional status for patients with cancer pain, which could be used as an important basis for improving the treatment of cancer pain.

Lactobacillus rhamnosus GG and butyrate supplementation in rats with bone cancer reduces mechanical allodynia and increases expression of μ-opioid receptor in the spinal cord

“…The dysbiosis of gut microbiota and decreased Lactobacillus was reported in patients with cancer pain ( Zhang et al, 2022 ). We hypothesized that the microbiota and metabolite might be regulated by LGG supplementation and thus led to pain relief and the biochemical changes as described in last paragraph.…”

“…BCP, one of the most unbearable symptoms presented in patients with advanced cancer, exhibits some characteristics similar to inflammatory and neuropathic pain ( Liu et al, 2013 ; Zajączkowska et al, 2019 ) and is usually accompanied with central inflammation and bone destruction ( Liu et al, 2013 ; Mantyh, 2013 ). The changed gut microbiome and impaired intestinal barrier function were also found in patients with cancer pain compared to cancer patients without pain ( Zhang et al, 2022 ). The μ-opioid receptor (MOR) is a G-protein coupled receptor (GPCR) that suppresses neuron excitability through inhibition of cyclic AMP, voltage-gated calcium channel (VGCC), and G protein inwardly rectifying potassium (GIRK) when activated by agonists ( Corder et al, 2018 ).…”