The impact of enteral immunonutrition on gut microbiota in colorectal cancer and gastric cancer patients in the preoperative period—preliminary results of randomized clinical trial

IntroductionImmunonutrition is a part of nutritional interventions in gastrointestinal cancer patients. It seems to be especially important in the preoperative period to reduce, among others, surgery-related complications. The relation between the immune system and gut microbiota has been previously...

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Main Authors: Karolina Kaźmierczak-Siedlecka, Ewa Stachowska, Robert Kucharski, Piotr Wiśniewski, Paweł Ulasiński, Michał Stańczak, Wojciech Makarewicz, Karolina Skonieczna-Żydecka, Leszek Kalinowski
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Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1606187/full
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author Karolina Kaźmierczak-Siedlecka
Ewa Stachowska
Robert Kucharski
Robert Kucharski
Piotr Wiśniewski
Paweł Ulasiński
Michał Stańczak
Michał Stańczak
Wojciech Makarewicz
Wojciech Makarewicz
Karolina Skonieczna-Żydecka
Leszek Kalinowski
Leszek Kalinowski
author_facet Karolina Kaźmierczak-Siedlecka
Ewa Stachowska
Robert Kucharski
Robert Kucharski
Piotr Wiśniewski
Paweł Ulasiński
Michał Stańczak
Michał Stańczak
Wojciech Makarewicz
Wojciech Makarewicz
Karolina Skonieczna-Żydecka
Leszek Kalinowski
Leszek Kalinowski
author_sort Karolina Kaźmierczak-Siedlecka
collection DOAJ
description IntroductionImmunonutrition is a part of nutritional interventions in gastrointestinal cancer patients. It seems to be especially important in the preoperative period to reduce, among others, surgery-related complications. The relation between the immune system and gut microbiota has been previously analyzed. However, the influence of immunonutrients on the composition of gut microbiota is still unclear. Therefore, the aim of this study was to assess the impact of enteral immunonutrition on gut microbiota in gastric/colorectal cancer patients in the preoperative period.Patients and methodsThis study included 14 patients (n = 9 colorectal cancer, n = 5 gastric cancer) allocated to receive immunonutrition or standard products by 7 days prior to the surgery. Randomization was performed using a random number generator. The stool samples were collected at day 0 and after 7 days of consuming the study products. Therefore, gut microbiota analysis was conducted at the beginning and after 7 days (follow-up). The analysis consists of alpha diversity analysis, taxonomic data processing, beta diversity analysis, and differential abundance analysis.ResultsStatistical analysis did not indicate any significant differences (p > 0.05) between the two dietary groups for any of the alpha diversity indices. Microbial community compositions were largely similar between the immunodiet and standard nutridrink groups. Differential abundance analysis (DAA) using the Wilcoxon test identified several taxa with nominal p-values <0.05, suggesting potential differences in abundance between groups. However, none of these findings remained statistically significant. The taxa with nominal significance included Bilophila, CAG-56, Clostridium sensu stricto 1, Coprobacter, Holdemania, Fusicatenibacter, Ruminococcus, and [Eubacterium] eligens group.ConclusionsThe analysis of gut microbiota in the context of immunonutrition is a new area in oncology. In the current study, despite some initial microbial alterations, it was not finally confirmed that immunonutrition has a beneficial effect on gut microbiota in gastric and colorectal cancer patients in the preoperative period. However, the small sample size is one of the study’s limitations.
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spelling doaj-art-a17c6b59acb74eb0a98ca3c1cb1e909e2025-08-20T03:40:45ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-08-011610.3389/fimmu.2025.16061871606187The impact of enteral immunonutrition on gut microbiota in colorectal cancer and gastric cancer patients in the preoperative period—preliminary results of randomized clinical trialKarolina Kaźmierczak-Siedlecka0Ewa Stachowska1Robert Kucharski2Robert Kucharski3Piotr Wiśniewski4Paweł Ulasiński5Michał Stańczak6Michał Stańczak7Wojciech Makarewicz8Wojciech Makarewicz9Karolina Skonieczna-Żydecka10Leszek Kalinowski11Leszek Kalinowski12Department of Medical Laboratory Diagnostics – Fahrenheit Biobank BBMRI.pl, Medical University of Gdansk, Gdańsk, PolandDepartment of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, Szczecin, PolandDepartment of Medical Laboratory Diagnostics – Fahrenheit Biobank BBMRI.pl, Medical University of Gdansk, Gdańsk, PolandNeodentica Dentistry Center, Gdansk, PolandUnit of Surgery with Unit of Surgery with Unit of Oncological Surgery, Specialist Hospital in Koscierzyna, Kościerzyna, PolandUnit of Surgery with Unit of Surgery with Unit of Oncological Surgery, Specialist Hospital in Koscierzyna, Kościerzyna, PolandDepartment of Surgical Oncology with the Subunit of Breast Cancer, Skin and Soft Tissue Surgery, Maritime Hospital PCK, Gdynia, PolandOncological Surgery Department, Medical University of Gdansk, Gdynia, PolandUnit of Surgery with Unit of Surgery with Unit of Oncological Surgery, Specialist Hospital in Koscierzyna, Kościerzyna, Poland2nd Division of Radiology, Medical University of Gdansk, Gdańsk, PolandDepartment of Biochemical Research, Pomeranian Medical University in Szczecin, Szczecin, PolandDepartment of Medical Laboratory Diagnostics – Fahrenheit Biobank BBMRI.pl, Medical University of Gdansk, Gdańsk, PolandBioTechMed Center, Department of Mechanics of Materials and Structures, Gdansk University of Technology, Gdańsk, PolandIntroductionImmunonutrition is a part of nutritional interventions in gastrointestinal cancer patients. It seems to be especially important in the preoperative period to reduce, among others, surgery-related complications. The relation between the immune system and gut microbiota has been previously analyzed. However, the influence of immunonutrients on the composition of gut microbiota is still unclear. Therefore, the aim of this study was to assess the impact of enteral immunonutrition on gut microbiota in gastric/colorectal cancer patients in the preoperative period.Patients and methodsThis study included 14 patients (n = 9 colorectal cancer, n = 5 gastric cancer) allocated to receive immunonutrition or standard products by 7 days prior to the surgery. Randomization was performed using a random number generator. The stool samples were collected at day 0 and after 7 days of consuming the study products. Therefore, gut microbiota analysis was conducted at the beginning and after 7 days (follow-up). The analysis consists of alpha diversity analysis, taxonomic data processing, beta diversity analysis, and differential abundance analysis.ResultsStatistical analysis did not indicate any significant differences (p > 0.05) between the two dietary groups for any of the alpha diversity indices. Microbial community compositions were largely similar between the immunodiet and standard nutridrink groups. Differential abundance analysis (DAA) using the Wilcoxon test identified several taxa with nominal p-values <0.05, suggesting potential differences in abundance between groups. However, none of these findings remained statistically significant. The taxa with nominal significance included Bilophila, CAG-56, Clostridium sensu stricto 1, Coprobacter, Holdemania, Fusicatenibacter, Ruminococcus, and [Eubacterium] eligens group.ConclusionsThe analysis of gut microbiota in the context of immunonutrition is a new area in oncology. In the current study, despite some initial microbial alterations, it was not finally confirmed that immunonutrition has a beneficial effect on gut microbiota in gastric and colorectal cancer patients in the preoperative period. However, the small sample size is one of the study’s limitations.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1606187/fullimmunonutritiongut microbiotagastric cancercolorectal cancersurgery
spellingShingle Karolina Kaźmierczak-Siedlecka
Ewa Stachowska
Robert Kucharski
Robert Kucharski
Piotr Wiśniewski
Paweł Ulasiński
Michał Stańczak
Michał Stańczak
Wojciech Makarewicz
Wojciech Makarewicz
Karolina Skonieczna-Żydecka
Leszek Kalinowski
Leszek Kalinowski
The impact of enteral immunonutrition on gut microbiota in colorectal cancer and gastric cancer patients in the preoperative period—preliminary results of randomized clinical trial
Frontiers in Immunology
immunonutrition
gut microbiota
gastric cancer
colorectal cancer
surgery
title The impact of enteral immunonutrition on gut microbiota in colorectal cancer and gastric cancer patients in the preoperative period—preliminary results of randomized clinical trial
title_full The impact of enteral immunonutrition on gut microbiota in colorectal cancer and gastric cancer patients in the preoperative period—preliminary results of randomized clinical trial
title_fullStr The impact of enteral immunonutrition on gut microbiota in colorectal cancer and gastric cancer patients in the preoperative period—preliminary results of randomized clinical trial
title_full_unstemmed The impact of enteral immunonutrition on gut microbiota in colorectal cancer and gastric cancer patients in the preoperative period—preliminary results of randomized clinical trial
title_short The impact of enteral immunonutrition on gut microbiota in colorectal cancer and gastric cancer patients in the preoperative period—preliminary results of randomized clinical trial
title_sort impact of enteral immunonutrition on gut microbiota in colorectal cancer and gastric cancer patients in the preoperative period preliminary results of randomized clinical trial
topic immunonutrition
gut microbiota
gastric cancer
colorectal cancer
surgery
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1606187/full
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