The Safety of Lactobacillus Plantarum Extract Used as a Possible Adjuvant Treatment of Breast Cancer
Keywords:
Efficacy of Lactobacillus plantarum extract, Breast cancerAbstract
Objective: Lactobacillus plantarum is one of the most interesting strains of probiotics with potential anticancer effects. However, few clinical studies have been done to demonstrate this. The objective of the present study was to evaluate clinical safety of Lactobacillus plantarum extract used as an adjuvant treatment for breast cancer.
Materials and Methods: This study was a prospective, randomized, double-blind, and placebo-controlled study of early-stage breast cancer patients who underwent surgical removal of tumor and given conventional chemotherapy. The treatment group received products containing L. plantarum extract, and the placebo group received only a placebo for the duration of six months. Evaluated clinical parameters include body weight, symptoms resulting from side effects from chemotherapy, quality of life and laboratory tests.
Results: There were 56 patients in the study, of whom 27 were randomly assigned to a treatment group and 29 to the placebo group. A significant difference in the WBC count between the two groups was found in the second month after chemotherapy (P=0.04). The mean white blood cell (WBC) count in the treatment group was 7,641 cells/mm3 and 5,108 cells/mm3 in placebo group, respectively. The mean bodyweight in the placebo group decreased in the second month to an extent more than in the treatment group, and continue to decrease in the sixth month while in the treatment group the mean bodyweight increased.
Conclusions: The present study demonstrated that L. plantarum extract can be used safely as a possible adjuvant therapy for breast cancer patients. There was a trend towards better clinical and laboratory profiles in the treatment group, but mostly without statistical significance. Only the WBC count at the second month of chemotherapy showed a significant difference.
References
Martau PR, de Vrese M, Cellier CJ, et al. Protection from gastrointestinal diseases with the use of probiotics. Am J Clin Nutr 2001;73:430S-6S.
Ley RE, Turnbaugh PJ, Klein S, et al. Microbial ecology: human gut microbes associated with obesity. Nature 2006;444:1022-3.
Manichanh C, Borruel N, Casellas F, et al. The gut bacteria in IBD. Nat Rev Gastroenteral hepatol 2012;9:599-608.
Russell SL, Gold MJ, Hartmann M, et al. Early life antibiotic driven changes in bacteria enhance susceptibility to allergic asthma. EMBO Rep 2012;13:440-7.
Xuan C, Shamonki JM, Chung A, et al. Microbial dysbiosis is associated with human breast cancer. PLoS One 2014;9.doi:10.1371/journal.pone.0083744.
Carding S, Verbeke K, Vipond DT, et al. Dysbiosis of gut microbiota in disease. Microb Ecol Health Dis 2015; 26: 26191.doi:10.3402/mehd.v26.26191. eCollection 2015.
Tsai YL, Lin TL, Chang CJ, et al. Probiotics, prebiotics and amelioration of diseases. J Biomed Sci 2019;26:3.doi:10.1186/s12929-018-0493-6.
Hassan Z. Anti-cancer and biotherapeutic potentials of probiotic bacteria. J cancer Sci Ther 2019;11: 9-13.
Redman MG, Ward EJ, Phillips RS. The efficacy and safety of probiotics in people with cancer: A systemic review. Ann Oncol 2014;25:1919-39.
Mego M, Holec V, drgona L, et al. Probitic bacteria in cancer patients undergoing chemotherapy and radiation therapy. Complement Ther Med 2013; 21:712-23.
Maria-Aggeliki KS, Nikolaos KL, kyrias GM, et al. The potential clinical impact of probiotic treatment for the prevention and/or anti-inflammatory therapeutic effect against radiation induced intestinal mucositis. A review. Recent Pat inflamm Allergy Drug Dicov 2009;3:195-200.
Viaud S, Saccheri F, Mignot G, et al. The intestinal bacteria modulates the anticancer immune effects of cyclosphosphamide. Science 2013;342:971-6.
MendoZa L, Influence of gastrointestinal flora in the treatment of cancer with immune checkpoint inhibitors. Klin Onkol 2018;31:465-7.
Flesch AT, Tonial ST, Contu PC, Domain DC. Perioperative synbiotics with colorectal cancer: A randomized, double-blind clinical trial. Rev Col bras Cir 2017; 44:567-73.
Aso Y, Akaza H, Kotake K, et al. Preventive effect of a lactobacillous casei preparation in the prevention on the recurrence of superficial bladder cancer in a double blind trial. Eur Urol 1995;27:104-9.
Zhong L, Zhang X, Covasa M. Emerging roles of lactic acid bacteria in protection against colorectal cancer. World J. Gastroenterol 2014;20:7878-86.
Adams CA, the probiotic paradox: live and dead cells are biological response modifiers. Nutr Res Rev 2010;23:37-46.
Rasouli IG, Ghadimi BS, Darsajini A, et al. In vitro activity of probiotic Lactobacillus Reuteri against gastric cancer progression by down-regulation of urokinase plasminogen activator/ urokinase plasminogen activator receptor gene expression. J Cancer Res Ther 2017;13:246-51.
Paulos CM, Wrzesinski C, Kaiser A, et al. Microbial translocation augments the function of adoptively transferred self/ tumor-specific. J Clin Invest 2007;117:2197-204.
EL-Deeb NM, Yassin AM, Al-Madboly, et al. A novel purified Lactobacillus acidophilus 20079exopolysaccharide, LA-EPS-20079, molecularly regulates both apoptotic and NF-KB inflammatory pathways in human colon cancer. Microb Cell Fact 2018;17:doi.org/10.1186/s12934-018-0877-z.
Wang C, Wu T, Hsieh S, et al. Antioxidant activity and growth inhibition of human colon cancer cells by crude and purified fucoidan preparations extracted from Sargassum cristaefolium. J Food drug Anal 2015;23:766-77.
Tukenmez U, Aktas B, Aslim B, et al. The relationship between the structural characteristics of lactobacilli-EPS and its ability to induce apoptosis in colon cancer cells in vitro. Sci Rep 2019;9:8268.doi.org/10.1038/s41598-019-44753-8.
Hassan Z, Mustafa S, Rahin RA, et al. Anti-breast cancer effect of live, heat- killed and cytoplasmic fractions of Enterococcus faecalis and Staphylococcus homonis isolated from human breast milk in vitro. Cell Dev Biol Anim 2016;5:337-48.
Kadirareddy RH, Verumi SG, Palempalli UM. Probiotic conjugated linoleic acid mediated Apoptosis in breast cancer cells by down regulation of NFkB. Asian Pac J Cancer Prev 2016;17:3395-403.
MendoZa L. Potential effect of probiotics in the treatment of breast cancer. Oncol Rev 2019;13:422.doi:10.4081/oncol.2019.422.
Vivarelli S, Falzone L, Basile MS, et al. Benefit of using probiotics as adjuvants in cancer therapy (Review). W Acad Sci J 2019;13:doi.org/10.3892/wasj.2019.13.
Bedada TL, Feto TK, Awoke KS, et al. Probiotics for cancer alternative prevention and treatment. Biomed Phamacother 2020;129;110409.doi10.1016/j.biopha.2020.110409.
Lee HA, Kim H, Lee K, et al. Dead nano-sized Lactobacillus plantarum inhibits azoxymethane / dextran sulfate sodium-induced colon cancer in Balb/c mice. J Med Food 2015;18:1400-5.
Yazdi MH, Mahdavi M, Kheradmand E, et al. The preventive oral supplementation of a selenium nanoparticle enriched probiotic increases the immune response and lifespan of 4T1 breast cancer bearing mice. Arzneimittelforchung 2012;62:525-31.
Kasssyova M, Bobrov N, Strojny L, et al. Preventive effects of probiotic bacteria Lactobacillus plantarum and dietary fiber in chemically incuced mammary carcinogenesis. Anticancer Res 2014;34:4969-75.
Li-Oon C, Hooi LF, Teck CL, et al. Postbiotic metabolites produced by Lactobacillus plantarum strains exert selective cytotoxicity effects on cancer cells. BMC Complement Altern Med 2019;19:114.doi:10.1186/s12906-019-2528-2.
Fongcom A, Dussadee K, Manopen P, et al. Efficacy and safety of polynucleotide for treatment HIV infected patients. Bull Dept Med Serv 2005;30:29-33.
Fongcom A, Dussadee K, Manopen P, et al. Efficacy of polynucleotide adjuvant treatment with antiretroviral drugs in HIV infected patients. Bull Dept Med Serv 2004;29:658-64.
Cyclophosphamide. In: Lexi-drugs online [database on the Internet]. Hudson (OH): Lexicomp, Inc.; 2016 [updated 1 July 2022; cited 5 July 2022]. Available from: https://online.lexi.com/
Doxorubicin (Conventional). In: Lexi-drugs online [database on the Internet]. Hudson (OH): Lexicomp, Inc.; 2016 [updated 29 June 2022; cited 5 July 2022]. Available from: https://online.lexi.com/
Fluorouracil (Systemic). In: Lexi-drugs online [database on the Internet]. Hudson (OH): Lexicomp, Inc.; 2016 [updated 1 July 2022; cited 5 July 2022]. Available from: https://online.lexi.com/
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 The Royal College of Surgeons of Thailand
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.
