Tilactase 50,000units/g oral drops

BACKGROUND: We aimed to identify plasma and urinary metabolites related to colorectal cancer (CRC) risk and elucidate their mediator role in the associations between modifiable risk factors and CRC. METHODS: Metabolite quantitative trait loci were derived from 2 published metabolomics genome-wide association studies, and summary-level data were extracted for 651 plasma metabolites and 208 urinary metabolites. Genetic associations with CRC were obtained from a large-scale genome-wide association study meta-analysis (100 204 cases, 154 587 controls) and the FinnGen cohort (4957 cases, 304 197 controls). Mendelian randomization and colocalization analyses were performed to evaluate the causal roles of metabolites in CRC. Druggability evaluation was employed to prioritize potential therapeutic targets. Multivariable Mendelian randomization and mediation estimation were conducted to elucidate the mediating effects of metabolites on the associations between modifiable risk factors and CRC. RESULTS: The study identified 30 plasma metabolites and 4 urinary metabolites for CRC. Plasma sphingomyelin and urinary lactose, which were positively associated with CRC risk, could be modulated by drug interventions (ie, olipudase alfa, tilactase). Thirteen modifiable risk factors were associated with 9 metabolites, and 8 of these modifiable risk factors were associated with CRC risk. These 9 metabolites mediated the effect of modifiable risk factors (Actinobacteria, body mass index, waist to hip ratio, fasting insulin, smoking initiation) on CRC. CONCLUSION: This study identified key metabolite biomarkers associated with CRC and elucidated their mediator roles in the associations between modifiable risk factors and CRC. These findings provide new insights into the etiology and potential therapeutic targets for CRC and the etiological pathways of modifiable environmental factors with CRC.

Abstract licence: CC BY

Objectives: Lactose intolerance (LI) is a condition characterized by absent or strongly decreased levels of intestinal lactase. This is a key enzyme for the lactose hydrolysis to monosaccharides, glucose, and galactose. Colonic bacteria metabolize the unabsorbed lactose, producing short-chain fatty acids and gas and resulting in nausea, bloating and diarrhea. Probiotics are gaining interest as a potential compensation for lactase insufficiency, particularly the predominant ones in the gastrointestinal microbiota, such as Bifidobacterium and Lactobacillus. Among the latter species, medical attention is nowadays focusing on a gram-positive strain, Lactobacillus Reuteri, which is able to stabilize intestinal permeability and to reduce flatulence, diarrhea and nausea. The aim of this review is to collect and summarize the current evidence concerning the beneficial effects of L. Reuteri in the treatment of LI. Materials and Methods: We conducted a thorough search on PubMed concerning evidence spanning from 2011 to 2021. Results: Lactobacillus Reuteri has been demonstrated to stabilize intestinal permeability and to be effective in attenuating clinical signs and symptoms of LI. In particular, one study shows that Lactobacillus reuteri treatment significantly improves lactose digestion with respect to placebo; however, its effects were lower than those observed with tilactase supplementation. Conclusions: Although literature is scant on this matter, Lactobacillus Reuteri seems to meet the requirements to be safely used in managing symptoms of lactose intolerance.

Abstract licence: CC BY-SA