發酵乳桿菌Lactobacillus fermentum對降低成年男性抽菸頻率之效用:一項隨機單盲交叉試驗研究

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2021

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香菸中的尼古丁 (nicotine)會刺激大腦中神經傳導物質多巴胺 (dopamine)釋放,使吸菸者獲得滿足感,因而調節腦中多巴胺濃度為目前戒菸療法之主要作用途徑。有鑑於精神益生菌 (psychobiotics)可藉腸腦軸線 (gut-brain axis)調控腦部神經傳導物質之釋放,繼而影響宿主的情緒及相關認知行為,因此本研究目的在於探討補充益生菌Lactobacillus fermentum GKF3是否能改善吸菸者之吸菸頻率。本研究採隨機單盲交叉對照模式 (a randomized single-blind crossover trial),招募45名無重大疾病且無酗酒、睡眠障礙及憂鬱狀態之成年男性吸菸者,將受試者隨機區分為安慰劑組 (placebo group)及GKF3組 (GKF3 group),連續給予四週安慰劑或GKF3樣品,再通過兩週洗除期 (washout period),交叉對調給予不同樣品連續四週。試驗期間受試者定期接受尼古丁成癮度量表 (Fagerstrom Test for Nicotine Dependence, FTND)、24小時飲食紀錄 (24-hour diet recall)以及國際身體活動量表 (International Physical Activity Questionnaire, IPAQ)之問卷調查,以評估其菸癮程度、營養素攝取及身體活動量。本研究亦分析受試者尿液中三種尼古丁之主要代謝物 nicotine, cotinine 及 trans-3’-hydroxycotinine (T3HC)濃度,以評估試驗前後之吸菸量變化。同時,分析血清左多巴 (L-3,4-dihydroxyphenylalanine, L-DOPA)以評估GKF3是否具有生成L-DOPA之活性;分析血漿丙二醛 (malondialdehyde, MDA)與蛋白質羰基 (protein carbonyl group),以作為體內氧化壓力之指標。試驗結果顯示,受試者於試驗期間之營養素攝取、身體活動量及基本血液生化數值,兩組間皆無顯著差異 (p>0.05)。試驗前後尿液尼古丁代謝物濃度變化,GKF3組受試者之下降率 (67 %)顯著低於安慰劑組 (36 %, p = 0.0031)。兩項氧化壓力指標物及L-DOPA濃度,兩組受試者於試驗前後均無顯著差異 (p> 0.05)。綜合上述,本研究證實補充Lactobacillus fermentum GKF3益生菌連續四週具有降低成年男性吸菸者吸菸頻率之效用,可能具有精神益生菌之特性,未來具有發展為戒菸輔助療法之潛力。
The nicotine in cigarette could stimulate the release of dopamine in the brain. Smokers may achieve the feeling of satisfaction after smoking by the release of dopamine. Thus, regulating dopamine in the brain to reduce the craving of smoking is the main mechanism of current smoking cessation therapy. Given that recent studies showed that psychobiotics could regulate the neurotransmitters via gut-brain axis and affect emotion and cognitive behavior of host. The aim of the study is to identify whether supplementing of the probiotic GKF3 could improve the craving of smoking and reduce smokers’ smoking frequency or not. A randomized single-blind crossover trial was adopted to collect the data. A total of 45 adult male smokers were recruited without having major disease, alcoholism, sleeping disorder and depression. Eligible subjects were randomly divided into the placebo group and the GKF3 group. Each subject has been required to take the placebo or GKF3 capsule for four weeks, and then after a two-week washout period, exchange and give a different sample for another four weeks. During the trial, using Fagerstrom Test for Nicotine Dependence (FTND), 24-hour diet recall, and International Physical Activity Questionnaire (IPAQ) to assess the level of nicotine addiction, nutrient intake and activity level in subject regularly. The study also analyzed the level of urinary nicotine metabolites (nicotine, cotinine& trans-3'-hydroxycotinine) to assess the change of smoking frequency after taking the sample. Analyzed the serum L-DOPA (L-3,4-dihydroxyphenylalanine) to evaluate whether GKF3 has the ability to synthesis L-DOPA or not. Futhermore, analyzed plasma malondialdehyde (MDA) and plasma protein carbonyl to evaluate the level of oxidative stress in subjects. The results revealed that there was no significant change in nutrient intake, activity level and blood routine in subjects (p > 0.05). The level of urinary nicotine metabolites were significantly decreased in the GKF3 group (67%) and the percentage reduction of urinary nicotine metabolites was also significantly higher than the placebo group (36 %, p = 0.0031). There wasn’t significant difference between two groups of subjects before and after the study for the two indicators of oxidative stress and the level of L-DOPA (p> 0.05). In summary, the study showed that taking Lactobacillus fermentum GKF3 for four weeks has the effect of reducing the frequency of smoking among adult male smokers. It may have the properties of psychobiotics and has the potential to develop into an adjuvant therapy for smoking cessation in the future.

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多巴胺, 發酵乳桿菌, 尼古丁, 精神益生菌, 吸菸頻率, dopamine, Lactobacillus fermentum, nicotine, psychobiotics, smoking frequency

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