Immunometabolism, Micronutrients, and Bariatric Surgery: The Use of Transcriptomics and Microbiota-Targeted Therapies

Table 2

Studies showing use of gut-targeting therapies/interventions in the bariatric surgery population.

Reference	Study Objective	Study Design	Sample	Intervention	Duration	Main results found
[158]	To study the effects of the probiotic administration on bacterial overgrowth, quality of life, gastrointestinal (GI) symptoms, and weight loss after surgery.	Prospective randomized controlled trial	35 RYGB patients.; Control group (); Probiotic group ()	Supplementation with 2.4 billion colonies of Lactobacillus daily postoperatively	6 months	(1) Statistically significant reduction in bacterial overgrowth.; (2) Higher postoperative B12 levels; (3) Greater percent excess weight loss
[159]	To investigate the effect of probiotic supplementation on inflammatory factors, anthropometric indices, and vitamin B12, folate, homocysteine, and 25-hydroxy vitamin D3 levels in One Anastomosis Gastric Bypass-Mini Gastric Bypass (OAGB-MGB) surgery patients.	Placebo-controlled, double-blind, randomized clinical trial	46 women candidates for (OAGB-MGB) surgery.; Placebo group (); Probiotics group ()	Probiotic supplement (Familact®) containing seven species of probiotic bacteria (Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium longum, Lactobacillus bulgaricus)	Total 16 weeks (4 weeks before surgery to 12 weeks after surgery)	(1) Significant improvement in serum inflammatory markers including reduction in TNF-α in the probiotic group.; (2) Percent weight loss and decreased BMI in the probiotic group.; (3) No significant difference in serum levels of vitamin B12, folate, and homocysteine between the placebo and probiotic groups
[140]	To study the effects prebiotic and synbiotic supplementation on inflammatory markers and anthropometric indices	Randomized, triple-blind, placebo-controlled study	9 patients undergoing open RYGB surgery and 9 healthy individuals	3 groups: 6 g/d of placebo (maltodextrin),; prebiotic (fructo-oligosaccharide, FOS), or synbiotic (FOS+Lactobacillus and Bifidobacteria strains)	15 days	(1) Increased weight loss and BMI reduction in the placebo and prebiotic groups.; (2) No significant changes in inflammatory markers between groups.
[160]	To investigate the effects of probiotic supplementation on improvement of symptomatic GI symptoms after surgery	Double-blind, prospective, randomized trial	60 patients who underwent RYGB divided into 3 groups of 20 subjects each.	3 groups: probiotic group A—1 g Clostridium butyricum MIYAIRI, Probiotic group B—Bifidobacterium longum BB536 and digestive enzymes group	2 weeks	Improvement in GI symptoms and quality of life in all the 3 groups after the intervention period.
[161]	To study the comparative effect of probiotics and placebo on hepatic, inflammatory, and clinical outcomes postlaparoscopic sleeve gastrectomy (LSG).	Randomized, double-blind, placebo-controlled, trial	100 morbidly obese subjects with nonalcoholic fatty liver disease who underwent LSG.	2 groups: probiotic (2 capsules per day of Bio-25 Supherb) group () and placebo group ()	6 months	Microbiota diversity increased in both the groups after 6 months of surgery and decreased at 12 months after surgery. No improvements were seen on hepatic, inflammatory, and clinical outcomes.