Effect Of Koumiss On The Fecal Metabolism And Intestinal Immunity In Patients With Chronic Atrophic Gastritis

Chronic atrophic gastritis(CAG)is a common chronic gastric disease that tends to develop into gastric cancer.As a traditional fermented dairy product with medicinal value and health benefits,koumiss can improve the clinical symptoms of CAG patients.Our previous study found that koumiss relieving the symptoms CAG patients by adjusting intestinal flora.This study further explored the efficacy of koumiss on CAG patients by metabolomics and intestinal immunity.Ten patients were treated with CAG by drinking koumiss,and the fecal samples of CAG patients were collected before treatment,30 days of treatment,60 days of treatment,and 30 days after koumiss withdrawal.The metabolites of fecal samples were determined by UPLC Q-TOF MS technology and the contents of cytokines and immunoglobulins were evaluated.In addition,we analyzed the correlation among CAG symptoms scores,differential abundant gut microbiota,immune factors and metabolites combined with the previous research.The results are as follows:(1)Koumiss modulated intestinal metabolism in feces of CAG patients.Significant modulation was observed in steroid and bile acid biosynthesis,phenylalanine metabolism,linoleic acid and arachidonic acid metabolism,and unsaturated fatty acids.Cholesterol,cholic acid,2-phenylethanol,3-phenylpropanoic acid,arachidonic acid,8-isoprostane,9-hydroxyoctadecadienoic acid,docosapentaenoic acid,and docosahexaenoic acid were significantly increased,whereas 5?-cyprinol sulfate,lithocholic acid,fumaric acid,?-linoleric and eicosapentaenoic acid were significantly decreased.(2)Koumiss effectively modulated intestinal immunity in CAG patients.Koumiss treatment decreased the level of TNF-? and IL-38,whereas increased the level of IgG.(3)Significant correlations existed among gut microbes and the differential abundant metabolites of CAG patients.The gut microbiota Roseburia inulinivorans correlated positively with 4-hydroxyretinoic acid,5 ?-cyprinol sulfate and 9-cis-retinoic acid.The gut microbiota Odoribacteraceae correlated positively with 4-hydroxyretinoic acid and urolithin A.The gut microbiota Blautia faecis correlated positively with glyceric acid and fumaric acid.The metabolite 3?-hydroxy-5-cholenoic acid correlated positively with the genus Lactococcus.This study explored the effect of koumiss on the fecal metabolome and intestinal immunity in CAG patients.Studies showed that koumiss modulated intestinal metabolomics and improved intestinal immunity.Our study laid the foundation for the exploitation and application of koumiss.