The gut microbiota predispose to the pathophysiology of acute postradiotherapy diarrhea
The gut microbiota predispose to the pathophysiology of acute postradiotherapy diarrhea
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DOI：
10.1111/j.1572-0241.2008.01868.x
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发表时间：
2008-07-01
影响因子：
9.8
通讯作者：
Malagelada, Juan-Ramon
中科院分区：
文献类型：
--
作者：
Manichanh, Chaysavanh;Varela, Encarna;Malagelada, Juan-Ramon
简介：严重腹泻可能会使盆腔放疗复杂化并迫使治疗中断。由于目前尚无关于肠道微生物群在此发病机制中的作用的临床或实验信息，因此我们对接受盆腔放疗的患者的粪便微生物群进行了一项初步观察性研究。 方法：该研究涉及 10 名接受 5 周腹部肿瘤放疗的患者和 5 名对照者。从每个个体收集四份粪便样本：治疗前、治疗期间、治疗结束时和治疗后 2 周。从样本中扩增细菌 16S rRNA 基因后，使用 DNA 指纹识别和克隆测序技术分别确定其微生物谱和组成。 结果：6 名患者出现急性放疗后腹泻，4 名则没有。在没有腹泻的患者以及健康志愿者中，微生物多样性在 7 周内保持稳定。然而，出现腹泻的患者的微生物多样性逐渐发生改变。在放疗结束时（P = 0.026）和放疗后 2 周（P = 0.014）观察到相似性指数急剧下降。有趣的是，对第一个样本 (S1)（在放疗前收集）中微生物谱的聚类分析显示了一个树状图，其中出现腹泻的患者与放疗后未出现腹泻的患者分开聚类。此外，S1样本中优势细菌的序列分析证实了腹泻组和非腹泻组之间的差异。讨论：在这组患者中，放疗后的易感性或对腹泻的保护作用可能与不同的初始微生物定植有关。
INTRODUCTION: Severe diarrhea may complicate pelvic radiotherapy and force interruption of treatment. As there is no current clinical or experimental information on the role of the gut microbiota in this pathogenesis, we conducted a pilot observational study on the fecal microbiota in patients receiving pelvic radiotherapy.METHODS: The study involved 10 patients who underwent 5 wk of radiotherapy for abdominal tumors and 5 controls. Four fecal samples were collected from each individual: before, during, at the end, and 2 wk after treatment. Following the amplification of the bacterial 16S rRNA gene from the samples, DNA fingerprinting and cloning-sequencing techniques were used to determine their microbial profile and composition, respectively.RESULTS: Six patients suffered acute postradiotherapy diarrhea and 4 did not. In patients without diarrhea, as well as in healthy volunteers, microbial diversity was stable over a period of 7 wk. However, patients exhibiting diarrhea showed a progressive modification in their microbial diversity. A radical drop in similarity index was observed at the end (P = 0.026) and still 2 wk after radiotherapy (P = 0.014). Interestingly, cluster analysis of the microbial profile in the first sample (S1) (collected before radiotherapy) displayed a dendogram where patients that presented diarrhea clustered separately from those that did not develop diarrhea after radiotherapy. Moreover, sequence analysis of dominant bacteria in the S1 sample confirmed differences between the diarrhea and nondiarrhea groups.DISCUSSION: In this set of patients, susceptibility or protection against diarrhea after radiotherapy could be linked to different initial microbial colonization.