Intestinal Microbiota Can Predict Acute Graft-versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation
Intestinal Microbiota Can Predict Acute Graft-versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation
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DOI：
10.1016/j.bbmt.2019.07.006
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发表时间：
2019
期刊：
影响因子：
--
通讯作者：
Qifa Liu
中科院分区：
文献类型：
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作者：
Lijie Han;Haiyan Zhang;Shan Chen;Lizhi Zhou;Yuanyuan Li;Ke Zhao;Fen Huang;Zhiping Fan;Li Xuan;Xin Zhang;Min Dai;Qianyun Lin;Zhongxing Jiang;Jie Peng;Hua Jin;Qifa Liu
The intestinal microbiome plays an important role in the development of acute graft-versus-host disease.(aGVHD). However, whether intestinal microbiota can predict the development of aGVHD has been reported only.rarely. Here we conducted a prospective study of microbiota in 141 patients after allogeneic hematopoietic stem.cell transplantation. We found lower microbiota diversity in the aGVHD group compared with the non-aGVHD.group at day 0 and day 15 § 1 (P = .018 and .009, respectively). Diversity was negatively associated with conditioning intensity (P = .017, day 0; P = .045, day 15) and b-lactam antibiotic administration (P = .004, day 15). Intensified.conditioning and b-lactam antibiotics were associated with a lower regulatory T (Treg)/T helper 17 (Th17) cell.ratio at day 15 (P = .030 and .047, respectively). At day 15, the levels of the inflammatory factors (tumor necrosis.factor a, interleukin [IL]-6, IL-17A, IL-1b, and lipopolysaccharide) were higher in the intensified conditioning.group compared with the standard group (P < .05). The accumulated intestinal microbiota (AIM) score was.defined as microbiota diversity and gradient of the 4 bacterials (Lachnospiraceae, Peptostreptococcaceae, Erysipelotrichaceae, and Enterobacteriaceae) at day 15 post-transplantation. The AIM score was positively correlated.with aGVHD grade (r = .481, P < .001), and the AIM score could be predictive of the development of aGVHD (grade.II-IV aGVHD: area under the curve [AUC], .75, P < .001; grade III-IV aGVHD: AUC, .84, P < .001). These findings suggest that intestinal microbiota and conditioning might induce aGVHD by inflammatory factors and the Treg/Th17.balance. The constitution of the intestinal microbiota at neutrophil engraftment may predict the development of.aGVHD.
