Probiotics to prevent gastrointestinal toxicity from cancer therapy: an interpretive review and call to action.
Probiotics to prevent gastrointestinal toxicity from cancer therapy: an interpretive review and call to action.
复制标题
DOI：
10.1097/spc.0000000000000134
复制
发表时间：
2015-06
影响因子：
2.1
通讯作者：
Parikh PJ
中科院分区：
文献类型：
--
作者：
Ciorba MA;Hallemeier CL;Stenson WF;Parikh PJ
目前，对能够预防与腹部和盆腔肿瘤化疗和放射治疗相关的胃肠道毒性(粘膜炎、肠炎)的药物的需求尚未得到满足。在这里，我们提供了一个概述如何操纵肠道微生物区系的益生菌管理影响这些胃肠道症状。我们将重点放在已发表的人体试验上，并就该领域如何向前发展提供建议。已经报道了几个不同设计、不同患者群体和不同益生菌产品的临床试验。适当剂量的乳杆菌益生菌在预防性给药时显示出减少胃肠道毒性的潜力。在这一点上，共同的研究局限性阻碍了这种做法的广泛采用，但对未来试验的合理设计是有帮助的。人类临床试验中还没有出现任何一种益生菌菌株或产品用于这一适应症。需要进一步的人体研究来解决当前文献中的局限性。临床前模型数据应该用来为这些新的临床试验的合理设计提供信息，以充分解决这一重要问题。
There is currently an unmet need for agents that can prevent the gastrointestinal toxicity (mucositis, enteritis) associated with chemotherapy and radiation therapy of abdominal and pelvic cancers. Herein we provide an overview of how manipulation of the gut microbiota by probiotic administration affects these gastrointestinal symptoms. We focus this review on published human trials and also provide suggestions on how the field can move forward. Several clinical trials of varying design, patient populations and probiotic product have been reported. Lactobacillus probiotics of adequate dosage demonstrate a potential to reduce gastrointestinal toxicity when administered prophylactically. Common study limitations prevent the widespread adoption of this practice at this point, but are informative for rational design of future trials. No single probiotic strain or product has emerged from human clinical trials for this indication. Further human studies are required to address limitations in the current literature. Preclinical model data should be used to inform the rational design of these new clinical trials to adequately address this important question.