Impact of chemotherapy on the association between fear of cancer recurrence and the gut microbiota in breast cancer survivors
Impact of chemotherapy on the association between fear of cancer recurrence and the gut microbiota in breast cancer survivors
复制标题
DOI：
10.1016/j.bbi.2019.02.025
复制
发表时间：
2020-03-01
影响因子：
15.1
通讯作者：
Matsuoka, Yutaka J.
中科院分区：
文献类型：
--
作者：
Okubo, Ryo;Kinoshita, Takayuki;Matsuoka, Yutaka J.
背景：恐惧记忆的功能失调可能与癌症复发恐惧（FCR）的病理生理学有关，这被认为是癌症幸存者主要的未满足的心理需求。新的证据表明，微生物群-肠-脑（MGB）轴影响抑郁症和焦虑症以及化疗相关的心理困扰。因此，我们假设肠道微生物群与癌症幸存者的 FCR 相关。方法：这项横断面研究纳入了被诊断患有浸润性乳腺癌且目前未接受化疗的女性。获取粪便样本以评估肠道微生物群。 FCR 等级使用复发担忧量表 (CARS) 进行评估。结果：参与者 (n = 126) 的平均年龄为 58 岁； 47% 患有 I 期疾病。调整可能混杂因素的多元回归分析表明，拟杆菌属的相对丰度（β = 0.180，p = 0.03）与 FCR 显着且直接相关。在 57 名有化疗史的参与者中，较高的 FCR 与门水平上较低的微生物多样性 (p = 0.04)、较低的厚壁菌门相对丰度 (p = 0.03) 和较高的拟杆菌门相对丰度 (p = 0.04) 以及较高的拟杆菌门相对丰度 (p < 0.01) 和较低的 Lachnospiraceae.g (p = 0.03) 相对丰度相关。属水平的瘤胃球菌 (p = 0.02)。 结论：我们的研究结果提供了肠道微生物群与 FCR 之间关联的第一个证据，并表明化疗引起的肠道微生物群变化可以影响 FCR。进一步的研究应该使用前瞻性设计来检验肠道微生物群对 FCR 的影响。
Background: Dysfunctional processing of fear memory may be involved in the pathophysiology of fear of cancer recurrence (FCR), which is cited as the major unmet psychological need of cancer survivors. Emerging evidence has shown that the microbiota-gut-brain (MGB) axis affects depressive and anxiety disorders, and chemotherapy-associated psychological distress. We therefore hypothesized that the gut microbiota is associated with FCR in cancer survivors.Methods: This cross-sectional study enrolled women diagnosed with invasive breast cancer who were not currently undergoing chemotherapy. Fecal samples were obtained to assess the gut microbiota. FCR grade was assessed using the Concerns About Recurrence Scale (CARS).Results: Mean age of the participants (n = 126) was 58 years; 47% had stage I disease. Multiple regression analysis with adjustment for possible confounders showed that the relative abundance of the Bacteroides genus (beta = 0.180, p = 0.03) was significantly and directly associated with FCR. In the 57 participants with a history of chemotherapy, higher FCR was associated with lower microbial diversity (p = 0.04), lower relative abundance of Firmicutes (p = 0.03) and higher relative abundance of Bacteroidetes (p = 0.04) at the phylum level, and higher relative abundance of Bacteroides (p < 0.01) and lower relative abundance of Lachnospiraceae.g (p = 0.03) and Ruminococcus (p = 0.02) at the genus level.Conclusion: Our findings provide the first evidence of an association between the gut microbiota and FCR and suggest that chemotherapy-induced changes in gut microbiota can influence FCR. Further studies should examine the effects of the gut microbiota on FCR using a prospective design.