Gut microbial dysbiosis may predict diarrhea and fatigue in patients undergoing pelvic cancer radiotherapy: a pilot study.
Gut microbial dysbiosis may predict diarrhea and fatigue in patients undergoing pelvic cancer radiotherapy: a pilot study.
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DOI：
10.1371/journal.pone.0126312
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Wang A;Ling Z;Yang Z;Kiela PR;Wang T;Wang C;Cao L;Geng F;Shen M;Ran X;Su Y;Cheng T;Wang J
疲劳和腹泻是盆腔放疗最常见的不良反应，而其病因在很大程度上是未知的。本研究的目的是探讨盆腔放疗引起的疲劳、腹泻和肠道菌群改变之间的相关性。11例肿瘤患者在盆腔放疗5周的治疗过程中，全身疲劳评分明显升高，以腹泻患者更为突出。疲劳评分与血清瓜氨酸（功能性肠细胞质量的指标）的降低和全身炎症蛋白（包括触珠蛋白、orosomuoid、α - 1-抗胰蛋白酶和TNF-α）的升高密切相关。血清脂多糖（LPS）水平也升高，特别是腹泻患者，表明上皮屏障破裂和内毒素血症。16S rRNA基因的Pyrosequencing分析显示，在放疗前发生腹泻的患者中，微生物多样性、丰富度和厚壁菌门/拟杆菌门比例显著改变。盆腔放疗引起了粪便微生物生态的进一步变化，其中一些变化是有或无腹泻患者特有的。我们的研究结果表明，放射治疗前的肠道微生物失调可以用来预测腹泻的发展，并指导预防性治疗方案。放射诱导的生态失调可能导致盆腔放射疾病，包括粘膜炎、腹泻、全身炎症反应和癌症患者盆腔放射治疗相关的疲劳。
Fatigue and diarrhea are the most frequent adverse effects of pelvic radiotherapy, while their etiologies are largely unknown. The aim of this study is to investigate the correlations between fatigue, diarrhea, and alterations in gut microbiota induced by pelvic radiotherapy. During the 5-week treatment of pelvic radiotherapy in 11 cancer patients, the general fatigue score significantly increased and was more prominent in the patients with diarrhea. The fatigue score was closely correlated with the decrease of serum citrulline (an indicator of the functional enterocyte mass) and the increases of systemic inflammatory proteins, including haptoglobin, orosomuoid, α1-antitrypsin and TNF-α. Serum level of lipopolysaccharide (LPS) was also elevated, especially in the patients with diarrhea indicating epithelial barrier breach and endotoxemia. Pyrosequencing analysis of 16S rRNA gene revealed that microbial diversity, richness, and the Firmicutes/Bacteroidetes ratio were significantly altered prior to radiotherapy in patients who later developed diarrhea. Pelvic radiotherapy induced further changes in fecal microbial ecology, some of which were specific to the patients with or without diarrhea. Our results indicate that gut microbial dysbiosis prior to radiation therapy may be exploited to predict development of diarrhea and to guide preventive treatment options. Radiation-induced dysbiosis may contribute to pelvic radiation disease, including mucositis, diarrhea, systemic inflammatory response, and pelvic radiotherapy-associated fatigue in cancer patients.
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影响因子：
14.9
作者：
Pruesse E;Quast C;Knittel K;Fuchs BM;Ludwig W;Peplies J;Glöckner FO
通讯作者：
Glöckner FO
影响因子：
9.8
作者：
Manichanh, Chaysavanh;Varela, Encarna;Malagelada, Juan-Ramon
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DOI：
10.1073/pnas.0807920105
发表时间：
2008-11-18
影响因子：
11.1
作者：
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通讯作者：
Knight, Rob
DOI：
10.1073/pnas.0504830102
发表时间：
2005-09-13
影响因子：
11.1
作者：
Crawford, PA;Gordon, JI
通讯作者：
Gordon, JI
影响因子：
4.4
作者：
Schloss, Patrick D.;Westcott, Sarah L.;Weber, Carolyn F.
通讯作者：
Weber, Carolyn F.