Microbiota modification in hematology: still at the bench or ready for the bedside?
Microbiota modification in hematology: still at the bench or ready for the bedside?
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DOI：
10.1182/bloodadvances.2019000365
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发表时间：
2019-11
期刊：
影响因子：
7.5
通讯作者：
C. Severyn;R. Brewster;T. Andermann
中科院分区：
文献类型：
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作者：
C. Severyn;R. Brewster;T. Andermann
越来越多的证据表明，人类微生物区系可能影响包括造血、化疗新陈代谢和疗效在内的各种过程，以及血液系统恶性肿瘤和其他癌症患者的总体生存。宿主遗传易感性和宿主-微生物区系的相互作用都可能影响癌症风险和治疗反应；然而，微生物区系有可能成为独特的可修改和可获得的治疗目标。在这里，我们专注于改变癌症患者微生物区系组成和功能的策略。首先，我们评估了粪便微生物区系移植在抗生素和化疗的干扰下恢复微生物平衡的用途，以及作为治疗造血干细胞移植(HSCT)并发症的一种方法，如移植物抗宿主病和多药耐药生物的定植。然后，我们讨论了益生菌和饮食益生菌化合物在靶向调节微生物区系中的潜在用途，旨在改善血液疾病的结果。对于每种类型的治疗，我们强调了异常或非微生物区系在疾病、治疗疗效和毒性中所起的作用，并评估了它们作为血液恶性肿瘤患者和接受HSCT的患者微生物区系操作的新兴策略的潜力。
Growing evidence suggests that human microbiota likely influence diverse processes including hematopoiesis, chemotherapy metabolism, and efficacy, as well as overall survival in patients with hematologic malignancies and other cancers. Both host genetic susceptibility and host-microbiota interactions may impact cancer risk and response to treatment; however, microbiota have the potential to be uniquely modifiable and accessible targets for treatment. Here, we focus on strategies to modify microbiota composition and function in patients with cancer. First, we evaluate the use of fecal microbiota transplant to restore microbial equilibrium following perturbation by antibiotics and chemotherapy, and as a treatment of complications of hematopoietic stem cell transplantation (HSCT), such as graft-versus-host disease and colonization with multidrug-resistant organisms. We then address the potential use of both probiotics and dietary prebiotic compounds in targeted modulation of the microbiota intended to improve outcomes in hematologic diseases. With each type of therapy, we highlight the role that abnormal, or dysbiotic, microbiota play in disease, treatment efficacy, and toxicity and evaluate their potential promise as emerging strategies for microbiota manipulation in patients with hematologic malignancies and in those undergoing HSCT.