Pilot Project 2: Social Correlates Of Variation in Intestinal and Oral Microbiome Among Hematopoietic Stem Cell Transplant Patients: A Geographic Exploration in the City of Chicago

摘要 越来越多的证据表明，人类肠道微生物组多样性水平低与 各种恶性肿瘤的生存结果存在差异，微生物组多样性水平较低 结果较差。在造血干细胞移植患者中，微生物组多样性与 感染、疾病复发和移植物抗宿主病发生的风险。这导致了关于 饮食和抗生素使用的影响，这与微生物组的组成有关。干细胞移植 来自少数族裔/种族群体和社会经济地位较低家庭的患者生存结果较差 相对于一般人群。受保状况、社会经济和社会文化因素可能会发挥作用 这些不同的结果。一种可以密切跟踪这些特征的生物标志物是肠道 微生物组。这种潜在的临床重要生物标志物，最近已以 香农-韦弗多样性标准尚未在社会多元化的患者中进行探索或比较 人口。很少有人关注社会心理或邻里层面的环境，这证明 在癌症的社会流行病学中具有如此重要的意义。芝加哥癌症健康股权合作 （芝加哥CHEC）试点研究项目旨在为变异的生态分析奠定基础 微生物组多样性。像芝加哥这样的大型、多元化和种族隔离的城市，在以下方面存在着不同的结果： 各种恶性肿瘤，是探索地理变异在肠道微生物组中的作用的理想城市中心 多样性。芝加哥CHEC 社区参与的研究为成功患者奠定了基础 通过我们附属的医疗中心进行招募，研究团队有能力承担这项工作 作为更大的微生物组研究计划的一部分的试点研究。我们提出一个创新的、多机构的、 前瞻性研究评估 50 名造血干细胞肠道和口腔微生物群的系列变化 细胞移植患者选自两个广泛不同的地区，每个地区都有大量人口的特征 在芝加哥大都市区。该研究将证明分析关联性的可行性 居住在芝加哥的干细胞移植患者的微生物组多样性及其早期临床结果 区。这些发现预计将更好地阐明地理特征所反映的区域特征的作用 位置，可能在肠道微生物组多样性中发挥作用。

ABSTRACT There is increasing evidence that low levels of human intestinal microbiome diversity are associated with differential survival outcomes for various malignancies, with low levels of microbiome diversity associated with poorer outcomes. Amongst hematopoietic stem cell transplant patients, microbiome diversity is associated with risk of infection, disease relapse, and the development of graft vs. host disease. This has led to research on the effects of diet and antibiotic usage, which have been implicated in microbiome composition. Stem cell transplant patients from ethnic/racial minority groups and low socioeconomic status families have inferior survival outcomes relative to the general population. Insured status, socioeconomic and sociocultural factors may play a role in these disparate outcomes. One biomarker that may closely track these characteristics is the intestinal microbiome. This potentially clinically important biomarker, which has recently been benchmarked to the Shannon-Weaver diversity standards, has not been explored or compared among socially diverse patient populations. There has been little attention to psychosocial or neighborhood level environments that are proving to be of such importance in the social epidemiology of cancer. This Chicago Cancer Health Equity Collaborative (ChicagoCHEC) pilot research project is designed to lay the groundwork for an ecological analysis of variation in microbiome diversity. A large, diverse, and segregated city like Chicago has known disparate outcomes in various malignancies, and is an ideal urban center to explore the role of geographic variation in gut microbiome diversity. ChicagoCHEC community engaged research has laid the groundwork for successful patient recruitment through our affiliated medical centers, and the study team is in a strong position to undertake this pilot study as part of a larger microbiome research program. We propose an innovative, multi-institutional, prospective study evaluating serial changes in intestinal and oral gut microbiota amongst 50 hematopoietic stem cell transplant patients selected from two widely diverse areas that are each characteristic of large populations in the Chicago metropolitan area. The study will demonstrate the feasibility of analyzing the association of microbiome diversity with early clinical outcomes amongst stem cell transplant patients residing in the Chicago area. These findings are expected to better elucidate the role that area characteristics, as reflected by geographic location, may play in intestinal gut microbiome diversity.