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，低水平的人类肠道微生物群多样性与 不同恶性肿瘤的不同生存结果，微生物群多样性水平较低与 更糟糕的结果。在造血干细胞移植患者中，微生物组多样性与 感染的风险、疾病复发以及移植物对宿主疾病的发展。这导致了对 饮食和抗生素使用的影响，这与微生物组组成有关。干细胞移植 来自少数族裔群体和低社会经济地位家庭的患者的生存结果较差 相对于一般人口而言。参保状况、社会经济和社会文化因素可能在 这些截然不同的结果。一个可能密切跟踪这些特征的生物标志物是肠道 微生物组。这一具有潜在临床重要性的生物标记物，最近已被作为基准 Shannon-Weaver多样性标准，尚未在社交不同的患者中进行探索或比较 人口。很少有人注意到心理社会或邻里层面的环境正在证明 在癌症的社会流行病学中具有如此重要的意义。这个芝加哥癌症健康公平协作组 (芝加哥化学公司)先导研究项目旨在为变异的生态分析奠定基础 在微生物群多样性方面。像芝加哥这样一个大的、多样化的和隔离的城市，已经知道在 各种恶性肿瘤，是探索肠道微生物群地理变异作用的理想城市中心 多样性。芝加哥社区参与研究为成功的患者奠定了基础 通过我们的附属医疗中心进行招聘，研究团队处于有利地位来承担这一任务 作为一个更大的微生物组研究计划的一部分的先导性研究。我们提出了一个创新的、多机构的、 50例造血干细胞肠道和口腔微生物区系动态变化的前瞻性研究 细胞移植患者是从两个差异很大的地区挑选出来的，每个地区都是大量人口的特征 在芝加哥大都市区。这项研究将论证分析两国关系的可行性 居住在芝加哥的干细胞移植患者的微生物群多样性与早期临床结果 区域。这些发现有望更好地阐明该地区的特征，如地理特征所反映的 位置，可能在肠道微生物群多样性中发挥作用。

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.