ObjectiveProgrammed death 1 and its ligand 1 (PD-1/PD-L1) immunotherapy is promising for late-stage lung cancer treatment, however, the response rate needs to be improved. Gut microbiota plays a crucial role in immunotherapy sensitisation and Panax ginseng has been shown to possess immunomodulatory potential. In this study, we aimed to investigate whether the combination treatment of ginseng polysaccharides (GPs) and αPD-1 monoclonal antibody (mAb) could sensitise the response by modulating gut microbiota.DesignSyngeneic mouse models were administered GPs and αPD-1 mAb, the sensitising antitumour effects of the combination therapy on gut microbiota were assessed by faecal microbiota transplantation (FMT) and 16S PacBio single-molecule real-time (SMRT) sequencing. To assess the immune-related metabolites, metabolomics analysis of the plasma samples was performed.ResultsWe found GPs increased the antitumour response to αPD-1 mAb by increasing the microbial metabolites valeric acid and decreasing L-kynurenine, as well as the ratio of Kyn/Trp, which contributed to the suppression of regulatory T cells and induction of Teff cells after combination treatment. Besides, the microbial analysis indicated that the abundance of Parabacteroides distasonis and Bacteroides vulgatus was higher in responders to anti-PD-1 blockade than non-responders in the clinic. Furthermore, the combination therapy sensitised the response to PD-1 inhibitor in the mice receiving microbes by FMT from six non-responders by reshaping the gut microbiota from non-responders towards that of responders.ConclusionOur results demonstrate that GPs combined with αPD-1 mAb may be a new strategy to sensitise non-small cell lung cancer patients to anti-PD-1 immunotherapy. The gut microbiota can be used as a novel biomarker to predict the response to anti-PD-1 immunotherapy.

Asbt: apical sodium-dependent bile acids transporter; AUC24h: area under the 24-hour BA concentration time curve; BAs: bile acids; Bsep: bile salt export pump; β-MCA: β-muricholic acid; CA: cholic acid; CDCA: chenodeoxycholic acid; Cyp3a11: cytochrome P450 3a11 (human CYP3A4); Cyp7a1: cholesterol 7α-hydroxylase cytochrome P450 7a1; DCA: deoxycholic acid; Fxr: farnesoid X receptor; Fgf15: fibroblast growth factor 15; G-: glycine conjugated bile acid; HDCA: hyodesoxycholic acid; LCA: lithocholic acid; Mrp2: multidrug resistance-associated protein 2; NDCA: demethylation deoxycholic acid; Ntcp: Na+-taurocholate co-transporting polypeptide; Oatp2: organic anion transporting polypeptide 2; Ostα/β: heterodimeric organic solute transporters alpha and beta; Shp: small heterodimer partner; T-: taurine conjugated bile acid; UDCA: ursodeoxycholic acid.

A simple, rapid and sensitive liquid chromatography-tandem mass spectrometry (LC-MS-MS) method was developed and validated for the simultaneous quantitation of metformin (MTF), metoprolol (MET), α-hydroxymetoprolol (HMT) and O-desmethylmetoprolol (DMT) in rat plasma using paracetamol as an internal standard (IS), respectively. The sample preparation involved a protein-precipitation method with methanol after the addition of IS. The separation was performed on an Agilent HC-C18 column (4.6 × 250 mm, 5 µm) at a flow rate of 1.0 mL/min, using methanol-water containing 0.1% formic acid (39:61, v/v) as mobile phase, and total run time was 8.5 min. MS-MS detection was accomplished in multiple reaction monitoring mode with positive electrospray ionization. The monitored transitions were m/z 130.1 → 60.2 for MTF, m/z 268.2 → 116.1 for MET, m/z 284.2 → 116.1 for HMT, m/z 254.2 → 116.1 for DMT and m/z 152.3 → 110.1 for IS. The method was fully validated in terms of selectivity, linearity, accuracy, precision, stability, matrix effect and recovery over a concentration range of 19.53-40,000 ng/mL for MTF, 3.42-7,000 ng/mL for MET, 2.05-4,200 ng/mL for HMT and 1.95-4,000 ng/mL for DMT, respectively. The analytical method was successfully applied to drug interaction study of MTF and MET after oral administration of MTF and MET. Results suggested that the coadministration of MTF and MET results in a significant drug interaction in rat.

No abstract