The Gut Microbiota and Immune System Relationship in Human Graft-Versus-Host Disease

Laterza, Lucrezia; Rizzatti, Gianenrico; Gaetani, Eleonora; Chiusolo, Patrizia; Gasbarrini, Antonio

doi:10.4084/mjhid.2016.025

Cited by 64 publications

(31 citation statements)

References 95 publications

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“…Taxonomic assignments can be performed using a variety of tools that assign each sequence to a microbial taxon (bacteria, archaea, or lower eukaryotes) at different taxonomic levels according to phyla, classes, orders, families, genera, and species [2]. In each body district, only a few phyla are represented, accounting for hundreds of bacterial species [5] (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

The lung microbiome: clinical and therapeutic implications

et al. 2019

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The human respiratory tract, usually considered sterile, is currently being investigated for human-associated microbial communities. According to Dickson's conceptual model, the lung microbiota (LMt) is a dynamic ecosystem, whose composition, in healthy lungs, is likely to reflect microbial migration, reproduction, and elimination. However, which microbial genera constitutes a "healthy microbiome" per se remains hotly debated. It is now widely accepted that a bi-directional gut-lung axis connects the intestinal with the pulmonary microbiota and that the diet could have a role in modulating both microbiotas as in health as in pathological status. The LMt is altered in numerous respiratory disorders such as obstructive airway diseases, interstitial lung diseases, infections, and lung cancer. Some authors hypothesize that the use of specific bacterial strains, termed "probiotics," with positive effects on the host immunity and/or against pathogens, could have beneficial effects in the treatment of intestinal disorders and pulmonary diseases. In this manuscript, we have reviewed the literature available on the LMt to delineate and discuss the potential relationship between composition alterations of LMt and lung diseases. Finally, we have reported some meaningful clinical studies that used integrated probiotics' treatments to contrast some lung-correlated disorders.

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Section: Introductionmentioning

confidence: 99%

The lung microbiome: clinical and therapeutic implications

et al. 2019

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“…Previous studies have demonstrated the complex and multidirectional interactions between inflammation, microbiota, and immune reconstitution in allotransplant recipients ( 39 – 43 ). Allo-HSCT can alter the intestinal flora and this may then be more pronounced in individuals with cGVHD ( 39 – 41 ). The human gut microbiome is involved in vital biological functions, such as maintenance of immune homeostasis, modulation of intestinal function and metabolic regulation; disturbances of the intestinal microbiota can thereby be associated with development and progression of inflammation, including GVHD ( 44 ).…”

Section: Discussionmentioning

confidence: 99%

Patients with Treatment-Requiring Chronic Graft versus Host Disease after Allogeneic Stem Cell Transplantation Have Altered Metabolic Profiles due to the Disease and Immunosuppressive Therapy: Potential Implication for Biomarkers

et al. 2018

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Chronic graft versus host disease (cGVHD) is a common long-term complication after allogeneic hematopoietic stem cell transplantation. The objective of our study was to compare the metabolic profiles for allotransplant recipients and thereby identify metabolic characteristics of patients with treatment-requiring cGVHD. The study included 51 consecutive patients (29 men and 22 women; median age: 44 years, range: 15–66 years) transplanted with peripheral blood stem cells derived from human leukocyte antigen-matched family donors. All serum samples investigated by global metabolomic profiling were collected approximately 1 year posttransplant (median 358 days). Thirty-one of the 51 patients (61%) had cGVHD 1 year posttransplant. The affected organs were (number of patients) liver/bile duct (23), eyes (15), gastrointestinal tract (14), skin (13), mouth (10), lungs (3), and urogenital tract (1). We compared the metabolic profile for patients with and without cGVHD, and a Random Forrest Classification Analysis then resulted in 75% accuracy in differentiating the two groups. The 30 top-ranked metabolites from this comparison included increased levels of bile acids, several metabolites from the cytokine-responsive kynurenine pathway for tryptophan degradation, pro-inflammatory lipid metabolites, phenylalanine and tyrosine metabolites derived from the gut microbial flora, and metabolites reflecting increased oxidative stress. However, nine of these 30 top-ranked metabolites were probably altered due to cyclosporine or steroid treatment, and we therefore did a hierarchical clustering analysis including all 51 patients but only based on the other 21 cGVHD-specific metabolites. This analysis identified three patient subsets: one cluster included mainly patients without cGVHD and had generally low metabolite levels; another cluster included mainly patients with cGVHD (most patients with at least three affected organs) and high metabolite levels, and the last intermediate group including cGVHD patients with limited organ involvement. We conclude that allotransplant recipients with cGVHD have an altered metabolic profile caused both by the disease and its immunosuppressive treatment.

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“…A modern approach to the problem of BSIs is probably the investigation of the patients’ microbioma before allo-SCT. Some data from the literature reported that intestinal domination, defined as occupation of at least 30 % of the microbiota by a single bacterial taxon, is associated with BSI in patients undergoing allo-SCT, that the gut microbiota can identify high-risk patients before allo-SCT and that manipulation of the gut microbiota for prevention of BSIs in high-risk patients may be a useful direction for future research 30,31,32. Thus, in the near future, we will probably need to include this analysis in the baseline work up and in the follow up of patients addressed to allo-SCT.…”

Section: Discussionmentioning

confidence: 99%

Bacterial Blood Stream Infections Negatively Impact on Outcome of Patients Treated With Allogeneic Stem Cell Transplantation: 6 Years Single-Centre Experience

Malagola

2017

Mediterr J Hematol Infect Dis

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BackgroundBlood stream infections (BSIs) represent a major complication of allo-SCT and are a major cause of morbidity and mortality during and after bone marrow aplasia.ObjectivesThe objective of this study was to describe the incidence and outcome of BSIs in a cohort of patients submitted to allo-SCT, in order to track changes of the epidemiology and bacteria resistance.MethodsWe retrospectively analyzed the microbiological data of 162 patients allotransplanted in Brescia University Hospital, over a period of 6 years.ResultsEighty patients experienced a BSIs for a total of 119 isolates. In 77 cases (65%) a Gram positive bacteria was isolated, being coagulase negative Staphilococci the most frequent species (77% of the cases). In 42 cases (35%) a Gram negative bacteria was isolated (E. coli 57% and P. aeruginosa 24%). Fluoroquinolones resistance was frequent (90% for S. epidermidis, 92% for E. coli, 90% for P. aeruginosa). Methycillin resistance of S. epidermidis was 100%, 76% of E. coli were ESBL positive and among P. aeruginosa resistance to carbapenems was 40%. The 2 years overall survival of patients with BSIs vs patients without BSIs was 46% vs 60% (HR1,48, p=0,07). P. aeruginosa and E. coli were the species with the highest mortality (50% and 33%, respectively).ConclusionsThese data confirm that BSIs, mainly sustained by Gram positive bacteria, are frequent in allotransplanted patients (50% of the cases) and may influence the outcome of allotransplanted patients, being antibiotics resistance highly frequent among these bacteria.

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The Gut Microbiota and Immune System Relationship in Human Graft-Versus-Host Disease

Cited by 64 publications

References 95 publications

The lung microbiome: clinical and therapeutic implications

The lung microbiome: clinical and therapeutic implications

Patients with Treatment-Requiring Chronic Graft versus Host Disease after Allogeneic Stem Cell Transplantation Have Altered Metabolic Profiles due to the Disease and Immunosuppressive Therapy: Potential Implication for Biomarkers

Bacterial Blood Stream Infections Negatively Impact on Outcome of Patients Treated With Allogeneic Stem Cell Transplantation: 6 Years Single-Centre Experience

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