Systematic review: the role of the gut microbiota in chemotherapy- or radiation-induced gastrointestinal mucositis - current evidence and potential clinical applications
| Autor: | Thomas Gastinne, Emmanuel Montassier, F. Le Vacon, Gilles Potel, S. Bruley des Varannes, Yann Touchefeu, M. F. de La Cochetière, Kristin M Nieman |
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| Rok vydání: | 2014 |
| Předmět: |
Diarrhea
Mucositis medicine.medical_specialty medicine.medical_treatment Faecalibacterium prausnitzii Antineoplastic Agents Gut flora Gastroenterology Neoplasms Internal medicine Animals Humans Medicine Pharmacology (medical) Radiation Injuries Bifidobacterium Gastrointestinal tract Chemotherapy Hepatology biology business.industry Microbiota Probiotics Cancer biology.organism_classification medicine.disease Intestines Clinical trial Intestinal Diseases Immunology business |
| Zdroj: | Alimentary Pharmacology & Therapeutics. |
| ISSN: | 0269-2813 |
| Popis: | SummaryBackground Gastrointestinal mucositis is defined as inflammation and/or ulcers of the gastrointestinal tract occurring as a complication of chemotherapy and radiation therapy, and affects about 50% of all cancer patients. Aim To assess the role of gut microbiota in the pathogenesis of gastrointestinal mucositis and the potential for manipulations of the microbiota to prevent and to treat mucositis. Methods Search of the literature published in English using Medline, Scopus and the Cochrane Library, with main search terms ‘intestinal microbiota’, ‘bacteremia’, ‘mucositis’, ‘chemotherapy-induced diarrhoea’, ‘chemotherapy-induced mucositis’, ‘radiotherapy-induced mucositis’. Results The gut microbiota plays a major role in the maintenance of intestinal homoeostasis and integrity. Patients receiving cytotoxic and radiation therapy exhibit marked changes in intestinal microbiota, with most frequently, decrease in Bifidobacterium, Clostridium cluster XIVa, Faecalibacterium prausnitzii, and increase in Enterobacteriaceae and Bacteroides. These modifications may contribute to the development of mucositis, particularly diarrhoea and bacteraemia. The prevention of cancer therapy-induced mucositis by probiotics has been investigated in randomised clinical trials with some promising results. Three of six trials reported a significantly decreased incidence of diarrhoea. One trial reported a decrease in infectious complications. Conclusions The gut microbiota may play a major role in the pathogenesis of mucositis through the modification of intestinal barrier function, innate immunity and intestinal repair mechanisms. Better knowledge of these effects may lead to new therapeutic approaches and to the identification of predictive markers of mucositis. |
| Databáze: | OpenAIRE |
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