TY - JOUR
T1 - Pitfalls and novel experimental approaches to optimize microbial interventions for chemotherapy-induced gastrointestinal mucositis
AU - da Silva Ferreira, Ana R
AU - Wardill, Hannah R
AU - Tissing, Wim J E
AU - Harmsen, Hermie J M
PY - 2020/6
Y1 - 2020/6
N2 - PURPOSE OF REVIEW: There is a growing number of studies implicating gut dysbiosis in mucositis development. However, few studies have shed light on the causal relationship limiting translational potential. Here, we detail the key supportive evidence for microbial involvement, candidate mechanisms by which the microbiome may contribute to mucositis and emerging approaches to model host-microbe interactions with clinical relevance and translational potential.RECENT FINDINGS: Synthesis of existing clinical data demonstrate that modulating the microbiome drastically alters the development and severity of mucositis, providing a strong rationale for its involvement. Review of the literature revealed potential microbiome-dependent mechanisms of mucosal injury including altered drug metabolism, bile acid synthesis and regulation of the intestinal barrier. Current studies are limited in their mechanistic insight due to cross-sectional and would benefit from longitudinal analyses and baseline phenotyping.SUMMARY: The causative role of the microbiome in mucositis development remains unclear. Future studies must adopt comprehensive microbial analyses with functional assessment, and utilize emerging ex-vivo models to interrogate host-microbe interactions in mucositis.
AB - PURPOSE OF REVIEW: There is a growing number of studies implicating gut dysbiosis in mucositis development. However, few studies have shed light on the causal relationship limiting translational potential. Here, we detail the key supportive evidence for microbial involvement, candidate mechanisms by which the microbiome may contribute to mucositis and emerging approaches to model host-microbe interactions with clinical relevance and translational potential.RECENT FINDINGS: Synthesis of existing clinical data demonstrate that modulating the microbiome drastically alters the development and severity of mucositis, providing a strong rationale for its involvement. Review of the literature revealed potential microbiome-dependent mechanisms of mucosal injury including altered drug metabolism, bile acid synthesis and regulation of the intestinal barrier. Current studies are limited in their mechanistic insight due to cross-sectional and would benefit from longitudinal analyses and baseline phenotyping.SUMMARY: The causative role of the microbiome in mucositis development remains unclear. Future studies must adopt comprehensive microbial analyses with functional assessment, and utilize emerging ex-vivo models to interrogate host-microbe interactions in mucositis.
KW - Antineoplastic Agents/adverse effects
KW - Bile Acids and Salts/biosynthesis
KW - Cross-Sectional Studies
KW - Dysbiosis/chemically induced
KW - Gastrointestinal Microbiome/drug effects
KW - Humans
KW - Mucositis/chemically induced
KW - Prebiotics/administration & dosage
KW - Probiotics/administration & dosage
KW - Radiotherapy/adverse effects
KW - Severity of Illness Index
U2 - 10.1097/SPC.0000000000000497
DO - 10.1097/SPC.0000000000000497
M3 - Review article
C2 - 32324645
VL - 14
SP - 127
EP - 134
JO - Current opinion in supportive and palliative care
JF - Current opinion in supportive and palliative care
SN - 1751-4258
IS - 2
ER -