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Gut microbiota may impact chemotherapy- or radiation- induced gastrointestinal mucositis
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Gut microbiota may play a key role in gastrointestinal mucositis occurring in patients with cancer as a complication of chemotherapy and radiation therapy, according to research data.
Researchers performed a systematic review of literature using Medline, Scopus and Cochrane Library databases to evaluate the roles of gut microbiota in the potential prevention and treatment of chemotherapy- or radiation-induced gastrointestinal mucositis. Studies included clinical trials that evaluated changes in intestinal microbiota during cancer therapy and assessed the preventive efficacy of probiotics.
Data on patients who received cytotoxic and radiation therapy indicated decreased proportions of Bifidobacterium, Clostridium cluster XIVa and Faecalibacterium prausnitzii, and increased proportions of Enterobacteriaceae and Bacteroides. Studies have established that chemotherapy and radiation therapy can increase intestinal permeability, and because commensal bacteria regulate intestinal barrier function, “microbiota disruption could play an important role in the alterations of intestinal permeability,” the researchers wrote.
Furthermore, three out of six clinical trials investigating mucositis prevention with probiotics showed reductions in diarrhea incidence compared with placebo using Lactobacillus acidophilus (P<.01), VSL#3 (P<.001) or Lactobacillus plus Bifidobacterium bifidum (P=.002). One trial showed reductions in infection-related complications (P=.02). In another study of 94 patients undergoing chemotherapy, those with at least 30% enterococcal or Proteobacteria microbiota domination had an increased risk for bacteraemia by ninefold and fivefold, respectively, supporting the “potential role for microbiota analyses to help predict chemotherapy-induced toxicity.”
“Basic and clinical data suggest that the intestinal microbiota may plan an important role in the pathogenesis of chemo- or radiation-induced mucositis,” the researchers concluded. “Chemotherapy and irradiation induce major changes in the composition of the gut microbiota, [and] these disruptions could also participate in the development of mucositis.”
Disclosure: The researchers report no relevant financial disclosures.
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