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Gut microbiota play a major role in chemotherapy-induced gastrointestinal mucositis

The most recent issue of the Alimentary Pharmacology & Therapeutics examines the role of the gut microbiota in chemotherapy- or radiation-induced gastrointestinal mucositis.

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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.

Dr Touchefeu and colleagues from France assessed 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.

The research team performed a search of the literature published in English using Medline, Scopus and the Cochrane Library, with main search terms ‘intestinal microbiota’, ‘bacteremia’, ‘mucositis’, ‘chemotherapy-induced diarrhea’, ‘chemotherapy-induced mucositis’, ‘radiotherapy-induced mucositis’.

The gut microbiota plays a major role in the maintenance of intestinal homoeostasis and integrity.

3 of 6 trials reported a significantly decreased incidence of diarrhea
Alimentary Pharmacology & Therapeutics

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.

The team noted that these modifications may contribute to the development of mucositis, particularly diarrhea and bacteremia.

The prevention of cancer therapy-induced mucositis by probiotics has been investigated in randomized clinical trials with some promising results.

The researchers observed that 3 of 6 trials reported a significantly decreased incidence of diarrhea.

One trial reported a decrease in infectious complications.

Dr Touchefeu's team commented, "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."

Alimentary Pharmacology & Ther 2014: 40(5): 409–421
20 August 2014

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