The gut microbiota as a booster for radiotherapy: novel insights into radio-protection and radiation injury

Experimental Hematology & Oncology

Review

Zhen Zhang¹  Lijun Shen¹  Weiqing Lu¹  Yuxi Yi¹  Yang Wu² 

[1] Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China;Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China;Shanghai Clinical Research Center for Radiation Oncology, Shanghai, China;Shanghai Key Laboratory of Radiation Oncology, Shanghai, China;Key Laboratory of Medical Molecular Virology (MOE/NHC/CAMS), Shanghai Frontiers Science Center of Pathogenic Microorganisms and Infection, School of Basic Medical Sciences, Shanghai Medical College, Fudan University, Shanghai, China;

关键词: Gut microbiota;    Radio-protection;    Lactobacillus;    Akkermansia;    Short chain fatty acid;    Microbiota transplantation;    Probiotic;    Toll-like receptor;   

DOI  :  10.1186/s40164-023-00410-5

 received in 2023-01-07, accepted in 2023-05-04,  发布年份 2023

来源: Springer

【 摘 要 】

Approximately 60–80% of cancer patients treated with abdominopelvic radiotherapy suffer post-radiotherapy toxicities including radiation enteropathy and myelosuppression. Effective preventive and therapeutic strategies are lacking for such radiation injury. The gut microbiota holds high investigational value for deepening our understanding of the pathogenesis of radiation injury, especially radiation enteropathy which resembles inflammatory bowel disease pathophysiology and for facilitating personalized medicine by providing safer therapies tailored for cancer patients. Preclinical and clinical data consistently support that gut microbiota components including lactate-producers, SCFA-producers, indole compound-producers and Akkermansia impose intestinal and hematopoietic radio-protection. These features serve as potential predictive biomarkers for radiation injury, together with the microbial diversity which robustly predicts milder post-radiotherapy toxicities in multiple types of cancer. The accordingly developed manipulation strategies including selective microbiota transplantation, probiotics, purified functional metabolites and ligands to microbe-host interactive pathways are promising radio-protectors and radio-mitigators that merit extensive validation in clinical trials. With massive mechanistic investigations and pilot clinical trials reinforcing its translational value the gut microbiota may boost the prediction, prevention and mitigation of radiation injury. In this review, we summarize the state-of-the-art landmark researches related with radio-protection to provide illuminating insights for oncologists, gastroenterologists and laboratory scientists interested in this overlooked complexed disorder.

【 授权许可】

CC BY   
© The Author(s) 2023