Characteristics in gut microbiome is associated with chemotherapy-induced pneumonia in pediatric acute lymphoblastic leukemia

Abstract

Background Children with acute lymphoblastic leukemia (ALL) undergoing chemotherapy experience a relatively high risk of infection. And the disturbance of gut microbiota is generally believed to impair intestinal barrier function and may induce bacterial infections and inflammation. The study aimed to investigate the alterations in the gut microbiota and assess its relationship with chemotherapy-induced pneumonia in pediatric ALL patients. Methods We conducted a case–control study with 14 cases affected by pneumonia and 44 unaffected subjects and characterized the physiological parameters and gut microbiota by microarray-based technique. Results There were significant differences in α- and β-diversity in the affected group compared with the control group. At species level, the LEfSe analysis revealed that Enterococcus malodoratus, Ochrobactrum anthropi and Actinomyces cardiffensis were significantly abundant in the affected subjects. A receiver operating characteristic (ROC) curve yielded the area under the curve (AUC) of 0.773 for classification between the two groups. In addition, the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways involved in the bacterial secretion system were more enriched in the affected group than in the control group. Conclusions Gut microbiota alteration was associated with chemotherapy-induced pneumonia in pediatric ALL patients, which provided a new perspective on the personalized clinical care of pediatric ALL.

Randomized Double-Blind Phase II Trial of Fecal Microbiota Transplantation Versus Placebo in Allogeneic Hematopoietic Cell Transplantation and AML

“…As an example, the gut microbiota has been linked to susceptibility to respiratory tract infections. [43][44][45] Including infections unrelated to the gut microbiota in the same composite end point might have diluted a potential protective FMT effect. For safety reasons, we did not administer the study product before hematopoietic engraftment.…”

“…To evaluate the clinical efficacy of FMT when used as a prophylactic approach, we conducted a randomized, double-enhance antiinfective immunity not only against intestinal pathogens but also distant infections of extraintestinal origin, 39 and (3) various types of infection after HCT and induction chemotherapy (eg, bloodstream, 5,6,40,41 Clostridioides difficile [CDI], 42 and respiratory tract infections [43][44][45] ) have been associated with intestinal dysbiosis.…”

“…To evaluate the clinical efficacy of FMT when used as a prophylactic approach, we conducted a randomized, double-blind, placebo-controlled phase II trial using a third-party, oral encapsulated product and with a clinical primary end point. We chose infection as the primary end point because (1) it has a high clinical burden, (2) commensal microbiota enhance antiinfective immunity not only against intestinal pathogens but also distant infections of extraintestinal origin, 39 and (3) various types of infection after HCT and induction chemotherapy (eg, bloodstream, 5,6,40,41 Clostridioides difficile [CDI], 42 and respiratory tract infections 43-45 ) have been associated with intestinal dysbiosis.…”

Role of the gut microbiota in hematologic cancer

“…Streptococcus is essential in the sugar fermentation process, producing lactic acid as the main compound, which could have implications for CML progression (van den Bogert et al, 2013). Therefore, an imbalance of microbiota components could lead to proinflammatory responses, potentially triggering carcinogenesis (Liu et al, 2021). An increased Streptococcus abundance may have a deleterious effect on leukemias, whereas the Actinobacteria abundance may help to decrease the adverse effects.…”

Border Control: The Role of the Microbiome in Regulating Epithelial Barrier Function

“…Indeed, the abundance of Enterococcaceae or Streptococcaceae at any stage of chemotherapy can predict infections in children treated for acute lymphoblastic leukaemia (ALL) [188]. This was further supported by another study, demonstrating clear differences in microbiome composition between ALL patients contracting pneumonia, following chemotherapy, and unaffected ALL patients [189]. Altogether, chemotherapy-induced barrier disruption not only resulted in gastrointestinal symptoms, but also, in combination with a certain microbiome makeup, can lead to life-threatening infections.…”