Diverse gut microbiota pattern between mild and severe cancer‐related fatigue in lung cancer patients treated with first‐line chemotherapy: A pilot study

Abstract

Background Cancer survivors perceive cancer‐related fatigue (CRF) as one of the most common symptoms. However, the potential relationship between CRF and gut microbiota has not been elucidated. Our study aimed to preliminary explore the diverse gut microbiota composition between mild and severe CRF in advanced lung cancer patients undergoing first‐line chemotherapy. Methods A total of 20 advanced lung patients treated with first‐line chemotherapy were enrolled, 10 with mild CRF and 10 with severe CRF. The self‐reported Piper Fatigue Scale and stool samples were collected from all eligible patients. The 16 S ribosomal ribonucleic acid gene was performed to analyze the intestinal microbiome. Results We identified the significantly diverse gut microbiota composition among patients with mild and severe CRF. The pattern was characterized by the increasing abundance in short‐chain fatty acid‐producing taxa for mild CRF patients (genus Lachnospiraceae‐UCG‐008 and family Lachnospiraceae, p < 0.05), whereas higher abundance in taxa related to inflammation (family Enterobacteriaceae and genus Escherichia‐Shigella, p < 0.05) for severe CRF patients. Significantly different Kyoto Encyclopedia of Genes and Genomes pathways between mild and severe CRF patients were evaluated concerning fatty acid metabolism, nucleotide metabolism, brain function, amino acid metabolism, and so on ( p < 0.05). Conclusions Our study observed a plausible association between different levels of CRF and the diverse gut microbiota composition, with increasing proinflammation taxa in severe CRF patients and anti‐inflammation taxa growing in mild CRF patients. Further studies are warranted to evaluate whether CRF can be improved by modulating the gut microbiota composition.

The Association between the Gut Microbiome and Development and Progression of Cancer Treatment Adverse Effects

“…Of the two remaining studies, Deleemans and colleagues investigated fatigue following predominantly CT for mixed cancers and observed no association between fatigue and alpha diversity or composition [52]. Finally, Wei and colleagues compared mild and severe fatigue in 20 participants with advanced lung cancer, and similar to some previous studies, reported no difference in alpha or beta diversity, but various changes in composition between the two groups [58]. Specifically, in patients with mild fatigue, there were lower levels of Enterobacteriaceae family and Escherichia-Shigella genus, both known to lead to increased inflammation, and higher levels of Lachnospiracea, known to increase SCFA production.…”

“…Of these studies that examined the influence of the gut microbiome on cancer treatmentrelated fatigue, all reported some differences in microbial composition between the participants with and without fatigue [18,31,52,[56][57][58]. The first of these was a study in 12 breast cancer survivors that reported fatigue being associated with higher alpha and beta diversity [31].…”

Management of Fatigue in Adult Survivors of Cancer: ASCO–Society for Integrative Oncology Guideline Update

“…The biology of fatigue is complex, and a variety of mechanisms have been implicated in its etiology and persistence, including dysregulation in key neurotransmitter and neuroendocrine systems, cellular metabolism, and immune and inflammatory activities, with emerging evidence in the gut microbiome. [184][185][186][187] Many of these processes are potential targets for intervention, and agents that influence these processes are currently under investigation (eg, bupropion 155 ; probiotic supplementation 188 ). With continuous advances in our understanding of the biology of CRF, there are exciting opportunities for developing and testing targeted pharmacotherapies to help manage this symptom.…”

Dextran sodium sulfate-induced colitis alters the proportion and composition of replicating gut bacteria

“…92 Lachnospiraceae UCG-008 is likely a butyrate producer, since the Lachnospiraceae family is known to contain many butyrate-producing members. [91][92][93][94] There is discrepancy between different studies as to whether Lachnospiraceae members are increased or decreased in various intestinal perturbations, and whether this is beneficial or detrimental to the host. 91,[94][95][96][97][98][99] It has been suggested that the impact of Lachnospiraceae members on the host is likely species or strain specific.…”