Impact of oral microbiota on pathophysiology of GVHD

Yamamoto, Akira; Kambara, Yui; Fujiwara, Hideaki

doi:10.3389/fimmu.2023.1132983

Cited by 3 publications

(2 citation statements)

References 146 publications

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“…Prolonged salivary gland cGVHD is associated with increased albumin, sodium, and anti-microbial proteins, such as lactoferrin ( 47 , 72 , 119 , 127 ). It is noteworthy to recognize that the interaction of and changes to the microbiota in oral cGVHD remains under explored and an area for potential future research ( 128 , 129 ).…”

Section: Gvhd Pathophysiology and Biological Phasesmentioning

confidence: 99%

Perspectives on oral chronic graft-versus-host disease from immunobiology to morbid diagnoses

2023

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Chronic Graft-versus-Host Disease (cGVHD) is a major long-term complication, associated with morbidity and mortality in patients following allogenic hematopoietic cell transplantation (HCT) for immune hematopoietic disorders. The mouth is one of the most frequently affected organs after HCT (45-83%) and oral cGVHD, which may appear as the first visible sign. Manifestations present with mucosal lichenoid lesions, salivary gland dysfunction and limited oral aperture. Diagnosis of oral cGVHD severity is based on mucosal lesions with symptoms of sensitivity and pain and reduced oral intake. However, diagnostic difficulties arise due to subjective definitions and low specificity to cover the spectrum of oral cGVHD. In recent years there have been significant improvements in our understanding of the underlying oral cGVHD disease mechanisms. Drawing upon the current knowledge on the pathophysiology and biological phases of oral cGVHD, we address oral mucosa lichenoid and Sjogren’s Syndrome-like sicca syndromes. We consider the response of alloreactive T-cells and macrophages to recipient tissues to drive the pathophysiological reactions and biological phases of acute inflammation (phase 1), chronic inflammation and dysregulated immunity (phase 2), and subsequent aberrant fibrotic healing (phase 3), which in time may be associated with an increased malignant transformation rate. When formulating treatment strategies, the pathophysiological spectrum of cGVHD is patient dependent and not every patient may progress chronologically through the biological stages. As such there remains a need to address and clarify personalized diagnostics and management to improve treatment descriptions. Within this review, we highlight the current state of the art knowledge on oral cGVHD pathophysiology and biological phases. We address knowledge gaps of oral cGVHD, with a view to facilitate clinical management and improve research quality on lichenoid biology and morbid forms of oral cGVHD.

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Section: Gvhd Pathophysiology and Biological Phasesmentioning

confidence: 99%

Perspectives on oral chronic graft-versus-host disease from immunobiology to morbid diagnoses

2023

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“…An increasing number of studies have shown that chemotherapy, reduction of oral intake, and broad-spectrum antibiotics play important roles in the pathophysiology of GvHD through the loss of gut microbiota diversity and the domination of a single bacterial taxon. The composition of oral and gut microbiota influences GvHD occurrence and severity [17,18]. One study revealed the role of Actinomyces and Prevotella melaninogenica in the oral cavity and of Lactobacillus in the gut of children before the allo-HCT procedure in predicting severe (grade III-IV) GvHD.…”

Section: Key Pointsmentioning

confidence: 99%

Nutritional interventions in patients with graft-versus-host disease

Séguy

Hueso

2023

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review This review aims to highlight the benefits of nutrition before and during graft-versus-host disease (GvHD) and the promising precision medicine approach that should be offered to prevent and mitigate GvHD. Recent findings The intestinal damage induced by preconditioning/conditioning chemotherapies is the main trigger of GvHD. Impaired nutritional status and decreased plasma citrulline level, which is the most sensitive biomarker of intestinal barrier health, predict the occurrence of acute GvHD after allogeneic hematopoietic cell transplantation (allo-HCT). Optimal oral and/or enteral nutrition and a lack of vitamin D deficiency limit this intestinal damage. As intestinal dysbiosis plays an important role in GvHD, probiotics and prebiotics supplementation could be a promising therapy. Diverting enterostomy combined with parenteral nutrition saves the lives of patients with severe steroid-refractory gastrointestinal GvHD. Summary Regardless of age, healthy nutritional status and a healthy gut barrier are protective factors against GvHD in patients undergoing allo-HCT, and above all, these are closely dependent on adequate oral and/or enteral intake. Therefore, maintaining gut barrier integrity through adequate oral nutrition before allo-SCT and early first-line enteral nutrition after allo-HCT are of critical importance, not forgetting vitamin D supplementation. In the future, probiotics and prebiotics are expected to play a growing role for replenishing the commensal microbiota given the impact of gut dysbiosis on GvHD. Parenteral nutrition remains the only nutritional support that can be used in the event of severe gastrointestinal GvHD.

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The Oral–Gut–Brain Axis: The Influence of Microbes as a Link of Periodontitis With Ischemic Stroke

Zhong,

Kang,

Bai

et al. 2024

CNS Neurosci Ther

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Periodontitis, a non‐communicable chronic inflammation disease resulting from dysbiosis of the oral microbiota, has been demonstrated to have a positive association with the risk of ischemic stroke (IS). The major periodontal pathogens contribute to the progression of stroke‐related risk factors such as obesity, diabetes, atherosclerosis, and hypertension. Transcriptional changes in periodontitis pathogens have been detected in oral samples from stroke patients, suggesting a new conceptual framework involving microorganisms. The bidirectional regulation between the gut and the central nervous system (CNS) is mediated by interactions between intestinal microflora and brain cells. The connection between the oral cavity and gut through microbiota indicates that the oral microbial community may play a role in mediating complex communication between the oral cavity and the CNS; however, underlying mechanisms have yet to be fully understood. In this review, we present an overview of key concepts and potential mechanisms of interaction between the oral–gut–brain axis based on previous research, focusing on how the oral microbiome (especially the periodontal pathogens) impacts IS and its risk factors, as well as the mediating role of immune system homeostasis, and providing potential preventive and therapeutic approaches.

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Impact of oral microbiota on pathophysiology of GVHD

Cited by 3 publications

References 146 publications

Perspectives on oral chronic graft-versus-host disease from immunobiology to morbid diagnoses

Perspectives on oral chronic graft-versus-host disease from immunobiology to morbid diagnoses

Nutritional interventions in patients with graft-versus-host disease

The Oral–Gut–Brain Axis: The Influence of Microbes as a Link of Periodontitis With Ischemic Stroke

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