Newly Developed Synbiotics and the Chemotherapy-Damaged Gut

Abstract

Mucositis is a common side-effect of cancer chemotherapy and radiotherapy. Features of mucositis include erythema, ulceration, and inflammation of the gastrointestinal tract accompanied by clinical symptoms of abdominal pain and digestive disturbances. New treatment strategies are required. Experimental evidence is accumulating showing therapeutic promise for new nutraceutical agents including probiotic bacteria, probiotic-derived factors, prebiotics, and plant extracts. However, the targeted development of new combinations of these agents (synbiotics) to combat mucositis remains largely unexplored. The current review addresses the potential for these nutraceutical agents to reduce the severity of chemotherapy-damaged mucositis by strategically aligning their underlying mechanism of action with features of mucositis pathogenesis. The potential for certain plant extracts to act as prebiotics, in combination with probiotics or their derived factors, is further investigated. These unique synbiotic formulations could form the basis of a new naturally sourced adjunctive approach to cancer chemotherapy.

Synbiotics as Supplemental Therapy for the Alleviation of Chemotherapy-Associated Symptoms in Patients with Solid Tumours

“…Cancer treatment depends on the type and stages of the disease [ 3 , 4 ]. Cancer treatment options include chemotherapy, radiotherapy, surgery, immunotherapy, and monoclonal antibody therapy [ 5 ]. Despite recent advances in cancer treatments, chemotherapy is still a cornerstone of cancer therapy [ 5 , 6 ].…”

The gastrointestinal antibiotic resistome in pediatric leukemia and lymphoma patients

“…To reduce infection related morbidity and mortality broad-spectrum antipseudomonal b-lactams, vancomycin and aminoglycosides are given frequently and often for extended periods of time (Lehrnbecher et al, 2017), which can result in dysbiosis or an "imbalance" in the gastrointestinal (GI) microbiome (Dethlefsen et al, 2008;Dethlefsen and Relman, 2011;Vangay et al, 2015;Iizumi et al, 2017). Children with leukemia and lymphoma are also subjected to high doses of chemotherapy over a period of many months to years and this can affect the integrity of the gastrointestinal tract (GIT) barrier (Keefe et al, 2000;Duncan and Grant, 2003;Wang et al, 2013). The loss of GIT integrity increases the chance that members of the dysbiotic GIT microbial community can cross the GI barrier, including those with antibiotic resistance genes (ARGs) (Sonis, 2004;Stringer et al, 2009;Huddleston, 2014).…”