Role of Gut Microbiota and Oxidative Stress in the Progression of Transplant-Related Complications following Hematopoietic Stem Cell Transplantation

Abstract

Hematopoietic stem cell transplantation (HSCT), also known as bone marrow transplantation, has curative potential for various hematologic malignancies but is associated with risks such as graft-versus-host disease (GvHD), severe bloodstream infection, viral pneumonia, idiopathic pneumonia syndrome (IPS), lung fibrosis, and sinusoidal obstruction syndrome (SOS), which severely deteriorate clinical outcomes and limit the wide application of HSCT. Recent research has provided important insights into the effects of gut microbiota and oxidative stress (OS) on HSCT complications. Therefore, based on recent studies, we describe intestinal dysbiosis and OS in patients with HSCT and review recent molecular findings underlying the causal relationships of gut microbiota, OS, and transplant-related complications, focusing particularly on the involvement of gut microbiota-mediated OS in postengraftment complications. Also, we discuss the use of antioxidative and anti-inflammatory probiotics to manipulate gut microbiota and OS, which have been associated with promising effects in improving HSCT outcomes.

The Critical Exploration into Current Evidence behind the Role of the Nutritional Support in Adult Patients Who Undergo Haematogenic Stem Cell Transplantation

“…Research into disorders of the naturalised intestinal flora in haematological malignancy patients has intensified in recent years. Post-HSCT patients experience changes in the gastrointestinal microbiome because of pharmacotherapy, stress, functional and intestinal dysfunction, and inflammation of their mucosa [ 107 , 108 , 109 ]. The role of the microbiome on the outcome of allo-HSCT has also been demonstrated: the dominance of enterococci in the gut correlates with the spectrum of antibiotics administered to patients and leads to reduced survival rates [ 109 ].…”

The Role of Fecal Microbiota Transplantation in the Allogeneic Stem Cell Transplant Setting

“…It has been known since the 1970s that the microbiota is involved in graft-versus-host disease (GvHD) pathogenesis, as demonstrated by the van Bekkum group in 1974, where mice raised in a germ-free environment did not develop gastrointestinal (GI) GvHD. Just recently, we have achieved a partial understanding of the panorama and the intricacies of the microbiota and GvHD [ 4 , 5 , 6 ]. The microbiota-derived signals can indirectly influence regulatory T lymphocytes (Tregs) by activating innate, gut-resident, antigen-presenting cells (APCs) known as CD103 + CD11b + dendritic cells (DCs) [ 7 ].…”