The intestinal microbiota in allogeneic hematopoietic cell transplant and graft-versus-host disease Review uri icon

Overview

MeSH Major

  • Gastrointestinal Microbiome
  • Graft vs Host Disease
  • Hematopoietic Stem Cell Transplantation
  • Intestines

abstract

  • Hematopoietic cell transplantation (HCT) is a critical treatment of patients with high-risk hematopoietic malignancies, hematological deficiencies, and other immune diseases. In allogeneic HCT (allo-HCT), donor-derived T cells recognize host tissues as foreign, causing graft-versus-host disease (GVHD) which is a main contributor to morbidity and mortality. The intestine is one of the organs most severely affected by GVHD and research has recently highlighted the importance of bacteria, particularly the gut microbiota, in HCT outcome and in GVHD development. Loss of intestinal bacterial diversity is common during the course of HCT and is associated with GVHD development and treatment with broad-spectrum antibiotics. Loss of intestinal diversity and outgrowth of opportunistic pathogens belonging to the phylum Proteobacteria and Enterococcus genus have also been linked to increased treatment-related mortality including GVHD, infections, and organ failure after allo-HCT. Experimental studies in allo-HCT animal models have shown some promising results for prebiotic and probiotic strategies as prophylaxis or treatment of GVHD. Continuous research will be important to define the relation of cause and effect for these associations between microbiota features and HCT outcomes. Importantly, studies focused on geographic and cultural differences in intestinal microbiota are necessary to define applicability of new strategies targeting the intestinal microbiota.

publication date

  • February 23, 2017

Research

keywords

  • Review

Identity

Language

  • eng

PubMed Central ID

  • PMC5324712

Digital Object Identifier (DOI)

  • 10.1182/blood-2016-09-691394

PubMed ID

  • 27940475

Additional Document Info

start page

  • 927

end page

  • 933

volume

  • 129

number

  • 8