Yoshioka Kosuke, Kakihana Kazuhiko, Doki Noriko, Ohashi Kazuteru
Hematology Division, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Japan.
Hematology Division, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Japan.
Pharmacol Res. 2017 Aug;122:90-95. doi: 10.1016/j.phrs.2017.05.028. Epub 2017 May 30.
Although allogeneic stem cell transplantation (allo-SCT) is a potentially curative treatment for various hematological diseases, acute graft-versus-host disease (GVHD) is a major cause of morbidity and mortality, and its management is clinically important. Advances in biological techniques have led to great progress in understanding the complex interactions between the host and the gut microbiota. The gut microbiota clearly modulates the immune response and is associated with the pathogenesis of various disorders. Also in allo-SCT, both preclinical and clinical results indicate that the gut microbiota is closely associated with the development of acute GVHD and transplant outcomes. These results led to the idea that improvement in quantitative and/or qualitative abnormalities of microbiota (dysbiosis) may be a new treatment strategy for acute GVHD. Evaluations of therapies targeting the gut microbiota such as probiotics or fecal microbiota transplantation have just begun. Furthermore, intervention in the gut microbiota with a nutritional approach including prebiotics, postbiotics, and antibiotics selection may also be another promising treatment option for acute GVHD.
尽管异基因干细胞移植（allo-SCT）是治疗各种血液系统疾病的一种潜在治愈性疗法，但急性移植物抗宿主病（GVHD）是发病和死亡的主要原因，其管理在临床上具有重要意义。生物技术的进步在理解宿主与肠道微生物群之间的复杂相互作用方面取得了巨大进展。肠道微生物群明显调节免疫反应，并与各种疾病的发病机制相关。在allo-SCT中，临床前和临床结果均表明肠道微生物群与急性GVHD的发生和移植结果密切相关。这些结果促使人们认为，改善微生物群的定量和/或定性异常（生态失调）可能是急性GVHD的一种新治疗策略。针对肠道微生物群的疗法，如益生菌或粪便微生物群移植的评估刚刚开始。此外，采用包括益生元、后生元和抗生素选择在内的营养方法干预肠道微生物群，也可能是急性GVHD的另一种有前景的治疗选择。
