Department of Gastroenterology and Hepatology, General Hospital, Tianjin Medical University, Tianjin, China.
Int J Cancer. 2019 Oct 15;145(8):2021-2031. doi: 10.1002/ijc.32003. Epub 2018 Dec 30.
The human gut is home to a large and diverse microbial community, comprising about 1,000 bacterial species. The gut microbiota exists in a symbiotic relationship with its host, playing a decisive role in the host's nutrition, immunity and metabolism. Accumulating studies have revealed the associations between gut dysbiosis or some special bacteria and various cancers. Emerging data suggest that gut microbiota can modulate the effectiveness of cancer therapies, especially immunotherapy. Manipulating the microbial populations with therapeutic intent has become a hot topic of cancer research, and the most dramatic manipulation of gut microbiota refers to fecal microbiota transplantation (FMT) from healthy individuals to patients. FMT has demonstrated remarkable clinical efficacy against Clostridium difficile infection (CDI) and it is highly recommended for the treatment of recurrent or refractory CDI. Lately, interest is growing in the therapeutic potential of FMT for other diseases, including cancers. We briefly reviewed the current researches about gut microbiota and its link to cancer, and then summarized the recent preclinical and clinical evidence to indicate the potential of FMT in cancer management as well as cancer-treatment associated complications. We also presented the rationale of FMT for cancer management such as reconstruction of intestinal microbiota, amelioration of bile acid metabolism, and modulation of immunotherapy efficacy. This article would help to better understand this new therapeutic approach for cancer patients by targeting gut microbiota.
人类肠道是一个庞大而多样的微生物群落的家园,其中包含约 1000 种细菌。肠道微生物群与宿主处于共生关系,对宿主的营养、免疫和代谢起着决定性作用。越来越多的研究揭示了肠道菌群失调或某些特殊细菌与各种癌症之间的关联。新出现的数据表明,肠道微生物群可以调节癌症治疗的效果,特别是免疫疗法。出于治疗目的而操纵微生物群已成为癌症研究的热门话题,对肠道微生物群最显著的操纵是将来自健康个体的粪便微生物群移植(FMT)到患者体内。FMT 已被证明对艰难梭菌感染(CDI)具有显著的临床疗效,强烈推荐用于治疗复发性或难治性 CDI。最近,人们对 FMT 在其他疾病(包括癌症)中的治疗潜力产生了兴趣。我们简要回顾了目前关于肠道微生物群及其与癌症的联系的研究,并总结了最近的临床前和临床证据,以表明 FMT 在癌症管理以及癌症治疗相关并发症中的潜在应用。我们还提出了 FMT 用于癌症管理的原理,例如重建肠道微生物群、改善胆汁酸代谢和调节免疫疗法的疗效。本文通过针对肠道微生物群,帮助更好地理解这种针对癌症患者的新治疗方法。
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