Segers Charlotte, Verslegers Mieke, Baatout Sarah, Leys Natalie, Lebeer Sarah, Mastroleo Felice
Interdisciplinary Biosciences Group, Belgian Nuclear Research Centre (SCK•CEN), Boeretang 200, 2400 Mol, Belgium.
Department of Bioscience Engineering, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium.
Microorganisms. 2019 Apr 3;7(4):97. doi: 10.3390/microorganisms7040097.
Pelvic radiotherapy has been frequently reported to cause acute and late onset gastrointestinal (GI) toxicities associated with significant morbidity and mortality. Although the underlying mechanisms of pelvic radiation-induced GI toxicity are poorly understood, they are known to involve a complex interplay between all cell types comprising the intestinal wall. Furthermore, increasing evidence states that the human gut microbiome plays a role in the development of radiation-induced health damaging effects. Gut microbial dysbiosis leads to diarrhea and fatigue in half of the patients. As a result, reinforcement of the microbiome has become a hot topic in various medical disciplines. To counteract GI radiotoxicities, apart from traditional pharmacological compounds, adjuvant therapies are being developed including food supplements like vitamins, prebiotics, and probiotics. Despite the easy, cheap, safe, and feasible approach to protect patients against acute radiation-induced toxicity, clinical trials have yielded contradictory results. In this review, a detailed overview is given of the various clinical, intestinal manifestations after pelvic irradiation as well as the role of the gut microbiome herein. Furthermore, whilst discussing possible strategies to prevent these symptoms, food supplements are presented as auspicious, prophylactic, and therapeutic options to mitigate acute pelvic radiation-induced GI injury by exploring their molecular mechanisms of action.
盆腔放疗经常被报道会导致急慢性胃肠道（GI）毒性反应，伴有显著的发病率和死亡率。尽管盆腔放疗诱发胃肠道毒性的潜在机制尚不清楚，但已知其涉及构成肠壁的所有细胞类型之间的复杂相互作用。此外，越来越多的证据表明，人类肠道微生物群在辐射诱发的健康损害效应的发展中起作用。肠道微生物失调会导致一半的患者出现腹泻和疲劳。因此，强化微生物群已成为各医学学科的热门话题。为了对抗胃肠道放射毒性，除了传统的药物化合物外，正在开发辅助疗法，包括维生素、益生元、益生菌等食品补充剂。尽管保护患者免受急性辐射诱发毒性的方法简便、廉价、安全且可行，但临床试验却得出了相互矛盾的结果。在这篇综述中，详细概述了盆腔照射后的各种临床和肠道表现以及肠道微生物群在其中的作用。此外，在讨论预防这些症状的可能策略时，通过探索其分子作用机制，将食品补充剂作为减轻急性盆腔辐射诱发胃肠道损伤的吉祥、预防和治疗选择进行了介绍。
