Curr Opin Organ Transplant. 2019 Dec;24(6):679-686. doi: 10.1097/MOT.0000000000000702.
The microbiota in mammalian hosts can affect maturation and function of the immune system and has been associated with health and disease. We will review new findings on how this dynamic environmental factor impacts alloimmunity and therapy in transplant hosts.
The microbiota changes after transplantation and immunosuppressive therapy. New data indicate that different microbial community structures have distinct impact on graft outcome, from promoting, to inhibiting or being neutral to transplant survival. In addition, we will address reciprocal interactions between the microbiota and immunosuppressive drugs, as well as the suitability of the microbiota as a predictive biomarker and its utility as adjunct therapy in transplantation.
Advances in microbiome sequencing and wider availability of gnotobiotic facilities are enabling mechanistic investigations into the commensal communities and pathways that modulate allograft outcome, responsiveness to immunosuppression and side effects of drugs. A better understanding of the functions of the microbiota may help mitigate drug toxicity, predict drug dosage and dampen alloimmunity in transplant patients.
哺乳动物宿主中的微生物群会影响免疫系统的成熟和功能，并与健康和疾病有关。我们将回顾有关这种动态环境因素如何影响移植宿主中的同种异体免疫和治疗的新发现。
移植和免疫抑制治疗后，微生物群会发生变化。新数据表明，不同的微生物群落结构对移植物的结果具有不同的影响，从促进、抑制或对移植存活无影响。此外，我们将讨论微生物群与免疫抑制药物之间的相互作用，以及微生物群作为预测生物标志物的适宜性及其在移植中的辅助治疗作用。
宏基因组测序技术的进步和无菌设施的广泛应用，使我们能够对调节移植物结果、对免疫抑制药物的反应性以及药物副作用的共生群落和途径进行机制研究。更好地了解微生物群的功能可以帮助减轻药物毒性、预测药物剂量并抑制移植患者的同种异体免疫。
