Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Division of Hematology, Oncology, and Transplantation, Department of Medicine, University of Minnesota, Minneapolis, Minnesota.
Transl Res. 2020 Jun;220:167-181. doi: 10.1016/j.trsl.2020.03.011. Epub 2020 Apr 5.
Despite advances in antimicrobial treatments, infection remains a common complication of intensive chemotherapy in patients with acute leukemia. It has become progressively apparent that the current antimicrobial focus has shortcomings that result from disruption of the commensal microbial communities of the gut. These effects, collectively known as dysbiosis, have been increasingly associated worldwide with growing complications such as Clostridioides difficile infection, systemic infections, and antibiotic resistance. A revision of the current practice is overdue. Several innovative concepts have been proposed and tested in animal models and humans, with the overarching goal of preventing damage to the microbiota and facilitating its recovery. In this review, we discuss these approaches, examine critical knowledge gaps, and explore how they may be filled in future research.
尽管在抗菌治疗方面取得了进展，但感染仍然是急性白血病患者强化化疗的常见并发症。目前的抗菌重点存在缺陷，这是由于肠道共生微生物群落的破坏，这一点变得越来越明显。这些影响被统称为“菌群失调”，已在全球范围内与越来越多的并发症（如艰难梭菌感染、全身感染和抗生素耐药性）相关联。当前实践的修订已经迫在眉睫。一些创新理念已经在动物模型和人类中提出并进行了测试，其首要目标是防止微生物组受损并促进其恢复。在这篇综述中，我们讨论了这些方法，检查了关键的知识空白，并探讨了如何在未来的研究中填补这些空白。
