Takahashi Miho, Toyosaki Masako, Matsui Keiko, Machida Shinichiro, Kikkawa Eri, Ota Yoshihide, Kaneko Akihiro, Ogawa Yoshiaki, Ando Kiyoshi, Onizuka Makoto
Department of Oral and Maxillofacial Surgery, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Department of Hematology and Oncology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
Int J Hematol. 2020 Nov;112(5):690-696. doi: 10.1007/s12185-020-02958-y. Epub 2020 Aug 8.
Even though the hematopoietic stem cell transplantation (HSCT) procedure has been improved, oral mucositis (OM) is still a severe complication of the conditioning regimen. We investigated the association between OM severity and the alteration of oral bacterial flora using 16S rRNA gene-based terminal restriction fragment length polymorphism (T-RFLP) analysis in 19 consecutive patients undergoing HSCT. Oral samples were collected at pre-transplantation, at the peak of mucositis and post-engraftment. T-RFLP profiles for each timepoint were constructed into an X-Y matrix, and the distances between timepoints were calculated. Patients with severe and moderate OM had larger changes in their oral bacterial flora from before HSCT to peak of mucositis than controls (p = 0.031 and 0.016, respectively). Moreover, severe mucositis was significantly associated with an extended period of fever until engraftment, high maximum C-reactive protein levels, and prolonged periods of opioid treatment and intravenous hyper-alimentation. These findings suggest that mucositis severity is associated with the magnitude of change in the oral bacterial flora. This novel finding may help advance strategies for the prevention or treatment of OM after HSCT.
尽管造血干细胞移植（HSCT）程序已得到改进，但口腔黏膜炎（OM）仍是预处理方案的严重并发症。我们使用基于16S rRNA基因的末端限制性片段长度多态性（T-RFLP）分析，对19例连续接受HSCT的患者进行研究，以探讨OM严重程度与口腔细菌菌群变化之间的关联。在移植前、黏膜炎高峰期和植入后采集口腔样本。将每个时间点的T-RFLP图谱构建成X-Y矩阵，并计算时间点之间的距离。与对照组相比，重度和中度OM患者从HSCT前到黏膜炎高峰期口腔细菌菌群的变化更大（分别为p = 0.031和0.016）。此外，严重黏膜炎与移植前持续发热时间延长、最高C反应蛋白水平升高以及阿片类药物治疗和静脉高营养时间延长显著相关。这些发现表明，黏膜炎严重程度与口腔细菌菌群变化的幅度有关。这一新发现可能有助于推进HSCT后OM的预防或治疗策略。
