Department of Paediatrics I, University Children's Hospital Heidelberg, Heidelberg, Germany.
Structural and Computational Biology Unit, European Molecular Biology Laboratory, Heidelberg, Germany.
Pediatr Transplant. 2020 Nov;24(7):e13866. doi: 10.1111/petr.13866. Epub 2020 Sep 30.
Despite ground-breaking advances in allogeneic transplantation, allograft rejection and immunosuppressant-specific complications remain a major challenge in transplant medicine. Growing evidence suggests the human gut microbiome as a potential contributor to transplant outcome and patient health. After breakthrough findings in haematopoietic stem cell transplantation (HSCT), the relevance of the microbiome in solid organ transplantation (SOT) is becoming increasingly clear. Here, we review the role of the microbiome in SOT focusing on its significance for transplant-associated complications such as allograft rejection and infections, and highlight its potential impact on immunosuppressive treatment. Moreover, we shed light on the emerging role of the microbiome as a diagnostic biomarker and therapeutic target and discuss current microbial intervention strategies. In addition, this review includes some practical considerations in designing clinical microbiome trials and offers some advice for the interpretation of the resulting data. Further investigation of the gut microbiome harbours countless clinical application possibilities and holds great promise of having a lasting impact on transplant medicine.
尽管同种异体移植取得了突破性进展，但移植物排斥和免疫抑制剂特异性并发症仍然是移植医学中的主要挑战。越来越多的证据表明，人类肠道微生物组可能是移植结果和患者健康的一个潜在影响因素。在造血干细胞移植 (HSCT) 取得突破性发现之后，微生物组在实体器官移植 (SOT) 中的相关性变得越来越明显。在这里，我们回顾了微生物组在 SOT 中的作用，重点关注其对移植相关并发症（如移植物排斥和感染）的意义，并强调其对免疫抑制治疗的潜在影响。此外，我们还介绍了微生物组作为诊断生物标志物和治疗靶点的新兴作用，并讨论了当前的微生物干预策略。此外，本综述还包括在设计临床微生物组试验时的一些实际考虑因素，并就解释由此产生的数据提供了一些建议。进一步研究肠道微生物组具有无数的临床应用可能性，并有望对移植医学产生持久影响。
