Alexander Tobias, Snowden John A, Burman Joachim, Chang Hyun-Dong, Del Papa Nicoletta, Farge Dominique, Lindsay James O, Malard Florent, Muraro Paolo A, Nitti Rosamaria, Salas Azucena, Sharrack Basil, Mohty Mohamad, Greco Raffaella
Department of Rheumatology and Clinical Immunology - Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and the Berlin Institute of Health (BIH), Berlin, Germany.
Deutsches Rheuma-Forschungszentrum (DRFZ Berlin) - a Leibniz Institute, Berlin, Germany.
Front Oncol. 2021 Oct 22;11:722436. doi: 10.3389/fonc.2021.722436. eCollection 2021.
Over the past decades, hematopoietic stem cell transplantation (HSCT) has been evolving as specific treatment for patients with severe and refractory autoimmune diseases (ADs), where mechanistic studies have provided evidence for a profound immune renewal facilitating the observed beneficial responses. The intestinal microbiome plays an important role in host physiology including shaping the immune repertoire. The relationships between intestinal microbiota composition and outcomes after HSCT for hematologic diseases have been identified, particularly for predicting the mortality from infectious and non-infectious causes. Furthermore, therapeutic manipulations of the gut microbiota, such as fecal microbiota transplant (FMT), have emerged as promising therapeutic approaches for restoring the functional and anatomical integrity of the intestinal microbiota post-transplantation. Although changes in the intestinal microbiome have been linked to various ADs, studies investigating the effect of intestinal dysbiosis on HSCT outcomes for ADs are scarce and require further attention. Herein, we describe some of the landmark microbiome studies in HSCT recipients and patients with chronic ADs, and discuss the challenges and opportunities of microbiome research for diagnostic and therapeutic purposes in the context of HSCT for ADs.
在过去几十年中，造血干细胞移植（HSCT）已逐渐发展成为治疗重症和难治性自身免疫性疾病（AD）患者的特异性疗法，其中机制研究已为深度免疫更新提供了证据，这种免疫更新促进了所观察到的有益反应。肠道微生物群在宿主生理中发挥着重要作用，包括塑造免疫库。肠道微生物群组成与血液系统疾病HSCT后结局之间的关系已被确定，特别是在预测感染性和非感染性原因导致的死亡率方面。此外，肠道微生物群的治疗性操控，如粪便微生物群移植（FMT），已成为恢复移植后肠道微生物群功能和解剖完整性的有前景的治疗方法。尽管肠道微生物群的变化已与各种AD相关联，但研究肠道生态失调对AD患者HSCT结局影响的研究很少，需要进一步关注。在此，我们描述了HSCT受者和慢性AD患者中一些具有里程碑意义的微生物群研究，并讨论了在AD的HSCT背景下，微生物群研究用于诊断和治疗目的的挑战与机遇。
