Laboratory for Stem Cell Engineering and Regenerative Medicine, Department of Biosciences and Bioengineering, Indian Institute of Technology Guwahati, Guwahati, India.
Front Immunol. 2022 Jul 7;13:932228. doi: 10.3389/fimmu.2022.932228. eCollection 2022.
The human microbiota heavily influences most vital aspects of human physiology including organ transplantation outcomes and transplant rejection risk. A variety of organ transplantation scenarios such as lung and heart transplantation as well as hematopoietic stem cell transplantation is heavily influenced by the human microbiotas. The human microbiota refers to a rich, diverse, and complex ecosystem of bacteria, fungi, archaea, helminths, protozoans, parasites, and viruses. Research accumulating over the past decade has established the existence of complex cross-species, cross-kingdom interactions between the residents of the various human microbiotas and the human body. Since the gut microbiota is the densest, most popular, and most studied human microbiota, the impact of other human microbiotas such as the oral, lung, urinary, and genital microbiotas is often overshadowed. However, these microbiotas also provide critical and unique insights pertaining to transplantation success, rejection risk, and overall host health, across multiple different transplantation scenarios. Organ transplantation as well as the pre-, peri-, and post-transplant pharmacological regimens patients undergo is known to adversely impact the microbiotas, thereby increasing the risk of adverse patient outcomes. Over the past decade, holistic approaches to post-transplant patient care such as the administration of clinical and dietary interventions aiming at restoring deranged microbiota community structures have been gaining momentum. Examples of these include prebiotic and probiotic administration, fecal microbial transplantation, and bacteriophage-mediated multidrug-resistant bacterial decolonization. This review will discuss these perspectives and explore the role of different human microbiotas in the context of various transplantation scenarios.
人类微生物组严重影响人类生理学的大多数重要方面，包括器官移植的结果和移植排斥的风险。多种器官移植场景，如肺和心脏移植以及造血干细胞移植，都受到人类微生物组的严重影响。人类微生物组是指一个丰富、多样且复杂的细菌、真菌、古菌、寄生虫、原生动物、寄生虫和病毒生态系统。过去十年的研究已经确立了各种人类微生物组居民与人体之间存在复杂的跨物种、跨领域的相互作用。由于肠道微生物组是最密集、最受欢迎和研究最多的人类微生物组，因此其他人类微生物组（如口腔、肺部、尿路和生殖道微生物组）的影响往往被忽视。然而，这些微生物组也为移植成功、排斥风险和整体宿主健康提供了关键而独特的见解，涉及多种不同的移植场景。器官移植以及患者接受的移植前、移植中和移植后药物治疗方案已知会对微生物组产生不利影响，从而增加患者不良结局的风险。在过去的十年中，针对移植后患者护理的整体方法，如管理旨在恢复失调的微生物群落结构的临床和饮食干预措施，已经越来越受到关注。这些方法包括益生菌和益生元的管理、粪便微生物移植和噬菌体介导的多药耐药菌去定植。这篇综述将讨论这些观点，并探讨不同人类微生物组在各种移植场景中的作用。
