Hwang Sung Wook, Kim Min Kyu, Kweon Mi-Na
Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Mucosal Immunology Laboratory, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Intest Res. 2023 Oct;21(4):433-442. doi: 10.5217/ir.2023.00019. Epub 2023 Aug 29.
Immune checkpoint inhibitors have dramatically revolutionized the therapeutic landscape for patients with advanced malignancies. Recently, convincing evidence has shown meaningful influence of gut microbiome on human immune system. With the complex link between gut microbiome, host immunity and cancer, the variations in the gut microbiota may influence the efficacy of immune checkpoint inhibitors. Indeed, some bacterial species have been reported to be predictive for cancer outcome in patients treated with immune checkpoint inhibitors. Although immune checkpoint inhibitors are currently proven to be an effective anti-tumor treatment, they can induce a distinct form of toxicity, termed immune-related adverse events. Immune-related colitis is one of the common toxicities from immune checkpoint inhibitors, and it might preclude the cancer therapy in severe or refractory cases. The manipulation of gut microbiome by fecal microbiota transplantation or probiotics administration has been suggested as one of the methods to enhance anti-tumor effects and decrease the risk of immune-related colitis. Here we review the role of gut microbiome on immune checkpoint inhibitor therapy and consequent immune-related colitis to provide a new insight for better anti-cancer therapy.
免疫检查点抑制剂极大地变革了晚期恶性肿瘤患者的治疗格局。最近,有确凿证据表明肠道微生物群对人体免疫系统有重要影响。鉴于肠道微生物群、宿主免疫和癌症之间的复杂联系,肠道微生物群的变化可能会影响免疫检查点抑制剂的疗效。事实上,据报道,某些细菌种类可预测接受免疫检查点抑制剂治疗患者的癌症预后。尽管目前已证实免疫检查点抑制剂是一种有效的抗肿瘤治疗方法,但它们可诱发一种独特的毒性形式,即免疫相关不良事件。免疫相关结肠炎是免疫检查点抑制剂常见的毒性之一,在严重或难治性病例中可能会妨碍癌症治疗。通过粪便微生物群移植或给予益生菌来操纵肠道微生物群,已被认为是增强抗肿瘤作用和降低免疫相关结肠炎风险的方法之一。在此,我们综述肠道微生物群在免疫检查点抑制剂治疗及随之发生的免疫相关结肠炎中的作用,为更好的抗癌治疗提供新的见解。