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胃癌免疫治疗疗效中肠道微生物群的可预测调节

Predictable regulation of gut microbiome in immunotherapeutic efficacy of gastric cancer.

作者信息

Gao Wei, Wang Xinli, Shi Yi, Wu Guangfeng, Zhou Min, Lin Xiaoyan

机构信息

Department of Medical Oncology, Fujian Medical University Union Hospital, No.29, Xinquan Road, Gulou District, Fuzhou, Fujian, 350001, China.

Department of Medical Oncology, Fujian Cancer Hospital, Fuzhou, Fujian, 350014, P.R. China.

出版信息

Genes Immun. 2025 Feb;26(1):1-8. doi: 10.1038/s41435-024-00306-2. Epub 2024 Nov 12.

Abstract

Immunotherapy has showcased remarkable progress in the management of gastric cancer (GC), prompting the need to proactively identify and classify patients suitable for immunotherapy. Here, 30 patients were enrolled and stratified into three groups (PR, partial response; SD, stable disease; PD, progressive disease) based on efficacy assessment. 16S rRNA sequencing were performed to analyze the gut microbiome signature of patients at three timepoints. We found that immunotherapy interventions perturbed the gut microbiota of patients. Additionally, although differences at the enterotype level did not distinguish patients' immunotherapy response, we identified 6, 7, and 19 species that were significantly enriched in PR, SD, and PD, respectively. Functional analysis showed that betalain biosynthesis and indole alkaloid biosynthesis were significantly different between the responders and non-responders. Furthermore, machine learning model utilizing only bacterial biomarkers accurately predicted immunotherapy efficacy with an Area Under the Curve (AUC) of 0.941. Notably, Akkermansia muciniphila and Dorea formicigenerans played a significant role in the classification of immunotherapy efficacy. In conclusion, our study reveals that gut microbiome signatures can be utilized as effective biomarkers for predicting the immunotherapy efficacy for GC.

摘要

免疫疗法在胃癌(GC)治疗方面已展现出显著进展,这促使我们需要积极识别并分类适合免疫疗法的患者。在此,我们招募了30名患者,并根据疗效评估将其分为三组(PR,部分缓解;SD,病情稳定;PD,疾病进展)。在三个时间点对患者进行16S rRNA测序,以分析肠道微生物群特征。我们发现免疫疗法干预扰乱了患者的肠道微生物群。此外,尽管在肠型水平上的差异无法区分患者的免疫疗法反应,但我们分别鉴定出在PR组、SD组和PD组中显著富集的6种、7种和19种物种。功能分析表明,应答者和非应答者之间的甜菜碱生物合成和吲哚生物碱生物合成存在显著差异。此外,仅利用细菌生物标志物的机器学习模型能够准确预测免疫疗法疗效,曲线下面积(AUC)为0.941。值得注意的是,嗜黏蛋白阿克曼氏菌和产甲酸多雷氏菌在免疫疗法疗效分类中发挥了重要作用。总之,我们的研究表明,肠道微生物群特征可作为预测GC免疫疗法疗效的有效生物标志物。

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