Gut microbiome and checkpoint inhibitor colitis.

Area of Science:

• Oncology
• Immunology
• Gastroenterology

Background:

• Immune checkpoint inhibitors (ICIs) like ipilimumab prolong survival in cancers such as metastatic melanoma.
• ICIs can cause immune-related adverse events, notably colitis.
• The exact cause of ICI-induced colitis is unknown, but the gut microbiota is implicated.

Purpose of the Study:

• To review the mechanisms of ICIs.
• To discuss ICI-related adverse events, focusing on colitis.
• To explore the suspected role of gut microbiota in colitis and potential modulation therapies.

Main Methods:

• Literature review of immune checkpoint inhibitors.
• Analysis of immune-related adverse events, particularly colitis.
• Examination of studies on gut microbiota alterations in patients receiving ICIs.

Main Results:

• ICIs activate the immune system, leading to potential off-target effects like colitis.
• Alterations in the gastrointestinal microbiota are observed in patients developing ICI-induced colitis.
• Fecal microbiota transplantation is being investigated as a potential treatment.

Conclusions:

• The gut microbiota plays a significant role in the pathogenesis of ICI-induced colitis.
• Modulating the gut microbiota may represent a promising therapeutic avenue.
• Further research is needed to establish the efficacy of microbiota-targeted therapies like fecal microbiota transplantation.