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Relationship between Chemotherapy-Induced Diarrhea and Intestinal Microbiome Composition
Yuka Kawasaki1, Kazuki Kakimoto1, Yasuyoshi Tanaka1
12nd Department of Internal Medicine, Osaka Medical and Pharmaceutical University, Osaka, Japan.
Digestion
|May 26, 2023
Summary
Chemotherapy-induced diarrhea in colorectal cancer patients is linked to significant changes in gut bacteria, specifically a decrease in beneficial Bifidobacterium. Understanding this gut microbiome shift can help manage side effects.
Area of Science:
- Oncology
- Microbiome Research
- Gastroenterology
Background:
- Fluoropyrimidines (FPs) are crucial chemotherapy agents but often cause diarrhea due to gastrointestinal toxicity.
- FPs disrupt the intestinal barrier, leading to dysbiosis that may worsen cell damage and diarrhea.
- The precise link between chemotherapy-induced dysbiosis and diarrhea remains unclear.
Purpose of the Study:
- To investigate the relationship between chemotherapy-induced diarrhea and the intestinal microbiome.
- To analyze changes in gut microbial composition following fluoropyrimidine-based chemotherapy.
Main Methods:
- A prospective observational study included 23 colorectal cancer patients receiving first-line fluoropyrimidine chemotherapy.
- Stool samples were collected pre-chemotherapy and post-cycle one for microbiome analysis.
- PICRUSt predictive metagenomic analysis was performed to infer functional changes.
Main Results:
- Diarrhea occurred in 17.4% of patients.
- Chemotherapy significantly reduced gut microbial alpha diversity in patients who developed diarrhea.
- Diarrheal patients showed decreased Firmicutes and increased Bacteroidetes, along with reduced Bifidobacterium abundance.
Conclusions:
- Chemotherapy-induced diarrhea is associated with specific alterations in the gut microbiome.
- A decrease in organic-acid-producing bacteria, such as Bifidobacterium, may play a role in chemotherapy-related diarrhea.
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