Gut microbiota and acute graft-versus-host disease

Area of Science:

• Microbiology
• Immunology
• Gastroenterology

Background:

• Acute graft-versus-host disease (aGVHD) significantly impacts allogeneic hematopoietic stem cell transplantation outcomes.
• Gut microbiota dysbiosis is increasingly recognized as a critical factor in aGVHD pathogenesis.
• Mechanisms include compromised intestinal barrier, inflammation, and altered immune responses.

Purpose of the Study:

• To review the mechanistic insights into the role of gut microbiota in aGVHD.
• To detail the clinical landscape of microbiome-targeted diagnostics and therapeutics for aGVHD.

Main Methods:

• Literature review synthesizing mechanistic and clinical findings.
• Focus on host-microbe crosstalk, metabolic disruption, and immune dysregulation.
• Analysis of diagnostic and therapeutic strategies targeting the microbiome.

Main Results:

• Gut dysbiosis, characterized by low diversity and pathogen dominance, predicts aGVHD morbidity and mortality.
• Microbial metabolites like SCFAs and secondary bile acids can exert protective effects.
• Fecal microbiota transplantation demonstrates efficacy in aGVHD prophylaxis and treatment.

Conclusions:

• The gut microbiome is a crucial therapeutic target for aGVHD.
• Ecological restoration via fecal microbiota transplantation offers a viable strategy.
• Further research into microbiome-based diagnostics and therapeutics is warranted.