通过便微生物种移植进行微生物组改变对耐火性免疫检查点抑制剂诱导的大肠炎有效
Taylor M Halsey1, Anusha S Thomas2, Tomo Hayase3
1Graduate School of Biomedical Sciences, Microbiology and Infectious Diseases, University of Texas MD Anderson Cancer Center UTHealth Houston, Houston, TX 77054, USA.
Science translational medicine
|June 14, 2023
概括
便微生物种移植 (FMT) 在接受免疫检查点抑制剂 (ICI) 的患者中有效治疗耐火性免疫媒介性结肠炎 (IMC). FMT导致高临床缓解率和改变肠道微生物组合,表明其作为IMC的救援疗法的潜力.
科学领域:
- 胃肠病学和肝病学
- 在瘤学瘤学.
- 微生物学与传染病的研究
背景情况:
- 免疫检查点抑制剂 (ICI) 对晚期癌症有效,但可以引起免疫介导性结肠炎 (IMC).
- 肠道微生物群影响ICI治疗反应和IMC发展,使微生物操纵成为潜在的治疗策略.
- 便微生物群移植 (FMT) 正在被探索为耐火性IMC的救援疗法.
研究的目的:
- 评估FMT作为耐性免疫介导性大肠炎 (IMC) 患者的救援疗法的疗效.
- 研究FMT对肠道微生物组成的影响及其与IMC患者治疗反应的关联.
主要方法:
- 一个由12名患有严重 (3-4级) ICI相关的IMC,耐标准治疗的患者组成的病例系列,从健康的捐赠者接受了FMT.
- 用16S rRNA测序分析患者便样本,以评估FMT前后的微生物组成.
- 在FMT后评估了临床反应,缓解率和组织学变化.
主要成果:
- 10名患者 (83%) 症状有所改善,92%的患者在FMT后获得IMC的临床缓解.
- 与非响应者相比,FMT响应者表现出不同的移植前微生物特征,FMT后的*Collinsella*和*Bifidobacterium*的具体增加.
- 组织学分析显示,FMT后完全响应者的结肠中CD8+T细胞减少.
结论:
- 便微生物种移植是一种经过验证和有效的救援治疗耐火性免疫媒介性结肠炎.
- FMT可以恢复肠道微生物多样性和特定的有益细菌,与IMC的临床反应相关.
- 识别的微生物特征可以作为FMT在治疗ICI相关大肠炎的有效性上的生物标志物.
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