自动HCT中的肠道与肠外营养:对临床结果和肠道微生物组动态的随机对照试验
Hannah R Wardill1,2, Lenneke F J van Groningen3,4, Mohsen Dorraki5,6
1Supportive Oncology Research Group, Precision Cancer Medicine Theme, South Australian Health and Medical Research Institute, North Terrace, Adelaide, Australia. hannah.wardill@adelaide.edu.au.
化疗破坏了肠道微生物群,增加了接受血造干细胞移植 (HCT) 患者的风险. 血中素的监测可以预测并发症,并指导维护肠道完整性和微生物平衡的策略.
科学领域:
- 在瘤学瘤学.
- 微生物学 微生物学
- 胃肠病学 胃肠病学
背景情况:
- 化疗诱导的肠道微生物组破坏与糟糕的结果有关,特别是在造血干细胞移植 (HCT) 接受者中.
- 肠道营养 (EN) 在理论上优于肠道营养 (TPN) 维持肠道健康,但临床数据有限.
- 表皮细胞亡与肠道屏障功能障碍和HCT后的微生物组变化有关.
研究的目的:
- 评估EN与TPN对肠道微生物组动态的临床可行性和影响.
- 为了研究肠道微生物组变化,肠球体质量和血中素水平之间的关系.
- 确定生物标志物来预测与肠道失调相关的HCT并发症.
主要方法:
- 一个临床试验比较EN和TPN在自身的HCT接受者 (荷兰试验注册:NL4069).
- 分析肠道微生物组的组成及其与临床参数的相关性.
- 机器学习模型被开发用于预测微生物组成,使用血中素轨迹作为肠细胞质量的生物标志物.
主要成果:
- 肠道营养 (EN) 在这个HCT队列中耐受性差且不可行.
- 血中素水平,一种肠细胞质量的标志物,与微生物组成相关.
- 机器学习模型成功地根据素轨迹预测了微生物状态,证实了关于表皮细胞亡导致微生物组破坏的临床前发现.
结论:
- 监测血氨酸可以识别由于肠道微生物组破坏而面临致命并发症风险的HCT患者.
- 维护上皮质完整性,可能通过最大限度地减少酶依赖的代谢物生产,可以增强微生物的弹性和减轻与治疗相关的不良事件.
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