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Relationship between Chemotherapy-Induced Diarrhea and Intestinal Microbiome Composition
BACKGROUND AND AIM: Fluoropyrimidines (FPs) are key drugs in many chemotherapy regimens; however, recipients are often prone to diarrhea due to gastrointestinal toxicity. Disruption of the intestinal epithelial barrier function by FPs leads to dysbiosis, which may exacerbate intestinal epithelial ce...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614279/ https://www.ncbi.nlm.nih.gov/pubmed/37231829 http://dx.doi.org/10.1159/000528282 |
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author | Kawasaki, Yuka Kakimoto, Kazuki Tanaka, Yasuyoshi Shimizu, Hikaru Nishida, Koji Numa, Keijiro Kinoshita, Naohiko Tatsumi, Yoshihiro Nakazawa, Kei Koshiba, Ryoji Hirata, Yuki Ota, Kazuhiro Sakiyama, Naokuni Terazawa, Tetsuji Takeuchi, Toshihisa Miyazaki, Takako Goto, Masahiro Yokota, Haruka Makizaki, Yutaka Tanaka, Yoshiki Nakajima, Shunji Ohno, Hiroshi Higuchi, Kazuhide Nakamura, Shiro Nishikawa, Hiroki |
author_facet | Kawasaki, Yuka Kakimoto, Kazuki Tanaka, Yasuyoshi Shimizu, Hikaru Nishida, Koji Numa, Keijiro Kinoshita, Naohiko Tatsumi, Yoshihiro Nakazawa, Kei Koshiba, Ryoji Hirata, Yuki Ota, Kazuhiro Sakiyama, Naokuni Terazawa, Tetsuji Takeuchi, Toshihisa Miyazaki, Takako Goto, Masahiro Yokota, Haruka Makizaki, Yutaka Tanaka, Yoshiki Nakajima, Shunji Ohno, Hiroshi Higuchi, Kazuhide Nakamura, Shiro Nishikawa, Hiroki |
author_sort | Kawasaki, Yuka |
collection | PubMed |
description | BACKGROUND AND AIM: Fluoropyrimidines (FPs) are key drugs in many chemotherapy regimens; however, recipients are often prone to diarrhea due to gastrointestinal toxicity. Disruption of the intestinal epithelial barrier function by FPs leads to dysbiosis, which may exacerbate intestinal epithelial cell damage as a secondary effect and trigger diarrhea. However, despite studies on chemotherapy-induced changes in the intestinal microbiome of humans, the relationship between dysbiosis and diarrhea is unclear. In this study, we aimed to investigate the relationship between chemotherapy-induced diarrhea and the intestinal microbiome. METHODS: We conducted a single-center prospective observational study. Twenty-three patients who received chemotherapy, including FPs as first-line chemotherapy for colorectal cancer, were included. Stool samples were collected before the start of chemotherapy and after one cycle of treatment to analyze intestinal microbiome composition and perform PICRUSt predictive metagenomic analysis. RESULTS: Gastrointestinal toxicity was observed in 7 of 23 patients (30.4%), diarrhea was observed in 4 (17.4%), and nausea and anorexia were observed in 3 (13.0%). In 19 patients treated with oral FPs, the α diversity of the microbial community decreased significantly following chemotherapy only in the diarrheal group. At the phylum level, the diarrheal group showed a significant decrease in the abundance of Firmicutes and a significant increase in the abundance of Bacteroidetes with chemotherapy (p = 0.013 and 0.011, respectively). In the same groups, at the genus level, Bifidobacterium abundance was significantly decreased (p = 0.019). In contrast, in the non-diarrheal group, Actinobacteria abundance increased significantly with chemotherapy at the phylum level (p = 0.011). Further, Bifidobacterium, Fusicatenibacter, and Dorea abundance significantly increased at the genus level (p = 0.006, 0.019, and 0.011, respectively). The PICRUSt predictive metagenomic analysis revealed that chemotherapy caused significant differences in membrane transport in KEGG pathway level 2 and in 8 KEGG pathway level 3, including transporters and oxidative phosphorylation in the diarrhea group. CONCLUSION: Organic-acid-producing bacteria seem to be involved in diarrhea associated with chemotherapy, including FPs. |
format | Online Article Text |
id | pubmed-10614279 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-106142792023-10-31 Relationship between Chemotherapy-Induced Diarrhea and Intestinal Microbiome Composition Kawasaki, Yuka Kakimoto, Kazuki Tanaka, Yasuyoshi Shimizu, Hikaru Nishida, Koji Numa, Keijiro Kinoshita, Naohiko Tatsumi, Yoshihiro Nakazawa, Kei Koshiba, Ryoji Hirata, Yuki Ota, Kazuhiro Sakiyama, Naokuni Terazawa, Tetsuji Takeuchi, Toshihisa Miyazaki, Takako Goto, Masahiro Yokota, Haruka Makizaki, Yutaka Tanaka, Yoshiki Nakajima, Shunji Ohno, Hiroshi Higuchi, Kazuhide Nakamura, Shiro Nishikawa, Hiroki Digestion Research Article BACKGROUND AND AIM: Fluoropyrimidines (FPs) are key drugs in many chemotherapy regimens; however, recipients are often prone to diarrhea due to gastrointestinal toxicity. Disruption of the intestinal epithelial barrier function by FPs leads to dysbiosis, which may exacerbate intestinal epithelial cell damage as a secondary effect and trigger diarrhea. However, despite studies on chemotherapy-induced changes in the intestinal microbiome of humans, the relationship between dysbiosis and diarrhea is unclear. In this study, we aimed to investigate the relationship between chemotherapy-induced diarrhea and the intestinal microbiome. METHODS: We conducted a single-center prospective observational study. Twenty-three patients who received chemotherapy, including FPs as first-line chemotherapy for colorectal cancer, were included. Stool samples were collected before the start of chemotherapy and after one cycle of treatment to analyze intestinal microbiome composition and perform PICRUSt predictive metagenomic analysis. RESULTS: Gastrointestinal toxicity was observed in 7 of 23 patients (30.4%), diarrhea was observed in 4 (17.4%), and nausea and anorexia were observed in 3 (13.0%). In 19 patients treated with oral FPs, the α diversity of the microbial community decreased significantly following chemotherapy only in the diarrheal group. At the phylum level, the diarrheal group showed a significant decrease in the abundance of Firmicutes and a significant increase in the abundance of Bacteroidetes with chemotherapy (p = 0.013 and 0.011, respectively). In the same groups, at the genus level, Bifidobacterium abundance was significantly decreased (p = 0.019). In contrast, in the non-diarrheal group, Actinobacteria abundance increased significantly with chemotherapy at the phylum level (p = 0.011). Further, Bifidobacterium, Fusicatenibacter, and Dorea abundance significantly increased at the genus level (p = 0.006, 0.019, and 0.011, respectively). The PICRUSt predictive metagenomic analysis revealed that chemotherapy caused significant differences in membrane transport in KEGG pathway level 2 and in 8 KEGG pathway level 3, including transporters and oxidative phosphorylation in the diarrhea group. CONCLUSION: Organic-acid-producing bacteria seem to be involved in diarrhea associated with chemotherapy, including FPs. S. Karger AG 2023-05-11 2023-10 /pmc/articles/PMC10614279/ /pubmed/37231829 http://dx.doi.org/10.1159/000528282 Text en © 2023 The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Research Article Kawasaki, Yuka Kakimoto, Kazuki Tanaka, Yasuyoshi Shimizu, Hikaru Nishida, Koji Numa, Keijiro Kinoshita, Naohiko Tatsumi, Yoshihiro Nakazawa, Kei Koshiba, Ryoji Hirata, Yuki Ota, Kazuhiro Sakiyama, Naokuni Terazawa, Tetsuji Takeuchi, Toshihisa Miyazaki, Takako Goto, Masahiro Yokota, Haruka Makizaki, Yutaka Tanaka, Yoshiki Nakajima, Shunji Ohno, Hiroshi Higuchi, Kazuhide Nakamura, Shiro Nishikawa, Hiroki Relationship between Chemotherapy-Induced Diarrhea and Intestinal Microbiome Composition |
title | Relationship between Chemotherapy-Induced Diarrhea and Intestinal Microbiome Composition |
title_full | Relationship between Chemotherapy-Induced Diarrhea and Intestinal Microbiome Composition |
title_fullStr | Relationship between Chemotherapy-Induced Diarrhea and Intestinal Microbiome Composition |
title_full_unstemmed | Relationship between Chemotherapy-Induced Diarrhea and Intestinal Microbiome Composition |
title_short | Relationship between Chemotherapy-Induced Diarrhea and Intestinal Microbiome Composition |
title_sort | relationship between chemotherapy-induced diarrhea and intestinal microbiome composition |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10614279/ https://www.ncbi.nlm.nih.gov/pubmed/37231829 http://dx.doi.org/10.1159/000528282 |
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