Journal Article

Gut Microbial Dysbiosis May Predict Diarrhea and Fatigue in Patients Undergoing Pelvic Cancer Radiotherapy: A Pilot Study

Geng, Fang, Cao, Le, Wang, Tao, Su, Yongping, Shen, Mingqiang, Wang, Aiping, Yang, Zhixiang, Ling, Zongxin, Wang, Cheng, Ran, Xinze, Wang, Junping, Cheng, Tianmin, Kiela, Pawel R.

2015

Overview

Fatigue and diarrhea are the most frequent adverse effects of pelvic radiotherapy, while their etiologies are largely unknown. The aim of this study is to investigate the correlations between fatigue, diarrhea, and alterations in gut microbiota induced by pelvic radiotherapy. During the 5-week treatment of pelvic radiotherapy in 11 cancer patients, the general fatigue score significantly increased and was more prominent in the patients with diarrhea. The fatigue score was closely correlated with the decrease of serum citrulline (an indicator of the functional enterocyte mass) and the increases of systemic inflammatory proteins, including haptoglobin, orosomuoid, α1-antitrypsin and TNF-α. Serum level of lipopolysaccharide (LPS) was also elevated, especially in the patients with diarrhea indicating epithelial barrier breach and endotoxemia. Pyrosequencing analysis of 16S rRNA gene revealed that microbial diversity, richness, and the Firmicutes/Bacteroidetes ratio were significantly altered prior to radiotherapy in patients who later developed diarrhea. Pelvic radiotherapy induced further changes in fecal microbial ecology, some of which were specific to the patients with or without diarrhea. Our results indicate that gut microbial dysbiosis prior to radiation therapy may be exploited to predict development of diarrhea and to guide preventive treatment options. Radiation-induced dysbiosis may contribute to pelvic radiation disease, including mucositis, diarrhea, systemic inflammatory response, and pelvic radiotherapy-associated fatigue in cancer patients.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: a1-antitrypsin / Adult / Analysis / Bioinformatics / Cancer / Cancer therapies / Care and treatment / Chemotherapy / Citrulline / Complications and side effects / Correlation analysis / Development and progression / Diarrhea / Diarrhea - etiology / Diarrhea - microbiology / Disease / Disease prevention / Dysbacteriosis / Ecology / Endotoxemia / Engineering research / Etiology / Fatigue / Fatigue - etiology / Feasibility studies / Fecal microflora / Female / Gastrointestinal Tract - microbiology / Haptoglobin / Health aspects / Hospitals / Humans / Inflammation / Inflammatory response / Intestinal microflora / Laboratories / Lipopolysaccharides / Male / Microbiota / Microbiota - physiology / Microbiota - radiation effects / Microorganisms / Middle Aged / Mucositis / Pathogenesis / Patients / Pelvic cancer / Pelvic Neoplasms - complications / Pelvic Neoplasms - radiotherapy / Pilot Projects / Preventive medicine / Proteins / Radiation / Radiation effects / Radiation therapy / Radiotherapy / Radiotherapy - adverse effects / Risk factors / RNA, Bacterial - analysis / RNA, Ribosomal, 16S - analysis / rRNA 16S / Trauma / Tumor necrosis factor-α