Abstract

Introduction

: Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is commonly performed to treat a variety of benign and malignant hematological diseases. Acute graft-versus-host disease (GVHD) is a major life-threatening complication that often occurs following allo-HSCT. Recently, improvements in methods to characterize the microbiota have led to a greater appreciation for how frequently and profoundly an alteration in microbial composition, or dysbiosis, can occur in allo-HSCT recipients to better decipher the complex interplay of between microbiota and allo-HSCT outcomes.

Areas covered

: This article reviews the current knowledge of the microbiota’s impact on allo-HSCT outcomes, including effects of microbiota-derived metabolites, and crosstalk between commensals and the allogeneic immune response. This article also summarizes the effects of HSCT and transplant-related procedures on microbiota, and recent developments in interventional strategies.

Expert opinion

: A growing body of literature indicate that the composition of the intestinal microbiota can function as a predictive biomarker for the risk and severity of acute GVHD, as well as overall survival, in patients undergoing allo-HSCT. Mechanisms underpinning this associations, however, are not well-understood, and clinical strategies that modulate the microbiome to improve outcomes have yet to be fully developed. There is an unmet need to determine mechanisms to improve the efficacy of allo-HSCT.

中文翻译：

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微生物群在同种异体造血干细胞移植中的作用

摘要

介绍

：同种异体造血干细胞移植（Allo-HSCT）通常用于治疗各种良性和恶性血液病。急性移植物抗宿主病（GVHD）是一种严重的危及生命的并发症，常发生于同种异体移植后。最近，表征微生物群的方法的改进已引起人们对异源HSCT受体中微生物成分改变或营养不良发生的频率和深度的更好了解，从而更好地理解了微生物群和异源HSCT结果之间的复杂相互作用。 。

覆盖区域

：本文回顾了微生物群对异源HSCT结果的影响的当前知识，包括微生物群衍生代谢产物的影响，以及共鸣和同种异体免疫反应之间的串扰。本文还总结了HSCT和移植相关程序对微生物群的影响，以及干预策略的最新进展。

专家意见

：越来越多的文献表明，在接受异基因造血干细胞移植的患者中，肠道菌群的组成可以作为急性GVHD的风险和严重程度以及总体生存的预测生物标志物。然而，建立这种关联的机制尚未得到很好的理解，调节微生物组以改善结果的临床策略尚未得到充分开发。存在尚未满足的需要确定改善同种异体-HSCT效力的机制。