Although studies have reported that intestinal microbiota are associated with acute graft-versus-host disease (aGVHD), they lacked a satisfactory method for predicting aGVHD. We collected stool and blood samples at day 15 posttransplant from 150 patients from two centers who underwent myeloablative conditioning allogeneic hematopoietic stem cell transplantation (allo-HSCT). Stool microbiota were detected by 16S ribosomal RNA gene sequencing; inflammatory factors and T lymphocytes were detected by multiplex immunoassays and flow cytometry, respectively. A gut microbiota score (GMS) from a LASSO (least absolute shrinkage and selection operator) model was developed and validated to predict aGVHD. In the discovery cohort, the GMS could predict II-IV aGVHD (area under the receiver operating characteristic [ROC] curve [AUC] = 0.904, P < .0001). Furthermore, the validation model was consistent with the discovery set (AUC = 0.887, P < .0001). Regulatory T/T-helper 17 (Treg/Th17) cells ratio in the low GMS subgroup was higher compared with the high GMS (P = .012), and the validation set is consistent with the discovery set (P = .003). In addition, high cytokine levels were associated with high GMS. In conclusion, the GMS at neutrophil engraftment could predict aGVHD, and it was a potential and novel method. The GMS was associated with the inflammatory factor and Treg/Th17 balance.

中文翻译：

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肠道微生物群评分预测清髓性同种异体造血干细胞移植后的急性移植物抗宿主病。

尽管有研究报道肠道微生物群与急性移植物抗宿主病 (aGVHD) 相关，但它们缺乏令人满意的预测 aGVHD 的方法。我们在移植后第 15 天收集了来自两个中心的 150 名患者的粪便和血液样本，这些患者接受了清髓性调节同种异体造血干细胞移植 (allo-HSCT)。通过16S核糖体RNA基因测序检测粪便微生物群；分别通过多重免疫测定和流式细胞术检测炎症因子和T淋巴细胞。开发并验证了来自 LASSO（最小绝对收缩和选择算子）模型的肠道微生物群评分 (GMS) 以预测 aGVHD。在发现队列中，GMS 可以预测 II-IV aGVHD（接受者操作特征 [ROC] 曲线下的面积 [AUC] = 0.904，P <.0001）。此外，验证模型与发现集一致（AUC = 0.887，P <.0001）。与高 GMS 相比，低 GMS 亚组中的调节性 T/T 辅助细胞 17 (Treg/Th17) 细胞比率更高 (P = .012)，验证集与发现集一致 (P = .003)。此外，高细胞因子水平与高 GMS 相关。总之，中性粒细胞植入时的 GMS 可以预测 aGVHD，这是一种有潜力的新方法。GMS 与炎症因子和 Treg/Th17 平衡有关。高细胞因子水平与高 GMS 相关。总之，中性粒细胞植入时的 GMS 可以预测 aGVHD，这是一种有潜力的新方法。GMS 与炎症因子和 Treg/Th17 平衡有关。高细胞因子水平与高 GMS 相关。总之，中性粒细胞植入时的 GMS 可以预测 aGVHD，这是一种有潜力的新方法。GMS 与炎症因子和 Treg/Th17 平衡有关。