Impact of intestinal dysbiosis-related drugs on the efficacy of immune checkpoint inhibitors in clinical practice.

PURPOSE: Intestinal dysbiosis has emerged as a biomarker of response to immune checkpoint inhibitors (ICIs). It can be caused by antibiotics, although it may also result from the use of other drugs that have been studied to a lesser extent. The objective of our study was to analyze the association between the use of potentially dysbiosis-related drugs and survival in patients treated with ICIs in the clinical practice. MATERIALS AND METHODS: A retrospective, multicenter, cohort study was conducted. Clinicopathological variables were collected and the concomitant use of drugs was analyzed. A descriptive analysis of variables and overall survival, estimated by the Kaplan-Meier method, was performed, and association with various independent variables was assessed using Cox regression. RESULTS: We included 253 patients, mainly with non-small cell lung cancer and melanoma. The most commonly used drugs were acid reducers, prescribed to 55.3% of patients, followed by corticosteroids (37.9%), anxiolytic drugs (35.6%), and antibiotics (20.5%). The use of acid reducers (9 vs. 18 months, P < .0001), antibiotics (7 vs. 15 months, P < .017), anxiolytic drugs (8 vs. 16 months, P < .015), and corticosteroids (6 vs. 19 months, P < .00001) was associated with poorer overall survival. Furthermore, the greater the number of drugs used concomitantly with ICIs, the higher the risk of death (1 drug: hazard ratio, 1.88; CI 95%, 1.07-3.30; 4 drugs: hazard ratio, 4.19; CI9 5%, 1.77-9.92; P < .001). CONCLUSION: Response to ICIs may be influenced by the use of drugs that lead to intestinal dysbiosis. Although a confirmatory prospective controlled study is required, our findings should be taken into account when analyzing ICI efficacy.

Determination of absolute threshold and just noticeable difference in the sensory perception of pungency.

Absolute threshold and just noticeable difference (JND) were determined for the perception of pungency using chili pepper in aqueous solutions. Absolute threshold and JND were determined using 2 alternative forced-choice sensory tests tests. High-performance liquid chromatography technique was used to determine capsaicinoids concentration in samples used for sensory analysis. Sensory absolute threshold was 0.050 mg capsaicinoids/kg sample. Five JND values were determined using 5 reference solutions with different capsaicinoids concentration. JND values changed proportionally as capsaicinoids concentration of the reference sample solutions changed. Weber fraction remained stable for the first 4 reference capsaicinoid solutions (0.05, 0.11, 0.13, and 0.17 mg/kg) but changed when the most concentrated reference capsaicinoids solution was used (0.23 mg/kg). Quantification limit for instrumental analysis was 1.512 mg/kg capsaicinoids. Sensory methods employed in this study proved to be more sensitive than instrumental methods. Practical Application: A better understanding of the process involved in the sensory perception of pungency is currently required because "hot" foods are becoming more popular in western cuisine. Absolute thresholds and differential thresholds are useful tools in the formulation and development of new food products. These parameters may help in defining how much chili pepper is required in a formulated product to ensure a perceptible level of pungency, as well as in deciding how much more chili pepper is required in a product to produce a perceptible increase in its pungency.