RESUMO
Polycystic ovary syndrome (PCOS) is a multifaceted disease with an intricate etiology affecting reproductive-aged women. Despite attempts to unravel the pathophysiology, the molecular mechanism of PCOS remains unknown. There are no effective or suitable therapeutic strategies available to ameliorate PCOS; however, the symptoms can be managed. In recent years, a strong association has been found between the gut microbiome and PCOS, leading to the formulation of novel ideas on the genesis and pathological processes of PCOS. Further, gut microbiome dysbiosis involving microbial metabolites may trigger PCOS symptoms via many mechanistic pathways including those associated with carbohydrates, short-chain fatty acids, lipopolysaccharides, bile acids, and gut-brain axis. We present the mechanistic pathways of PCOS-related microbial metabolites and therapeutic opportunities available to treat PCOS, such as prebiotics, probiotics, and fecal microbiota therapy. In addition, the current review highlights the emerging treatment strategies available to alleviate the symptoms of PCOS.
Assuntos
Disbiose , Microbioma Gastrointestinal , Síndrome do Ovário Policístico , Probióticos , Síndrome do Ovário Policístico/metabolismo , Síndrome do Ovário Policístico/microbiologia , Síndrome do Ovário Policístico/terapia , Humanos , Feminino , Microbioma Gastrointestinal/fisiologia , Disbiose/terapia , Probióticos/uso terapêutico , Probióticos/administração & dosagem , Prebióticos/administração & dosagem , Eixo Encéfalo-Intestino/fisiologia , Transplante de Microbiota Fecal , AnimaisRESUMO
The exploration of the complex mechanisms of cancer immunotherapy is rapidly evolving worldwide, and our focus is on the interaction of hepatocellular carcinoma (HCC) with immune checkpoint inhibitors (ICIs), particularly as it relates to the regulatory role of the gut microbiome. An important basis for the induction of immune responses in HCC is the presence of specific anti-tumor cells that can be activated and reinforced by ICIs, which is why the application of ICIs results in sustained tumor response rates in the majority of HCC patients. However, mechanisms of acquired resistance to immunotherapy in unresectable HCC result in no long-term benefit for some patients. The significant heterogeneity of inter-individual differences in the gut microbiome in response to treatment with ICIs makes it possible to target modulation of specific gut microbes to assist in augmenting checkpoint blockade therapies in HCC. This review focuses on the complex relationship between the gut microbiome, host immunity, and HCC, and emphasizes that manipulating the gut microbiome to improve response rates to cancer ICI therapy is a clinical strategy with unlimited potential.
Assuntos
Carcinoma Hepatocelular , Microbioma Gastrointestinal , Inibidores de Checkpoint Imunológico , Neoplasias Hepáticas , Humanos , Microbioma Gastrointestinal/efeitos dos fármacos , Microbioma Gastrointestinal/imunologia , Carcinoma Hepatocelular/imunologia , Carcinoma Hepatocelular/microbiologia , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/patologia , Neoplasias Hepáticas/imunologia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/microbiologia , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/patologia , Inibidores de Checkpoint Imunológico/uso terapêutico , Inibidores de Checkpoint Imunológico/farmacologia , Imunoterapia/métodos , AnimaisRESUMO
BACKGROUND: The gut microbiota is strongly associated with radiation-induced gut damage. This study aimed to assess the effectiveness and safety of intestinal microecological transplantation for treating patients with chronic radiation enteritis. CASE SUMMARY: A 64-year-old female with cervical cancer developed abdominal pain, diarrhea, and blood in the stool 1 year after radiotherapy. An electronic colonoscopy was performed to diagnose chronic radiation enteritis. Two courses of intestinal microecological transplantation and full-length 16S rRNA microbiological analysis were performed. The patient experienced short- and long-term relief from symptoms without adverse effects. Whole 16S rRNA sequencing revealed significant differences in the intestinal flora's composition between patient and healthy donors. Pathogenic bacteria, such as Escherichia fergusonii and Romboutsia timonensis, were more in the patient. Beneficial bacteria such as Faecalibacterium prausnitzii, Fusicatenibacter saccharivorans, Ruminococcus bromii, and Bifidobacterium longum were more in the healthy donors. Intestinal microbiota transplantation resulted in a significant change in the patient's intestinal flora composition. The composition converged with the donor's flora, with an increase in core beneficial intestinal bacteria, such as Eubacterium rectale, and a decrease in pathogenic bacteria. Changes in the intestinal flora corresponded with the patients' alleviating clinical symptoms. CONCLUSION: Intestinal microecological transplantation is an effective treatment for relieving the clinical symptoms of chronic radiation enteritis by altering the composition of the intestinal flora. This study provides a new approach for treating patients with chronic radiation enteritis.
Assuntos
Enterite , Transplante de Microbiota Fecal , Microbioma Gastrointestinal , Lesões por Radiação , Neoplasias do Colo do Útero , Humanos , Feminino , Pessoa de Meia-Idade , Enterite/microbiologia , Enterite/diagnóstico , Enterite/etiologia , Enterite/terapia , Lesões por Radiação/diagnóstico , Lesões por Radiação/microbiologia , Lesões por Radiação/etiologia , Lesões por Radiação/cirurgia , Microbioma Gastrointestinal/efeitos da radiação , Transplante de Microbiota Fecal/métodos , Neoplasias do Colo do Útero/radioterapia , RNA Ribossômico 16S/genética , Resultado do Tratamento , Doença Crônica , Colonoscopia , Intestinos/microbiologia , Intestinos/efeitos da radiação , Fezes/microbiologia , Radioterapia/efeitos adversosRESUMO
Resumen La microbiota intestinal sana se define a partir de la presencia de grupos de microorganismos que potencian el metabolismo del huésped. Estos microorganismos le confieren resistencia ante las infecciones, así como ante procesos inflamatorios y frente al desarrollo de neoplasias o autoinmunidad. Además, favorecen las funciones endocrinas y colaboran con la función neurológica a través del eje intestino-cerebro. Por otro lado, el trasplante de microbiota fecal consiste en la introducción de una suspensión de materia fecal de un donante sano en el tracto gastrointestinal de otra persona, que generalmente es un paciente que presenta una patología concreta. Esto se realiza con el fin de manipular la composición de la microbiota del destinatario y contribuir al tratamiento de su problema. El concepto de trasplante de microbiota fecal rompe con la consideración tradicional de las bacterias como elementos dañinos y presta atención a las que, probablemente, son las más subvaloradas de las excretas del cuerpo humano: las heces. En efecto, se ha evidenciado su alta eficacia y el procedimiento es reconocido por el número de pacientes a los que ha ayudado, que se puede ya cifrar en miles. El objetivo de esta revisión de literatura fue describir aspectos básicos para comprender el trasplante de microbiota fecal enfocado al tratamiento de infecciones producidas por Clostridioides difficile.
Abstract Gut microbiota is defined as healthy when there are groups of microorganisms that enhance the host's metabolism, confer resistance to infections, inflammatory processes, the development of malignancies or autoimmunity, promote endocrine functions and support neurological function through the so-called gut-brain axis. Fecal microbial transplantation is the transfer of fecal matter from a healthy donor into the gastrointestinal tract of another person, usually a patient with a specific pathology, to manipulate the composition of the recipient's microbiota and contribute to the treatment of his or her condition. The concept of fecal microbial transplantation breaks with the traditional thought of bacteria as harmful elements and draws attention to what is probably the most undervalued of the human body's excreta: feces. Its high efficiency has been demonstrated and the procedure is recognized by the many patients it has helped, which can already be counted in thousands. The objective of this literature review was to describe the basics of fecal microbial transplantation for the treatment of Clostridioides difficile infections.