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Intestinal Microbiota Can Predict Acute Graft-versus-Host Disease Following Allogeneic Hematopoietic Stem Cell Transplantation.

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机构: [1]Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China [2]Department of Hematology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China [3]Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, China [4]School of Foreign Languages, Henan University of Chinese Medicine, Zhengzhou, China [5]Department of Gastroenterology, Nanfang Hospital, Southern Medical University, Guangzhou, China [6]Department of Oncology, Second Affiliated Hospital of Guizhou Medical University, Kaili, China [7]Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China [8]Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China
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关键词: Intestinal microbiota Microbiota marker Microbiota diversity Acute graft-versus-host disease Allogeneic hematopoietic stem cell transplantation

摘要:
The intestinal microbiome plays an important role in the development of acute graft-versus-host disease (aGVHD). However, whether intestinal microbiota can predict the development of aGVHD has been reported only rarely. Here we conducted a prospective study of microbiota in 141 patients after allogeneic hematopoietic stem cell transplantation. We found lower microbiota diversity in the aGVHD group compared with the non-aGVHD group at day 0 and day 15 ± 1 (P = .018 and .009, respectively). Diversity was negatively associated with conditioning intensity (P = .017, day 0; P = .045, day 15) and β-lactam antibiotic administration (P = .004, day 15). Intensified conditioning and β-lactam antibiotics were associated with a lower regulatory T (Treg)/T helper 17 (Th17) cell ratio at day 15 (P = .030 and .047, respectively). At day 15, the levels of the inflammatory factors (tumor necrosis factor α, interleukin [IL]-6, IL-17A, IL-1β, and lipopolysaccharide) were higher in the intensified conditioning group compared with the standard group (P < .05). The accumulated intestinal microbiota (AIM) score was defined as microbiota diversity and gradient of the 4 bacterials (Lachnospiraceae, Peptostreptococcaceae, Erysipelotrichaceae, and Enterobacteriaceae) at day 15 post-transplantation. The AIM score was positively correlated with aGVHD grade (r = .481, P < .001), and the AIM score could be predictive of the development of aGVHD (grade II-IV aGVHD: area under the curve [AUC], .75, P < .001; grade III-IV aGVHD: AUC, .84, P < .001). These findings suggest that intestinal microbiota and conditioning might induce aGVHD by inflammatory factors and the Treg/Th17 balance. The constitution of the intestinal microbiota at neutrophil engraftment may predict the development of aGVHD. Copyright © 2019 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.

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出版当年[2018]版:
大类 | 2 区 医学
小类 | 2 区 免疫学 2 区 移植 3 区 血液学
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第一作者机构: [1]Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China [2]Department of Hematology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
通讯作者:
通讯机构: [1]Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China [8]Guangdong Provincial Key Laboratory of Construction and Detection in Tissue Engineering, Southern Medical University, Guangzhou, China [*1]Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou 510515, China [*2]Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou Dadao North Street, Guangzhou 510515, China
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