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Ben-Arye E, Samuels N, Seifert G, Gressel O, Peleg R, Jong M. Integrative Medicine Across the Pediatric Cancer Care Trajectory: A Narrative Review. Curr Oncol Rep 2024; 26:714-734. [PMID: 38733465 PMCID: PMC11169001 DOI: 10.1007/s11912-024-01538-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2024] [Indexed: 05/13/2024]
Abstract
PURPOSE OF THE REVIEW Children and adolescents with cancer, along with their parents and other informal caregivers, often report using complementary and alternative medicine (CAM) during active oncology and hemato-oncology treatment. Some adopt an "alternative" approach to conventional medical care, which often entails the use of these practices without the knowledge of the treating pediatrician. In contrast, many others search for consultation provided by a pediatric integrative oncology (IO) practitioner working with the conventional medical team. IO seeks to provide evidence-based complementary medicine therapies, many of which have been shown to augment conventional supportive and palliative care, while ensuring the patient's safety. The present narrative review examines the current state of and future direction for the IO setting of care. RECENT FINDINGS A large body of published clinical research supports the effectiveness of leading Pediatric IO modalities, while addressing potential safety-related concerns. Despite the growing amount of clinical research supporting the beneficial effects and implementation of Pediatric IO models of care, there is still a need for further studies in order to establish clinical guidelines in the treatment of children and adolescents with cancer. Such IO-directed guidelines will need to address both the effectiveness and the safety of the CAM modalities being used in pediatric oncology and hemato-oncology settings, promoting a better understanding among pediatric healthcare professionals and helping them understand the indications for referral to the IO treatment service.
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Affiliation(s)
- Eran Ben-Arye
- Integrative Oncology Program, The Oncology Service, Zebulun Medical Centers, Clalit Health Services, Haifa and Western Galilee District, Carmel &, Lin, Israel.
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Noah Samuels
- Center for Integrative Complementary Medicine, Faculty of Medicine, Shaare Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Georg Seifert
- Department of Pediatrics, Division of Oncology and Hematology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Orit Gressel
- Integrative Oncology Program, The Oncology Service, Zebulun Medical Centers, Clalit Health Services, Haifa and Western Galilee District, Carmel &, Lin, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Raviv Peleg
- Pediatric Hematology Oncology, Schneider Children's Medical Center of Israel, Integrative Pediatric Medicine Program, Petach Tikva, Israel
| | - Miek Jong
- Department of Community Medicine, Faculty of Health Sciences, The Arctic University of Norway, National Research Center in Complementary and Alternative Medicine (NAFKAM), UiT, Tromsø, Norway
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2
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Bai J, Eldridge R, Houser M, Martin M, Powell C, Sutton KS, Noh HI, Wu Y, Olson T, Konstantinidis KT, Bruner DW. Multi-omics analysis of the gut microbiome and metabolites associated with the psychoneurological symptom cluster in children with cancer receiving chemotherapy. J Transl Med 2024; 22:256. [PMID: 38461265 PMCID: PMC10924342 DOI: 10.1186/s12967-024-05066-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/05/2024] [Indexed: 03/11/2024] Open
Abstract
BACKGROUND Children with cancer receiving chemotherapy commonly report a cluster of psychoneurological symptoms (PNS), including pain, fatigue, anxiety, depression, and cognitive dysfunction. The role of the gut microbiome and its functional metabolites in PNS is rarely studied among children with cancer. This study investigated the associations between the gut microbiome-metabolome pathways and PNS in children with cancer across chemotherapy as compared to healthy children. METHODS A case-control study was conducted. Cancer cases were recruited from Children's Healthcare of Atlanta and healthy controls were recruited via flyers. Participants reported PNS using the Pediatric Patient-Reported Outcomes Measurement Information System. Data for cases were collected pre-cycle two chemotherapy (T0) and post-chemotherapy (T1), whereas data for healthy controls were collected once. Gut microbiome and its metabolites were measured using fecal specimens. Gut microbiome profiling was performed using 16S rRNA V4 sequencing, and metabolome was performed using an untargeted liquid chromatography-mass spectrometry approach. A multi-omics network integration program analyzed microbiome-metabolome pathways of PNS. RESULTS Cases (n = 21) and controls (n = 14) had mean ages of 13.2 and 13.1 years. For cases at T0, PNS were significantly associated with microbial genera (e.g., Ruminococcus, Megasphaera, and Prevotella), which were linked with carnitine shuttle (p = 0.0003), fatty acid metabolism (p = 0.001) and activation (p = 0.001), and tryptophan metabolism (p = 0.008). Megasphaera, clustered with aspartate and asparagine metabolism (p = 0.034), carnitine shuttle (p = 0.002), and tryptophan (p = 0.019), was associated with PNS for cases at T1. Gut bacteria with potential probiotic functions, along with fatty acid metabolism, tryptophan, and carnitine shuttle, were more clustered in cancer cases than the control network and this linkage with PNS needs further studies. CONCLUSIONS Using multi-omics approaches, this study indicated specific microbiome-metabolome pathways linked with PNS in children with cancer across chemotherapy. Due to limitations such as antibiotic use in cancer cases, these findings need to be further confirmed in a larger cohort.
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Affiliation(s)
- Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA, 30322, USA.
- Winship Cancer Institute, Emory University, Atlanta, GA, USA.
| | - Ronald Eldridge
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA, 30322, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Madelyn Houser
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Melissa Martin
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Christie Powell
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Kathryn S Sutton
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- School of Medicine, Emory University, Atlanta, GA, USA
| | - Hye In Noh
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Yuhua Wu
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Thomas Olson
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
- School of Medicine, Emory University, Atlanta, GA, USA
| | | | - Deborah W Bruner
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Atlanta, GA, 30322, USA
- Winship Cancer Institute, Emory University, Atlanta, GA, USA
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Lovell AL, Gardiner B, Henry L, Bate JM, Brougham MFH, Iniesta RR. The evolution of nutritional care in children and young people with acute lymphoblastic leukaemia: a narrative review. J Hum Nutr Diet 2024. [PMID: 38185902 DOI: 10.1111/jhn.13273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 12/08/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Acute lymphoblastic leukaemia (ALL) is the most common paediatric malignancy in the world. Advances in treatment protocols have resulted in survival rates of >80% in most high-income countries (HIC); however, children and young people (CYP) with ALL continue to face significant nutrition-related challenges during treatment. METHODS This narrative review outlines the changing landscape of treatment and survivorship for CYP with ALL and the advances in nutrition knowledge that call for changes to clinical nutrition practice. RESULTS The incidence of ALL has remained stable in HIC; however, there have been significant advances in survival over the past 30 years. Overweight and obesity are increasingly prevalent in CYP with ALL at diagnosis, during treatment and in survivorship. Coupled with poor diet quality, high-energy and saturated fat intakes, altered eating behaviours and inactivity, this necessitates the need for a shift in nutrition intervention. Undernutrition remains a concern for CYP with high-risk treatment protocols where oral or enteral nutrition support remains a cornerstone of maintaining nutrition status. CONCLUSIONS With improved treatment protocols and high survival rates, a shift to focusing on diet quality, prevention of excessive weight gain and obesity during treatment and survivorship is necessary.
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Affiliation(s)
- Amy L Lovell
- Department of Nutrition and Dietetics, The University of Auckland, Faculty of Medical and Health Sciences, Auckland, New Zealand
- Starship Blood and Cancer Centre, Starship Child Health, Auckland, New Zealand
| | - Breeana Gardiner
- Department of Nutrition and Dietetics, Great Ormond Street Hospital NHS Foundation Trust, London, UK
| | - Louise Henry
- Department of Nutrition and Dietetics, Royal Marsden NHS Foundation Trust, Surrey, UK
| | - Jessica M Bate
- Department of Paediatric Oncology, Southampton Children's Hospital, Southampton, UK
| | - Mark F H Brougham
- Department of Haematology and Oncology, Royal Hospital for Sick Children, Edinburgh, UK
| | - Raquel Revuelta Iniesta
- Children's Health and Exercise Research Centre (CHERC), Faculty of Health and Life Sciences, Public Health and Sport Sciences, Medical School, St Luke's Campus, University of Exeter, Exeter, UK
- Child Life and Health, University of Edinburgh, Edinburgh, UK
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Hussein N, Rajasuriar R, Khan AM, Lim YAL, Gan GG. The Role of the Gut Microbiome in Hematological Cancers. Mol Cancer Res 2024; 22:7-20. [PMID: 37906201 DOI: 10.1158/1541-7786.mcr-23-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 06/23/2023] [Accepted: 10/27/2023] [Indexed: 11/02/2023]
Abstract
Humans are in a complex symbiotic relationship with a wide range of microbial organisms, including bacteria, viruses, and fungi. The evolution and composition of the human microbiome can be an indicator of how it may affect human health and susceptibility to diseases. Microbiome alteration, termed as dysbiosis, has been linked to the pathogenesis and progression of hematological cancers. A variety of mechanisms, including epithelial barrier disruption, local chronic inflammation response trigger, antigen dis-sequestration, and molecular mimicry, have been proposed to be associated with gut microbiota. Dysbiosis may be induced or worsened by cancer therapies (such as chemotherapy and/or hematopoietic stem cell transplantation) or infection. The use of antibiotics during treatment may also promote dysbiosis, with possible long-term consequences. The aim of this review is to provide a succinct summary of the current knowledge describing the role of the microbiome in hematological cancers, as well as its influence on their therapies. Modulation of the gut microbiome, involving modifying the composition of the beneficial microorganisms in the management and treatment of hematological cancers is also discussed. Additionally discussed are the latest developments in modeling approaches and tools used for computational analyses, interpretation and better understanding of the gut microbiome data.
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Affiliation(s)
- Najihah Hussein
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Reena Rajasuriar
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Asif M Khan
- School of Data Sciences, Perdana University, Kuala Lumpur, Malaysia
- Beykoz Institute of Life Sciences and Biotechnology, Bezmialem Vakif University, Istanbul, Turkiye
- College of Computing and Information Technology, University of Doha for Science and Technology, Doha, Qatar
| | - Yvonne Ai-Lian Lim
- Department of Parasitology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Gin Gin Gan
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
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Andersen S, Henden A, Staudacher H, Kennedy G, Gavin N. Fibre intake and supplementation during treatment for haematological malignancies: A scoping review. J Hum Nutr Diet 2023; 36:1982-1991. [PMID: 37403340 DOI: 10.1111/jhn.13209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 07/03/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND Gastrointestinal microbiome diversity decreases rapidly during haematological cancer treatment with low diversity associated with poorer clinical outcomes. Therefore, factors that may benefit the microbiome require evaluation. This scoping review aimed to identify and describe the available research on fibre intake and supplementation during haematological cancer treatment. METHODS This scoping review included observational studies of usual fibre intake and intervention fibre supplementation trials with patients undergoing chemotherapy, immunotherapy or stem cell transplantation for haematological malignancy. Comprehensive searching of four databases plus grey literature was conducted. Study design, type of fibre (for fibre supplementation trials) and evaluated outcomes were recorded. The review was registered on Open Science Framework and completed in three stages. There were no date restrictions in the search and only studies in English were included. RESULTS Five studies met the inclusion criteria for the review including two observational studies and three supplementation trials. No randomised control trials were identified. The interventional studies provided either a single fibre supplement (fructo-oligosaccharide) or a combination of fibres (polydextrose, lactosucrose, resistant starch or oligosaccharides plus fibre) during stem cell transplantation. The most frequently evaluated outcomes included tolerability of the fibre supplement, clinical outcomes (infection, graft versus host disease, survival) and the impact on the gastrointestinal microbiome. CONCLUSIONS Further research, including randomised controlled trials, is needed to investigate the role of fibre during haematological cancer treatment, including the pathways in which it might improve disease outcome.
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Affiliation(s)
- Sarah Andersen
- Department of Dietetics and Foodservices, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, Australia
| | - Andrea Henden
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Translational Cancer Immunotherapy Laboratory, QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Heidi Staudacher
- Food & Mood Centre, IMPACT Institute, School of Medicine, Geelong, Australia
| | - Glen Kennedy
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Nicole Gavin
- Cancer Care Services, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
- Centre for Healthcare Transformation, Kelvin Grove, QLD, Australia
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Role of Nutrition in Pediatric Patients with Cancer. Nutrients 2023; 15:nu15030710. [PMID: 36771416 PMCID: PMC9920596 DOI: 10.3390/nu15030710] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 02/01/2023] Open
Abstract
Children with cancer are at high risk for developing short-term and long-term nutritional problems related to their underlying disease and side effects of multimodal treatments. Nutritional status (NS) can influence several clinical outcomes, such as overall survival (OS) and event-free survival (EFS), treatment tolerance, risk of developing infections and quality of life (QoL). However, the importance of nutrition in children with cancer is still underestimated. This review focuses on alterations of NS that occurs in children during cancer treatment. In particular, we reviewed the pathogenesis of undernutrition in oncological children, as well as how NS affects treatment tolerance and response, the immune system and the risk of infections of children with cancer. Thanks to recent advances in all types of supportive therapy and to the progress of knowledge on this topic, it has been realized that NS is a modifiable prognostic factor that can be intervened upon to improve the outcome of these patients. Currently, there is a lack of a systematic approach and standard recommendations for nutritional care in the pediatric cancer population. Literature analysis showed that it is essential to define the NS and treat any alterations in a timely manner ensuring proper growth and development. Nutritional follow-up should become an integral part of the care pathway. Regular nutritional monitoring should be performed at diagnosis, during treatment and during follow-up. A close collaboration and sharing of expertise between pediatric oncologists and nutrition specialists, combined with careful and participatory sharing of the feeding experience with the family and the child (after age 6 years), is strongly required.
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Liang S, Wang L, Wu X, Hu X, Wang T, Jin F. The different trends in the burden of neurological and mental disorders following dietary transition in China, the USA, and the world: An extension analysis for the Global Burden of Disease Study 2019. Front Nutr 2023; 9:957688. [PMID: 36698474 PMCID: PMC9869872 DOI: 10.3389/fnut.2022.957688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 12/06/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction The highly processed western diet is substituting the low-processed traditional diet in the last decades globally. Increasing research found that a diet with poor quality such as western diet disrupts gut microbiota and increases the susceptibility to various neurological and mental disorders, while a balanced diet regulates gut microbiota and prevents and alleviates the neurological and mental disorders. Yet, there is limited research on the association between the disease burden expanding of neurological and mental disorders with a dietary transition. Methods We compared the disability-adjusted life-years (DALYs) trend by age for neurological and mental disorders in China, in the United States of America (USA), and across the world from 1990 to 2019, evaluated the dietary transition in the past 60 years, and analyzed the association between the burden trend of the two disorders with the changes in diet composition and food production. Results We identified an age-related upward pattern in disease burden in China. Compared with the USA and the world, the Chinese neurological and mental disorders DALY percent was least in the generation over 75 but rapidly increased in younger generations and surpassed the USA and/or the world in the last decades. The age-related upward pattern in Chinese disease burdens had not only shown in the presence of cardiovascular diseases, neoplasms, and diabetes mellitus but also appeared in the presence of depressive disorders, Parkinson's disease, Alzheimer's disease and other dementias, schizophrenia, headache disorders, anxiety disorders, conduct disorders, autism spectrum disorders, and eating disorders, successively. Additionally, the upward trend was associated with the dramatic dietary transition including a reduction in dietary quality and food production sustainability, during which the younger generation is more affected than the older. Following the increase in total calorie intake, alcohol intake, ratios of animal to vegetal foods, and poultry meat to pulses, the burdens of the above diseases continuously rose. Then, following the rise of the ratios of meat to pulses, eggs to pulses, and pork to pulses, the usage of fertilizers, the farming density of pigs, and the burdens of the above disease except diabetes mellitus were also ever-increasing. Even the usage of pesticides was positively correlated with the burdens of Parkinson's disease, schizophrenia, cardiovascular diseases, and neoplasms. Contrary to China, the corresponding burdens of the USA trended to reduce with the improvements in diet quality and food production sustainability. Discussion Our results suggest that improving diet quality and food production sustainability might be a promising way to stop the expanding burdens of neurological and mental disorders.
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Affiliation(s)
- Shan Liang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Key Laboratory of Microbial Physiological and Metabolic Engineering, Institute of Microbiology, Chinese Academy of Sciences, Beijing, China,Gut-brain Psychology Laboratory, Beijing, China,*Correspondence: Shan Liang,
| | - Li Wang
- Department for the History of Science and Scientific Archaeology, University of Science and Technology of China, Hefei, Anhui, China
| | - Xiaoli Wu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Gut-brain Psychology Laboratory, Beijing, China
| | - Xu Hu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Gut-brain Psychology Laboratory, Beijing, China
| | - Tao Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Gut-brain Psychology Laboratory, Beijing, China
| | - Feng Jin
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China,Gut-brain Psychology Laboratory, Beijing, China,Feng Jin,
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Deleemans JM, Toivonen K, Reimer RA, Carlson LE. The Chemo-Gut Study: A Cross-Sectional Survey Exploring Physical, Mental, and Gastrointestinal Health Outcomes in Cancer Survivors. Glob Adv Health Med 2022; 11:2164957X221145940. [PMID: 36583068 PMCID: PMC9793028 DOI: 10.1177/2164957x221145940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 10/03/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Background Cancer treatments, such as chemotherapy, may adversely affect gastrointestinal (GI), physical and mental health in survivors of cancer. Objective This study investigated associations between GI, mental and physical health outcomes, and cancer treatment-related variables, such as chemotherapy, in adult cancer survivors. Methods A one-time cross-sectional survey with patient-reported outcomes was used. Cancer survivors (N = 317) aged ≥18 years, living in Canada, who completed cancer treatments were included. Descriptive statistics, correlation, and linear regression analyses are reported. Results Mean age at diagnosis was 40.90 ± 15.40 years. Most survivors received chemotherapy (86.1%). Persistent GI symptoms include constipation (53.6%), diarrhea (50.5%), and bloating/pain (54.9%). Mean GI symptom duration was 30.53 ± 33.42 months. Severity of GI symptom interference was moderate to extreme for 51.9% of survivors. Compared to normative values of 50 in healthy people, survivors scored poorer for mental health (M = 42.72 ± 8.16) and physical health (M = 45.55 ± 7.93), and reported more belly pain (M = 56.10 ± 8.58), constipation (M = 54.38 ± 6.81), diarrhea (M = 55.69 ± 6.77), and gas/bloating (M = 56.08 ± 8.12). Greater GI symptom severity was associated with poorer mental and physical health (P < .01). Chemotherapy was associated with increased belly pain (B = 4.83, SE = 1.65, P < .01) and gas/bloating (B = 3.06, SE = 1.45, P = .04). Conclusion We provide novel evidence that many cancer survivors experience chronic, moderate to severe GI symptoms lasting for years after cancer treatment, which are associated with worse mental and physical health. Chemotherapy is associated with specific GI symptoms. Integrative therapies are needed to address GI symptoms in cancer survivors.
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Affiliation(s)
- Julie M. Deleemans
- Department of Oncology, University of Calgary Cumming School
of Medicine, Calgary, AB, Canada,Julie M. Deleemans, Department of Oncology,
University of Calgary Cumming School of Medicine, Holy Cross Hospital, 2210 2 St
SW, Calgary, AB T2S 3C3, Canada.
| | - Kirsti Toivonen
- Department of Adult Mental Health, Thunday Bay Regional Health Sciences
Centre, Thunder Bay, ON, Canada
| | | | - Linda E. Carlson
- Department of Oncology, University of Calgary Cumming School
of Medicine, Calgary, AB, Canada
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The Influence of the Gut Microbiome in Paediatric Cancer Origin and Treatment. Antibiotics (Basel) 2022; 11:antibiotics11111521. [PMID: 36358176 PMCID: PMC9686478 DOI: 10.3390/antibiotics11111521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 10/27/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Knowledge of the complexity of the gut microbiota is expanding, and its importance in physiological processes and disease development is widely studied. The aim of this review is to present the most relevant and recent research on the associations between gut microbiota and oncologic disease. Recently, a number of associations between the gut microbiome and neoplasms—regarding tumorigenesis, prognosis and therapeutic efficacy—have been reported. The effects of the gut microbiome on these processes are via the direct and indirect immunomodulating effects of bacteria. Studies have been done mainly in adult populations, where its effect on immunomodulating therapies was unambiguous. In paediatric populations, however, due to the low number of cases and the complex therapeutic approaches, there have been only a few studies. Among them, children with acute lymphoblastic leukaemia were mainly involved. Significant alterations in the abundance of certain bacteria were associated with altered therapeutic responses. Regarding solid tumours, studies with low case numbers have been reported; no significant discoveries have been described so far. In the future, studies with larger cohorts are needed in order to better understand the associations between bacteria and neoplasms and to improve prognosis in the paediatric oncologic population.
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10
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Withycombe JS, Eldridge R, Jin Y, Gu H, Castellino SM, Sears DD. Metabolites Associated With Fatigue and Physical Activity in Childhood Cancer. Biol Res Nurs 2022; 24:350-361. [PMID: 35466716 DOI: 10.1177/10998004221085029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Children and adolescents with cancer report increased fatigue and decreased physical activity, introducing risk factors for chronic disease and suppressed quality of life. Research suggests an inverse relationship between fatigue and physical activity, but the biological explanation is not well understood. The purpose of this study was to 1) explore metabolites associated with fatigue or physical activity and 2) to identify any shared metabolomic elements. Methods: Children, ages 8-17 years, attending a pediatric oncology summer camp provided Patient-Reported Outcome Measurement System® (PROMIS) Pediatric Fatigue assessments, physical activity data (steps/day), and urine samples pre- and post-camp. Differences in PROMIS Pediatric Fatigue scores and average daily steps were calculated using paired t-tests. Liquid chromatography-tandem mass spectrometry was conducted using a targeted metabolomic approach. Results: Thirty-two enrolled children had complete data. Fatigue scores decreased (pre-camp 45.1; post-camp 42.1; p = 0.04) while steps-per-day increased (pre-camp 6699; post-camp 16,021; p < 0.001). Twenty-seven metabolites significantly differentiated (false discovery rate <0.20) between low, medium, or high physical activity, while 8 metabolites discriminated between high and low fatigue. Indole-3-lactic acid, a tryptophan metabolite, was significantly associated with both physical activity and fatigue. Conclusion: This study provides evidence of metabolome associations with fatigue and physical activity in children with cancer. Overlapping metabolomic elements provide evidence of biological inter-connectivity and suggest areas for future research. Given the known evidence regarding the benefits of physical activity, and the potential interaction with fatigue, nurses should routinely assess patient reports of these elements and provide patient/family education related to fatigue management and physical activity goals.
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Affiliation(s)
- Janice S Withycombe
- 47810Clemson University School of Nursing, Clemson, SC, USA.,Nell Hodgson Woodruff School of Nursing, 15792Emory University, Atlanta, GA, USA
| | - Ronald Eldridge
- Nell Hodgson Woodruff School of Nursing, 15792Emory University, Atlanta, GA, USA
| | - Yan Jin
- College of Health Solutions, 7864Arizona State University, Phoenix, AZ, USA
| | - Haiwai Gu
- College of Health Solutions, 7864Arizona State University, Phoenix, AZ, USA.,Department of Environmental Health Sciences, the Robert Stempel College of Public Health and Social Work, 584996Florida International University, Miami, FL, USA.,Center for Translational Science, Cellular Biology and Pharmacology Department, the Herbert Wertheim College of Medicine, Florida International University, Port St Lucie, FL, USA
| | - Sharon M Castellino
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.,Emory University School of Medicine, Atlanta, GA, USA
| | - Dorothy D Sears
- College of Health Solutions, 7864Arizona State University, Phoenix, AZ, USA.,Moores Cancer Center, UC San Diego, La Jolla, CA, USA.,Department of Medicine, UC San Diego, La Jolla, CA, USA
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11
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Infection prevention requirements for the medical care of immunosuppressed patients: recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) at the Robert Koch Institute. GMS HYGIENE AND INFECTION CONTROL 2022; 17:Doc07. [PMID: 35707229 PMCID: PMC9174886 DOI: 10.3205/dgkh000410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In Germany, guidelines for hygiene in hospitals are given in form of recommendations by the Commission for Hospital Hygiene and Infection Prevention (Kommission für Krankenhaushygiene und Infektionsprävention, "KRINKO"). The KRINKO and its voluntary work are legitimized by the mandate according to § 23 of the Infection Protection Act (Infektionsschutzgesetz, "IfSG"). The original German version of this document was published in February 2021 and has now been made available to the international professional public in English. The guideline provides recommendations on infection prevention and control for immunocompromised individuals in health care facilities. This recommendation addresses not only measures related to direct medical care of immunocompromised patients, but also management aspects such as surveillance, screening, antibiotic stewardship, and technical/structural aspects such as patient rooms, air quality, and special measures during renovations.
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12
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Zhou S, Martin M, Powell C, Sutton KS, George B, Olson T, Konstantinidis KT, Bruner DW, Bai J. How to Maintain a Healthy Gut Microbiome in Children with Cancer? Gut Microbiome Association with Diet in Children with Solid Tumors Postchemotherapy. OMICS: A JOURNAL OF INTEGRATIVE BIOLOGY 2022; 26:236-245. [PMID: 35230178 PMCID: PMC9051874 DOI: 10.1089/omi.2022.0002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Malnutrition is a common complication in children with cancer. Cancer treatment and malnutrition can disrupt gut microbiome diversity and composition. The gut microbiome is of broad interest to better understand the mechanisms of malnutrition in cancer therapy. This study aimed to compare the gut microbiome between children with solid tumors postchemotherapy and healthy controls, and investigated the association of the putative microbiome differences with diet. Study participants were 27 children (7-18 years) with solid tumors within the first year after the completion of chemotherapy and 22 healthy controls. The study groups did not have a statistically significant difference in age, race, sex, and body mass index. At study intake, the participants completed the Block Kids Food Screener for dietary intakes in the past week. Fecal specimens were collected and analyzed for the gut microbiome. The cancer and control groups differed in gut microbial β-diversity and abundance analyses. The macronutrient intakes such as carbohydrates, fiber, beta-carotene, and vitamin B6 were positively associated with α-diversity. Children with adequate vitamin B6 had a higher Chao1 diversity index than children with inadequate or excessive intake (p = 0.0004). Children with excessive selenium intake had a trend for higher Pielou's_e index than children with inadequate intake (p = 0.091). Maintaining a healthy gut microbiome is critical among children with cancer. This study provides new insights on the linkages between dietary intakes and the gut microbiome in children with solid tumors postchemotherapy. These findings, if replicated in future independent studies, may help anticipate malnutrition and plan for personalized nutrition approaches during chemotherapy in pediatric cancers.
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Affiliation(s)
- Shuqi Zhou
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Melissa Martin
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Christie Powell
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Kathryn S. Sutton
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Bradley George
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Thomas Olson
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
- School of Medicine, Emory University, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | | | - Deborah W. Bruner
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
| | - Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
- School of Medicine, Emory University, Atlanta, Georgia, USA
- Winship Cancer Institute, Emory University, Atlanta, Georgia, USA
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13
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Bai J, Barandouzi ZA, Rowcliffe C, Meador R, Tsementzi D, Bruner DW. Gut Microbiome and Its Associations With Acute and Chronic Gastrointestinal Toxicities in Cancer Patients With Pelvic Radiation Therapy: A Systematic Review. Front Oncol 2021; 11:745262. [PMID: 34938654 PMCID: PMC8685326 DOI: 10.3389/fonc.2021.745262] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 11/22/2021] [Indexed: 12/12/2022] Open
Abstract
Aim Pelvic radiation therapy (RT) can impact the gut microbiome in patients with cancer and result in gastrointestinal (GI) toxicities. The purpose of this systematic review was to describe the effects of RT on the gut microbiome and the associations between the gut microbiome and GI toxicities in patients treated with pelvic RT. Methods PubMed, Embase, and Web of Science databases were searched from their earliest records to August 2020. The articles screening process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The Mixed Method Assessment Tool was used to assess the methodological quality for each included study. All study findings were synthesized and presented in narrative format. Thirteen studies were included. The gut microbiome of fecal samples was analyzed using 16S rRNA sequencing approaches. Results There were disparities in alpha and beta diversities that existed across the studies. Divergent results were found among various phyla, including Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria, Cyanobacteria, Fusobacteria, and Deinococcus-Thermus. Moreover, alteration in the gut microbiome diversity and abundance related to cancer treatment was associated with pelvic toxicities, specifically diarrhea. Following treatment, increases in the abundance of Bacteroides was associated with diarrhea and radiation enteritis. Conclusions Pelvic RT can disrupt the diversity and abundance of commensal gut microorganisms. A dysbiotic gut microbiome showed a promising association with radiation enteritis through alterations of the intestinal barrier function, innate immunity, and intestinal repair mechanisms; however, confounders, such as diet, were not thoroughly addressed.
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Affiliation(s)
- Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States.,Winship Cancer Institute, Emory University, Atlanta, GA, United States
| | - Zahra A Barandouzi
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Claire Rowcliffe
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Rebecca Meador
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States
| | - Despina Tsementzi
- Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Deborah Watkins Bruner
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States.,Winship Cancer Institute, Emory University, Atlanta, GA, United States
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14
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Yuan G, Dong Y, Zhou X. Image classification of vaginal microecology detection based on gabor texture and LSTM model. Technol Health Care 2021; 30:919-936. [PMID: 34957969 DOI: 10.3233/thc-213509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Gynecological diseases threaten women's health, and vaginal microecological testing is a common method for detecting gynecological diseases. Efficient and accurate microecological testing methods have always been the goal pursued by gynecologists. OBJECTIVE In order to automatically identify different types of microbial images in vaginal micromorphology detection, this paper proposes a vaginal microecological image recognition method based on Gabor texture analysis combined with long and short-term memory network (LSTM) model. METHOD Firstly, we denoise the microecological morphological im-ages, which selects the area of interest and sets the label of the microorganism according to the doctors label. Secondly, texture analysis is carried out for the region of interest, which uses Gabor filters with 8 directions and 5 scales to filter the region of interest to extract the texture features on the image. Comparing the differences between different microbial image features, and screening suitable features to reduce the number of features. Then, we design an LSTM model to analyze the relationship of image features in different categories of microorganisms. Finally, we use the full connection layer and Softmax function to realize the automatic recognition of different microbial images. RESULTS The experimental results show that the image classification accuracy of 8 common microorganisms is 81.26%. CONCLUSION Texture analysis combined with LSTM network strategy can identify different kinds of vaginal micro ecological images. Gabor-LSTM model has better classification effect on imbalanced data sets.
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Affiliation(s)
- Gaoteng Yuan
- College of Computer and Information, Hohai University, Nanjing, Jiangsu, China
| | - Yinping Dong
- Department of Gastroenterology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy at Tianjin, Tianjins Clinical Research Center for Cancer, Tianjin, China
| | - Xiaofeng Zhou
- College of Computer and Information, Hohai University, Nanjing, Jiangsu, China
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15
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Deleemans JM, Gajtani Z, Baydoun M, Reimer RA, Piedalue KA, Carlson LE. The Use of Prebiotic and Probiotic Interventions for Treating Gastrointestinal and Psychosocial Health Symptoms in Cancer Patients and Survivors: A Systematic Review. Integr Cancer Ther 2021; 20:15347354211061733. [PMID: 34844479 PMCID: PMC8649088 DOI: 10.1177/15347354211061733] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cancer treatments can cause significant gastrointestinal (GI) health issues, and negatively affect patient's psychosocial health and quality of life (QOL). Novel, integrative strategies using prebiotics and probiotics have been explored for treating adverse cancer treatment-related side effects. We evaluated the current literature for interventions using prebiotics or probiotics specifically to treat GI and psychosocial health issues in cancer patients and survivors. METHODS Five databases (PubMed, MEDLINE (Ovid), CINHAL, PsychINFO, Web of Science) were searched for studies with prebiotic or probiotic interventions where GI and/or psychosocial health outcomes were measured in adult cancer patients and survivors, and published before September 12th 2021. RESULTS Twelve studies (N = 974 participants) meeting the inclusion criteria were identified (randomized controlled trials [n = 10], single-group pre-post studies [n = 2]). Ten studies were conducted with patients on active cancer treatment, and 2 studies treated patients after anti-cancer therapies. Three studies used prebiotics, 7 studies used probiotics, and 2 studies used a combination therapy. The most commonly used probiotic strains were from the Lactobacillus genus. There was minimal evidence for prebiotics to improve GI or psychosocial health. Probiotics were associated with significant improvements in abdominal pain (n = 2), gas/bloating (n = 2), and especially diarrhea (n = 5), and with improvements in anxiety (n = 1), depression (n = 1), fatigue (n = 1), and QOL (n = 2). CONCLUSIONS Studies specifically examining effects of prebiotics and probiotics on GI and psychosocial health outcomes are scarce. Probiotic intervention may improve some GI symptoms in cancer patients, and QOL in survivors. Controlled trials that consistently include GI and psychosocial health outcomes are needed.
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16
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Listening in on the conversation between the human gut microbiome and its host. Curr Opin Microbiol 2021; 63:150-157. [PMID: 34352595 DOI: 10.1016/j.mib.2021.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/09/2021] [Accepted: 07/15/2021] [Indexed: 02/07/2023]
Abstract
The gut microbiome is an ecosystem. Natural selection favored microbes fit for the gut, which can utilize and convert molecules produced by the host for their own benefit. But natural selection also favored the host's mechanisms to sense and respond to the microbial ecosystem for its own benefit. We can listen in on the host-microbiome 'conversation' in the simultaneous responses of the microbiome and the host to strong perturbations. In laboratory animals a perturbation can be done for research; in human patients a perturbation can be caused by disease or therapy. Advances in metagenomics, metabolomics and computation amplify our means to listen in on the conversation between the gut microbiome and its host.
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17
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Bélanger V, Benmoussa A, Napartuk M, Warin A, Laverdière C, Marcoux S, Levy E, Marcil V. The Role of Oxidative Stress and Inflammation in Cardiometabolic Health of Children During Cancer Treatment and Potential Impact of Key Nutrients. Antioxid Redox Signal 2021; 35:293-318. [PMID: 33386063 DOI: 10.1089/ars.2020.8143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Significance: The 5-year survival rate of childhood cancers is now reaching 84%. However, treatments cause numerous acute and long-term side effects. These include cardiometabolic complications, namely hypertension, dyslipidemia, hyperglycemia, insulin resistance, and increased fat mass. Recent Advances: Many antineoplastic treatments can induce oxidative stress (OxS) and trigger an inflammatory response, which may cause acute and chronic side effects. Critical Issues: Clinical studies have reported a state of heightened OxS and inflammation during cancer treatment in children as the result of treatment cytotoxic action on both cancerous and noncancerous cells. Higher levels of OxS and inflammation are associated with treatment side effects and with the development of cardiometabolic complications. Key nutrients (omega-3 polyunsaturated fatty acids, dietary antioxidants, probiotics, and prebiotics) have the potential to modulate inflammatory and oxidative responses and, therefore, could be considered in the search for adverse complication prevention means as long as antineoplastic treatment efficiency is maintained. Future Directions: There is a need to better understand the relationship between cardiometabolic complications, OxS, inflammation and diet during pediatric cancer treatment, which represents the ultimate goal of this review. Antioxid. Redox Signal. 35, 293-318.
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Affiliation(s)
- Véronique Bélanger
- Research Centre, CHU Sainte-Justine University Health Centre, Montreal, Canada.,Department of Nutrition, Université de Montréal, Montreal, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada
| | - Abderrahim Benmoussa
- Research Centre, CHU Sainte-Justine University Health Centre, Montreal, Canada.,Department of Nutrition, Université de Montréal, Montreal, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada
| | - Mélanie Napartuk
- Research Centre, CHU Sainte-Justine University Health Centre, Montreal, Canada.,Department of Nutrition, Université de Montréal, Montreal, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada
| | - Alexandre Warin
- Research Centre, CHU Sainte-Justine University Health Centre, Montreal, Canada
| | | | - Sophie Marcoux
- Department of Public Health & Preventive Medicine, Université de Montréal, Montreal, Canada
| | - Emile Levy
- Research Centre, CHU Sainte-Justine University Health Centre, Montreal, Canada.,Department of Nutrition, Université de Montréal, Montreal, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada.,Department of Pediatrics, Université de Montréal, Montreal, Canada
| | - Valérie Marcil
- Research Centre, CHU Sainte-Justine University Health Centre, Montreal, Canada.,Department of Nutrition, Université de Montréal, Montreal, Canada.,Institute of Nutrition and Functional Foods, Laval University, Quebec City, Canada
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18
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Cuozzo M, Castelli V, Avagliano C, Cimini A, d’Angelo M, Cristiano C, Russo R. Effects of Chronic Oral Probiotic Treatment in Paclitaxel-Induced Neuropathic Pain. Biomedicines 2021; 9:biomedicines9040346. [PMID: 33808052 PMCID: PMC8066538 DOI: 10.3390/biomedicines9040346] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/12/2022] Open
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) represents one of the most prevalent and potentially disabling side effects due to the use of anticancer drugs, one of the primary neuropathies detected is peripheral neuropathy induced by administration of taxanes, including paclitaxel. It has been demonstrated that gut microbiota is crucial for the therapeutic effect of chemotherapeutic drugs for inhibiting tumor growth and contributed to the pathogenesis of the CIPN. The use of nutraceuticals has receiving growing attention from the research community due to their phytochemical, biological, and pharmacological properties. It has been demonstrated that probiotic formulations may both reduce inflammation and modulate the expression of pain receptors. Our studies tested the efficacy of a probiotic formulation, SLAB51, in preventing paclitaxel-induced neuropathy. Interestingly, our probiotic formulation was able to keep the gut integrity, preserving its functionality, in CIPN-mice, moreover, it prevented the mechanical and cold hypersensitivity induced in paclitaxel-mice. Additionally, ex-vivo analysis showed that in CIPN-mice the pro-biotic treatment increased the expression of opioid and cannabinoid receptors in spinal cord, it prevented in the reduction in nerve fiber damage in the paws and modulated the serum proinflammatory cytokines concentration. On basis of these data, the use of this specific probiotic formulation may represent a valid adjuvant agent to paclitaxel, useful and not toxic for long-lasting therapies.
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Affiliation(s)
- Mariarosaria Cuozzo
- Department of Pharmacy, University of Naples Federico II, 80131 Napoli, Italy; (M.C.); (C.A.); (R.R.)
| | - Vanessa Castelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (V.C.); (A.C.)
| | - Carmen Avagliano
- Department of Pharmacy, University of Naples Federico II, 80131 Napoli, Italy; (M.C.); (C.A.); (R.R.)
| | - Annamaria Cimini
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (V.C.); (A.C.)
- Sbarro Institute for Cancer Research and Molecular Medicine and Center for Biotechnology, Temple University, Philadelphia, PA 19122, USA
| | - Michele d’Angelo
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (V.C.); (A.C.)
- Correspondence: (M.d.); (C.C.)
| | - Claudia Cristiano
- Department of Pharmacy, University of Naples Federico II, 80131 Napoli, Italy; (M.C.); (C.A.); (R.R.)
- Task Force on Microbiome Studies, University of Naples “Federico II”, 80131 Naples, Italy
- Correspondence: (M.d.); (C.C.)
| | - Roberto Russo
- Department of Pharmacy, University of Naples Federico II, 80131 Napoli, Italy; (M.C.); (C.A.); (R.R.)
- Task Force on Microbiome Studies, University of Naples “Federico II”, 80131 Naples, Italy
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19
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Anforderungen an die Infektionsprävention bei der medizinischen Versorgung von immunsupprimierten Patienten. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:232-264. [PMID: 33394069 PMCID: PMC7780910 DOI: 10.1007/s00103-020-03265-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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20
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Morel S, Delvin E, Marcil V, Levy E. Intestinal Dysbiosis and Development of Cardiometabolic Disorders in Childhood Cancer Survivors: A Critical Review. Antioxid Redox Signal 2021; 34:223-251. [PMID: 32390455 DOI: 10.1089/ars.2020.8102] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Significance: Survivors of pediatric cancers have a high risk of developing side effects after the end of their treatments. Many potential factors have been associated with the onset of cardiometabolic disorders (CMD), including cancer disease itself, chemotherapy, hormonal treatment, radiotherapy, and genetics. However, the precise etiology and underlying mechanisms of these long-term complications are poorly understood. Recent Advances: Greater awareness is currently paid to the role of microbiota in the emergence of cancers and modulation of cancer therapies in both children and adults. Alterations in the composition and diversity of intestinal microbiota can clearly influence tumor development and progression as well as immune responses and clinical output. As dysbiosis is closely linked to the development of host metabolic diseases, including obesity, metabolic syndrome, type 2 diabetes, and non-alcoholic fatty liver disease, it may increase the risk of CMD in cancer populations. Critical Issues: Only limited studies targeting the profile of intestinal dysbiosis before and after cancer treatment have been conducted. Further, the exact contribution of intestinal dysbiosis to the development of CMD in cancer survivors is poorly appreciated. This review intends to clarify the influence of gut microbiota on CMD in childhood cancer survivors, elucidate the potential mechanisms, and evaluate the latest research on the interplay between diet/food supplement, microbiota, and cancer-related CMD. Future Directions: The implication of intestinal dysbiosis in late metabolic complications of childhood cancer survivors should be clarified. Intervention strategies could be developed to reduce the risk of survivors to CMD. Antioxid. Redox Signal. 34, 223-251.
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Affiliation(s)
- Sophia Morel
- Research Centre, Sainte-Justine University Hospital Health Center, Université de Montréal, Montreal, Canada.,Department of Nutrition and Université de Montréal, Montreal, Canada
| | - Edgard Delvin
- Research Centre, Sainte-Justine University Hospital Health Center, Université de Montréal, Montreal, Canada
| | - Valérie Marcil
- Research Centre, Sainte-Justine University Hospital Health Center, Université de Montréal, Montreal, Canada.,Department of Nutrition and Université de Montréal, Montreal, Canada
| | - Emile Levy
- Research Centre, Sainte-Justine University Hospital Health Center, Université de Montréal, Montreal, Canada.,Department of Nutrition and Université de Montréal, Montreal, Canada.,Department of Pediatrics, Université de Montréal, Montreal, Canada
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21
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Davoodvandi A, Marzban H, Goleij P, Sahebkar A, Morshedi K, Rezaei S, Mahjoubin-Tehran M, Tarrahimofrad H, Hamblin MR, Mirzaei H. Effects of therapeutic probiotics on modulation of microRNAs. Cell Commun Signal 2021; 19:4. [PMID: 33430873 PMCID: PMC7798223 DOI: 10.1186/s12964-020-00668-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 09/22/2020] [Indexed: 12/15/2022] Open
Abstract
Probiotics are beneficial bacteria that exist within the human gut, and which are also present in different food products and supplements. They have been investigated for some decades, due to their potential beneficial impact on human health. Probiotics compete with pathogenic microorganisms for adhesion sites within the gut, to antagonize them or to regulate the host immune response resulting in preventive and therapeutic effects. Therefore, dysbiosis, defined as an impairment in the gut microbiota, could play a role in various pathological conditions, such as lactose intolerance, gastrointestinal and urogenital infections, various cancers, cystic fibrosis, allergies, inflammatory bowel disease, and can also be caused by antibiotic side effects. MicroRNAs (miRNAs) are short non-coding RNAs that can regulate gene expression in a post-transcriptional manner. miRNAs are biochemical biomarkers that play an important role in almost all cellular signaling pathways in many healthy and disease states. For the first time, the present review summarizes current evidence suggesting that the beneficial properties of probiotics could be explained based on the pivotal role of miRNAs. Video Abstract
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Affiliation(s)
| | - Havva Marzban
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
| | - Pouya Goleij
- Department of Genetics, Faculty of Biology,Sana Institute of Higher Education, Sari, Iran
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.,Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Korosh Morshedi
- Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran
| | - Samaneh Rezaei
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Mahjoubin-Tehran
- Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Medical Biotechnology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Tarrahimofrad
- Department of Animal Biotechnology, National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, 40 Blossom Street, Boston, MA, 02114, USA.
| | - Hamed Mirzaei
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Institute for Basic Sciences, Kashan University of Medical Sciences, Kashan, Iran.
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22
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Huybrechts I, Zouiouich S, Loobuyck A, Vandenbulcke Z, Vogtmann E, Pisanu S, Iguacel I, Scalbert A, Indave I, Smelov V, Gunter MJ, Michels N. The Human Microbiome in Relation to Cancer Risk: A Systematic Review of Epidemiologic Studies. Cancer Epidemiol Biomarkers Prev 2020; 29:1856-1868. [PMID: 32727720 PMCID: PMC7541789 DOI: 10.1158/1055-9965.epi-20-0288] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/06/2020] [Accepted: 07/22/2020] [Indexed: 12/12/2022] Open
Abstract
The microbiome has been hypothesized to play a role in cancer development. Because of the diversity of published data, an overview of available epidemiologic evidence linking the microbiome with cancer is now needed. We conducted a systematic review using a tailored search strategy in Medline and EMBASE databases to identify and summarize the current epidemiologic literature on the relationship between the microbiome and different cancer outcomes published until December 2019. We identified 124 eligible articles. The large diversity of parameters used to describe microbial composition made it impossible to harmonize the different studies in a way that would allow meta-analysis, therefore only a qualitative description of results could be performed. Fifty studies reported differences in the gut microbiome between patients with colorectal cancer and various control groups. The most consistent findings were for Fusobacterium, Porphyromonas, and Peptostreptococcus being significantly enriched in fecal and mucosal samples from patients with colorectal cancer. For the oral microbiome, significantly increased and decreased abundance was reported for Fusobacterium and Streptococcus, respectively, in patients with oral cancer compared with controls. Overall, although there was a large amount of evidence for some of these alterations, most require validation in high-quality, preferably prospective, epidemiologic studies.
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Affiliation(s)
| | - Semi Zouiouich
- International Agency for Research on Cancer, Lyon, France
| | - Astrid Loobuyck
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Zeger Vandenbulcke
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Emily Vogtmann
- Division of Cancer Epidemiology & Genetics, NCI, Bethesda, Maryland
| | - Silvia Pisanu
- International Agency for Research on Cancer, Lyon, France
- Department of Biomedical Sciences, Section of Microbiology and Virology, University of Cagliari, Cagliari, Italy
| | - Isabel Iguacel
- International Agency for Research on Cancer, Lyon, France
- GENUD (Growth, Exercise, NUtrition and Development) Research Group, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | | | - Iciar Indave
- International Agency for Research on Cancer, Lyon, France
| | - Vitaly Smelov
- International Agency for Research on Cancer, Lyon, France
- Division of Noncommunicable Diseases and Promoting Health through the Life-course, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Marc J Gunter
- International Agency for Research on Cancer, Lyon, France
| | - Nathalie Michels
- Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
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23
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Bai J, Bruner DW, Fedirko V, Beitler JJ, Zhou C, Gu J, Zhao H, Lin IH, Chico CE, Higgins KA, Shin DM, Saba NF, Miller AH, Xiao C. Gut Microbiome Associated with the Psychoneurological Symptom Cluster in Patients with Head and Neck Cancers. Cancers (Basel) 2020; 12:cancers12092531. [PMID: 32899975 PMCID: PMC7563252 DOI: 10.3390/cancers12092531] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 08/24/2020] [Accepted: 09/04/2020] [Indexed: 01/04/2023] Open
Abstract
Cancer patients experience a cluster of co-occurring psychoneurological symptoms (PNS) related to cancer treatments. The gut microbiome may affect severity of the PNS via neural, immune, and endocrine signaling pathways. However, the link between the gut microbiome and PNS has not been well investigated in cancer patients, including those with head and neck cancers (HNCs). This pilot study enrolled 13 patients with HNCs, who reported PNS using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (CTCAEs). Stool specimens were collected to analyze patients' gut microbiome. All data were collected pre- and post-radiation therapy (RT). Associations between the bacterial abundances and the PNS clusters were analyzed using the linear discriminant analysis effect size; functional pathway analyses of 16S rRNA V3-V4 bacterial communities were conducted using Tax4fun. The high PNS cluster had a greater decrease in microbial evenness than the low PNS cluster from pre- to post-RT. The high and low PNS clusters showed significant differences using weighted UniFrac distance. Those individuals with the high PNS cluster were more likely to have higher abundances in phylum Bacteroidetes, order Bacteroidales, class Bacteroidia, and four genera (Ruminiclostridium9, Tyzzerella, Eubacterium_fissicatena, and DTU089), while the low PNS cluster had higher abundances in family Acidaminococcaceae and three genera (Lactococcus, Phascolarctobacterium, and Desulfovibrio). Both glycan metabolism (Lipopolysaccharide biosynthesis) and vitamin metabolism (folate biosynthesis and lipoic acid metabolism) were significantly different between the high and low PNS clusters pre- and post-RT. Our preliminary data suggest that the diversity and abundance of the gut microbiome play a potential role in developing PNS among cancer patients.
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Affiliation(s)
- Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA 30322, USA;
- Correspondence: ; Tel.: +1-404-727-2466
| | | | - Veronika Fedirko
- Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, GA 30322, USA;
| | - Jonathan J. Beitler
- Department of Radiation Oncology, School of Medicine, Emory University, Atlanta, GA 30322, USA; (J.J.B.); (K.A.H.)
| | - Chao Zhou
- Department Biostatistics, Yale School of Public Health, Yale University, New Haven, CT 06520, USA; (C.Z.); (J.G.); (H.Z.)
| | - Jianlei Gu
- Department Biostatistics, Yale School of Public Health, Yale University, New Haven, CT 06520, USA; (C.Z.); (J.G.); (H.Z.)
| | - Hongyu Zhao
- Department Biostatistics, Yale School of Public Health, Yale University, New Haven, CT 06520, USA; (C.Z.); (J.G.); (H.Z.)
| | - I-Hsin Lin
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10017, USA;
| | - Cynthia E. Chico
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA 30322, USA; (C.E.C.); (A.H.M.)
| | - Kristin A. Higgins
- Department of Radiation Oncology, School of Medicine, Emory University, Atlanta, GA 30322, USA; (J.J.B.); (K.A.H.)
| | - Dong M. Shin
- Department of Hematology and Medical Oncology, School of Medicine, Emory University, Atlanta, GA 30322, USA; (D.M.S.); (N.F.S.)
| | - Nabil F. Saba
- Department of Hematology and Medical Oncology, School of Medicine, Emory University, Atlanta, GA 30322, USA; (D.M.S.); (N.F.S.)
| | - Andrew H. Miller
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA 30322, USA; (C.E.C.); (A.H.M.)
| | - Canhua Xiao
- School of Nursing, Yale University, New Haven, CT 06477, USA;
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24
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Bhuta R, Nieder M, Jubelirer T, Ladas EJ. The Gut Microbiome and Pediatric Cancer: Current Research and Gaps in Knowledge. J Natl Cancer Inst Monogr 2020; 2019:169-173. [PMID: 31532533 DOI: 10.1093/jncimonographs/lgz026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/05/2019] [Accepted: 07/08/2019] [Indexed: 12/12/2022] Open
Abstract
The human microbiome consists of trillions of microbial cells that interact with one another and the human host to play a clinically significant role in health and disease. Gut microbial changes have been identified in cancer pathogenesis, at disease diagnosis, during therapy, and even long after completion of treatment. Alterations in the gut microbiome have been linked to treatment-related toxicity and potential long-term morbidity and mortality in children with cancer. Such alterations are plausible given immune modulation due to disease as well as exposure to cytotoxic chemotherapy, infections, and antibiotics. The following review presents our current scientific understanding on the role of the gut microbiome in pediatric cancer, identifies gaps in knowledge, and suggests future research goals.
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Affiliation(s)
- Roma Bhuta
- Division of Pediatric Hematology-Oncology, Hasbro Children's Hospital, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Michael Nieder
- Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, University of South Florida College of Medicine, Tampa, FL
| | - Tracey Jubelirer
- Division of Oncology, The Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Elena J Ladas
- Division of Hematology/Oncology/Stem Cell Transplant in the Department of Pediatrics (in Epidemiology and in the Institute of Human Nutrition) at the, Columbia University Medical Center, New York, NY
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25
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Barr RD, Stevens MCG. The influence of nutrition on clinical outcomes in children with cancer. Pediatr Blood Cancer 2020; 67 Suppl 3:e28117. [PMID: 32134218 DOI: 10.1002/pbc.28117] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 11/14/2019] [Accepted: 11/19/2019] [Indexed: 12/14/2022]
Abstract
Adequate and appropriate nutrition is essential for growth and development in children; all put at risk in those with cancer. Overnutrition and undernutrition at diagnosis raise the risk of increased morbidity and mortality during therapy and beyond. All treatment modalities can jeopardize nutritional status with potentially adverse effects on clinical outcomes. Accurate assessment of nutritional status and nutrient balance is essential, with remedial interventions delivered promptly when required. Children with cancer in low- and middle-income countries (LMICs) are especially disadvantaged with concomitant challenges in the provision of nutritional support. Cost-effective advances in the form of ready-to-use therapeutic foods (RUTF) may offer solutions. Studies in LMICs have defined a critical role for the gut microbiome in the causation of undernutrition in children and have demonstrated a beneficial effect of selected RUTF in redressing the imbalanced microbiota and improving nutritional status. Challenges in high-income countries relate both to concerns about the potential disadvantage of preexisting obesity in those newly diagnosed and to undernutrition identified at diagnosis and during treatment. Much remains to be understood but the prospects are bright for offsetting malnutrition in children with cancer, resulting in enhanced opportunity for healthy survival.
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Affiliation(s)
- Ronald D Barr
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Michael C G Stevens
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom.,NIHR Cancer and Nutrition Collaboration, Southampton, United Kingdom
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26
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Diorio C, Kelly KM, Afungchwi GM, Ladas EJ, Marjerrison S. Nutritional traditional and complementary medicine strategies in pediatric cancer: A narrative review. Pediatr Blood Cancer 2020; 67 Suppl 3:e28324. [PMID: 32614139 DOI: 10.1002/pbc.28324] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/25/2020] [Accepted: 03/22/2020] [Indexed: 12/20/2022]
Abstract
Traditional and complementary medicine (T&CM) strategies are commonly used by pediatric cancer patients. Nutritional approaches to T&CM include bioactive compounds, supplements, and herbs as well as dietary approaches. Pediatric cancer patients and their families commonly request and use nutritional T&CM strategies. We review the potential risks and benefits of nutritional T&CM use in pediatric cancer care and provide an overview of some commonly used and requested supplements, including probiotics, antioxidants, cannabinoids, vitamins, turmeric, mistletoe, Carica papaya, and others. We also discuss the role of specific diets such as the ketogenic diet, caloric restriction diets, whole-food diets, and immune modulating diets. There is a growing body of evidence to support the use of some T&CM agents for the supportive care of children with cancer. However, further study is needed into these agents and approaches. Open communication with families about T&CM use is critical.
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Affiliation(s)
- Caroline Diorio
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kara M Kelly
- Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | | | - Elena J Ladas
- Division of Pediatric Hematology/Oncology/Stem Cell Transplant, Columbia University Medical Center, New York, New York
| | - Stacey Marjerrison
- Division of Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, Ontario, L8N 3Z5, Canada
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Joffe L, Ladas EJ. Nutrition during childhood cancer treatment: current understanding and a path for future research. THE LANCET CHILD & ADOLESCENT HEALTH 2020; 4:465-475. [PMID: 32061318 DOI: 10.1016/s2352-4642(19)30407-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/20/2019] [Accepted: 11/25/2019] [Indexed: 12/18/2022]
Abstract
Proper nutritional status during cancer therapy has been recognised as being integral to a variety of health outcome measures, including overall survival, treatment tolerance, and quality of life. The prevalence of malnutrition, defined by WHO as either undernutrition or overnutrition, among children and adolescents with cancer is reported to be as high as 75%. Yet, over the past two decades there have been limited advances in elucidating the underlying pathophysiological drivers of malnutrition in this population. This effect has resulted in a paucity of research aimed at improving nutritional assessment and intervention among this group. This Review presents an in-depth discussion of the role of nutritional status in paediatric cancer care, as well as evolving avenues of investigation that might propel personalised nutrition into a viable reality. Thus, nutritional science might facilitate individualised intervention strategies, and thereby help to optimise clinical outcomes for patients and survivors of childhood cancer.
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Affiliation(s)
- Lenat Joffe
- Department of Pediatrics, Division of Pediatric Hematology, Oncology, and Stem Cell Transplant, Columbia University Irving Medical Center, New York, NY, USA
| | - Elena J Ladas
- Department of Pediatrics, Division of Pediatric Hematology, Oncology, and Stem Cell Transplant, Columbia University Irving Medical Center, New York, NY, USA.
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28
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Abstract
Introduction: Obesity compromises survival in children with cancer in high-income countries (HICs) and is accompanied often by sarcopenia. In low and middle-income countries (LMICs), where the great majority of children live, the prevalence of under-nutrition is as high as 95% in those with cancer. Nutritional support improves clinical outcomes, including survival.Areas covered: This narrative review describes the evolution of attention to nutrition in children with cancer and the increasing understanding of this relationship. An initial focus on obesity in children with acute leukemias in HICs has been matched more recently by a recognition of the negative effect of under-nutrition on survival in children with cancer in LMICs. These observations have stimulated explorations of underlying mechanisms, including dysbiosis of the gut microbiome, and structured nutritional interventions to redress adverse outcomes.Expert opinion: Studies of the gut microbiome and metabolome have yielded important information on the pathogenesis of malnutrition in children, providing new avenues for interventions. Combinations of plant products that are inexpensive and readily available in LMICs have been shown to 'mature' the microbiome and the corresponding plasma proteome in children with acute malnutrition, offering the prospect of cost-effective remedies that are tested in children with cancer.
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Affiliation(s)
- Ronald D Barr
- Division of Hematology and Oncology, Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Elena J Ladas
- Division of Hematology-Oncology/Stem Cell Transplant, Department of Pediatrics, Columbia University, Irving Medical Centre, New York, USA
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Miao R, Badger TC, Groesch K, Diaz-Sylvester PL, Wilson T, Ghareeb A, Martin JA, Cregger M, Welge M, Bushell C, Auvil L, Zhu R, Brard L, Braundmeier-Fleming A. Assessment of peritoneal microbial features and tumor marker levels as potential diagnostic tools for ovarian cancer. PLoS One 2020; 15:e0227707. [PMID: 31917801 PMCID: PMC6952086 DOI: 10.1371/journal.pone.0227707] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/26/2019] [Indexed: 12/15/2022] Open
Abstract
Epithelial ovarian cancer (OC) is the most deadly cancer of the female reproductive system. To date, there is no effective screening method for early detection of OC and current diagnostic armamentarium may include sonographic grading of the tumor and analyzing serum levels of tumor markers, Cancer Antigen 125 (CA-125) and Human epididymis protein 4 (HE4). Microorganisms (bacterial, archaeal, and fungal cells) residing in mucosal tissues including the gastrointestinal and urogenital tracts can be altered by different disease states, and these shifts in microbial dynamics may help to diagnose disease states. We hypothesized that the peritoneal microbial environment was altered in patients with OC and that inclusion of selected peritoneal microbial features with current clinical features into prediction analyses will improve detection accuracy of patients with OC. Blood and peritoneal fluid were collected from consented patients that had sonography confirmed adnexal masses and were being seen at SIU School of Medicine Simmons Cancer Institute. Blood was processed and serum HE4 and CA-125 were measured. Peritoneal fluid was collected at the time of surgery and processed for Next Generation Sequencing (NGS) using 16S V4 exon bacterial primers and bioinformatics analyses. We found that patients with OC had a unique peritoneal microbial profile compared to patients with a benign mass. Using ensemble modeling and machine learning pathways, we identified 18 microbial features that were highly specific to OC pathology. Prediction analyses confirmed that inclusion of microbial features with serum tumor marker levels and control features (patient age and BMI) improved diagnostic accuracy compared to currently used models. We conclude that OC pathogenesis alters the peritoneal microbial environment and that these unique microbial features are important for accurate diagnosis of OC. Our study warrants further analyses of the importance of microbial features in regards to oncological diagnostics and possible prognostic and interventional medicine.
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Affiliation(s)
- Ruizhong Miao
- Department of Statistics, University of Virginia, Charlottesville, Virginia, United States of America
| | - Taylor C. Badger
- Department of Medical Microbiology, Immunology and Cell Biology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Kathleen Groesch
- Center for Clinical Research, SIU School of Medicine, Springfield, Illinois, United States of America
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Paula L. Diaz-Sylvester
- Center for Clinical Research, SIU School of Medicine, Springfield, Illinois, United States of America
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Teresa Wilson
- Center for Clinical Research, SIU School of Medicine, Springfield, Illinois, United States of America
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Allen Ghareeb
- Center for Clinical Research, SIU School of Medicine, Springfield, Illinois, United States of America
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Jongjin Anne Martin
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
| | - Melissa Cregger
- Oak Ridge National Laboratory, Oak Ridge, Tennessee, United States of America
- Department of Ecology and Evolutionary Biology, University of Tennessee, Knoxville, Tennessee, United States of America
| | - Michael Welge
- National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Colleen Bushell
- Applied Research Institute, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Loretta Auvil
- National Center for Supercomputing Applications, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Ruoqing Zhu
- Department of Statistics, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Laurent Brard
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
- Simmons Cancer Institute at SIU, Springfield, Illinois, United States of America
| | - Andrea Braundmeier-Fleming
- Department of Medical Microbiology, Immunology and Cell Biology, SIU School of Medicine, Springfield, Illinois, United States of America
- Department of Obstetrics & Gynecology, SIU School of Medicine, Springfield, Illinois, United States of America
- Simmons Cancer Institute at SIU, Springfield, Illinois, United States of America
- * E-mail:
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30
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Deleemans JM, Chleilat F, Reimer RA, Henning JW, Baydoun M, Piedalue KA, McLennan A, Carlson LE. The chemo-gut study: investigating the long-term effects of chemotherapy on gut microbiota, metabolic, immune, psychological and cognitive parameters in young adult Cancer survivors; study protocol. BMC Cancer 2019; 19:1243. [PMID: 31870331 PMCID: PMC6927187 DOI: 10.1186/s12885-019-6473-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 12/17/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The gut microbiota is an important modulator of immune, metabolic, psychological and cognitive mechanisms. Chemotherapy adversely affects the gut microbiota, inducing acute dysbiosis, and alters physiological and psychological function. Cancer among young adults has risen 38% in recent decades. Understanding chemotherapy's long-term effects on gut microbiota and psycho-physiological function is critical to improve survivors' physical and mental health, but remains unexamined. Restoration of the gut microbiota via targeted therapies (e.g. probiotics) could potentially prevent or reverse the psycho-physiological deficits often found in young survivors following chemotherapy, ultimately leading to reduced symptom burden and improved health. METHODS This longitudinal study investigates chemotherapy induced long-term gut dysbiosis, and associations between gut microbiota, and immune, metabolic, cognitive and psychological parameters using data collected at < 2 month (T1), 3-4 months (T2), and 5-6 months (T3) post-chemotherapy. Participants will be 18-39 year old blood or solid tumor cancer survivors (n = 50), and a healthy sibling, partner or friend as a control (n = 50). Gut microbiota composition will be measured from fecal samples using 16 s RNA sequencing. Psychological and cognitive patient reported outcome measures will include depression, anxiety, post-traumatic stress disorder symptoms, pain, fatigue, and social and cognitive function. Dual-energy X-ray Absorptiometry (DXA) will be used to measure fat and lean mass, and bone mineral concentration. Pro-inflammatory cytokines, C-reactive protein (CRP), lipopolysaccharide (LPS), serotonin, and brain derived neurotrophic factor (BDNF) will be measured in serum, and long-term cortisol will be assayed from hair. Regression and linear mixed model (LMM) analyses will examine associations across time points (T1 - T3), between groups, and covariates with gut microbiota, cognitive, psychological, and physiological parameters. CONCLUSION Knowing what bacterial species are depleted after chemotherapy, how long these effects last, and the physiological mechanisms that may drive psychological and cognitive issues among survivors will allow for targeted, integrative interventions to be developed, helping to prevent or reverse some of the late-effects of treatment that many young cancer survivors face. This protocol has been approved by the Health Research Ethics Board of Alberta Cancer Committee (ID: HREBA.CC-19-0018).
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Affiliation(s)
- Julie M. Deleemans
- Cumming School of Medicine, Division of Medical Science, University of Calgary, Calgary, Canada
- Cumming School of Medicine, Division of Psychosocial Oncology, University of Calgary, Calgary, Canada
| | - Faye Chleilat
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Raylene A. Reimer
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, Calgary, Canada
| | | | - Mohamad Baydoun
- Cumming School of Medicine, Division of Psychosocial Oncology, University of Calgary, Calgary, Canada
| | - Katherine-Ann Piedalue
- Cumming School of Medicine, Division of Psychosocial Oncology, University of Calgary, Calgary, Canada
| | - Andrew McLennan
- Cumming School of Medicine, Division of Psychosocial Oncology, University of Calgary, Calgary, Canada
| | - Linda E. Carlson
- Cumming School of Medicine, Division of Psychosocial Oncology, University of Calgary, Calgary, Canada
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Yan S, Tian Z, Li M, Li B, Cui W. Effects of probiotic supplementation on the regulation of blood lipid levels in overweight or obese subjects: a meta-analysis. Food Funct 2019; 10:1747-1759. [PMID: 30860222 DOI: 10.1039/c8fo02163e] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Obesity is a risk factor for many deadly diseases. Meanwhile, the prevalence of obesity has been continuously increasing in many countries. Probiotics are defined as live microorganisms that confer health benefits on hosts. Probiotic supplementation could reduce body weight, body mass index (BMI) and fat percentage. However, it is unclear whether supplementation with probiotics is beneficial to lower blood lipid levels for obese or overweight people. METHODS In this study, a comprehensive search across multiple databases was performed to identify studies that focused on the effects of probiotics on blood lipid levels in overweight or obese subjects. The meta-analysis included studies that compared the variations in blood lipid (total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and triglyceride (TG)) concentrations between overweight and obese subjects who were supplemented with probiotics versus the controls who were not supplemented with probiotics. RESULTS Our findings indicated that probiotic supplementation in obese or overweight people was associated with significantly larger reductions in TC and LDL levels compared to a lack of probiotic supplementation in the control subjects. However, there was no significant difference in the variations between HDL and TG concentrations. CONCLUSION Probiotic supplementation reduced TC and LDL concentrations in obese or overweight people. Additional data from large clinical trials are required to confirm the efficacy and safety of probiotics in the regulation of blood lipid levels in obese or overweight people.
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Affiliation(s)
- Shoumeng Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, 130021, P. R. China.
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32
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Mikó E, Kovács T, Sebő É, Tóth J, Csonka T, Ujlaki G, Sipos A, Szabó J, Méhes G, Bai P. Microbiome-Microbial Metabolome-Cancer Cell Interactions in Breast Cancer-Familiar, but Unexplored. Cells 2019; 8:cells8040293. [PMID: 30934972 PMCID: PMC6523810 DOI: 10.3390/cells8040293] [Citation(s) in RCA: 109] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/22/2019] [Accepted: 03/26/2019] [Indexed: 12/18/2022] Open
Abstract
Breast cancer is a leading cause of death among women worldwide. Dysbiosis, an aberrant composition of the microbiome, characterizes breast cancer. In this review we discuss the changes to the metabolism of breast cancer cells, as well as the composition of the breast and gut microbiome in breast cancer. The role of the breast microbiome in breast cancer is unresolved, nevertheless it seems that the gut microbiome does have a role in the pathology of the disease. The gut microbiome secretes bioactive metabolites (reactivated estrogens, short chain fatty acids, amino acid metabolites, or secondary bile acids) that modulate breast cancer. We highlight the bacterial species or taxonomical units that generate these metabolites, we show their mode of action, and discuss how the metabolites affect mitochondrial metabolism and other molecular events in breast cancer. These metabolites resemble human hormones, as they are produced in a “gland” (in this case, the microbiome) and they are subsequently transferred to distant sites of action through the circulation. These metabolites appear to be important constituents of the tumor microenvironment. Finally, we discuss how bacterial dysbiosis interferes with breast cancer treatment through interfering with chemotherapeutic drug metabolism and availability.
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Affiliation(s)
- Edit Mikó
- Department of Medical Chemistry, University of Debrecen, 4032 Debrecen, Hungary.
- Department of Microbiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
| | - Tünde Kovács
- Department of Medical Chemistry, University of Debrecen, 4032 Debrecen, Hungary.
| | - Éva Sebő
- Kenézy Breast Center, Kenézy Gyula County Hospital, 4032 Debrecen, Hungary.
| | - Judit Tóth
- Kenézy Breast Center, Kenézy Gyula County Hospital, 4032 Debrecen, Hungary.
| | - Tamás Csonka
- Department of Pathology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
| | - Gyula Ujlaki
- Department of Medical Chemistry, University of Debrecen, 4032 Debrecen, Hungary.
| | - Adrienn Sipos
- Department of Medical Chemistry, University of Debrecen, 4032 Debrecen, Hungary.
| | - Judit Szabó
- Department of Microbiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
| | - Gábor Méhes
- Department of Pathology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
| | - Péter Bai
- Department of Medical Chemistry, University of Debrecen, 4032 Debrecen, Hungary.
- MTA-DE Lendület Laboratory of Cellular Metabolism, 4032 Debrecen, Hungary.
- Research Center for Molecular Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
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Kan JM, Cowan CSM, Ooi CY, Kasparian NA. What can the gut microbiome teach us about the connections between child physical and mental health? A systematic review. Dev Psychobiol 2019; 61:700-713. [DOI: 10.1002/dev.21819] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 12/30/2022]
Affiliation(s)
- Janice M. Kan
- Discipline of Paediatrics, School of Women’s and Children’s Health; UNSW Medicine, The University of New South Wales (UNSW); Sydney New South Wales Australia
- Heart Centre for Children; The Sydney Children’s Hospitals Network Cardiac Service; Sydney New South Wales Australia
| | | | - Chee Y. Ooi
- Discipline of Paediatrics, School of Women’s and Children’s Health; UNSW Medicine, The University of New South Wales (UNSW); Sydney New South Wales Australia
- Department of Gastroenterology; Sydney Children’s Hospital; Randwick New South Wales Australia
| | - Nadine A. Kasparian
- Discipline of Paediatrics, School of Women’s and Children’s Health; UNSW Medicine, The University of New South Wales (UNSW); Sydney New South Wales Australia
- Harvard Medical School; Harvard University; Boston Massachusetts
- Department of Cardiology; Boston Children’s Hospital; Boston Massachusetts
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34
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Avelar Rodriguez D, Peña Vélez R, Toro Monjaraz EM, Ramirez Mayans J, Ryan PM. The Gut Microbiota: A Clinically Impactful Factor in Patient Health and Disease. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s42399-018-0036-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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35
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Norder Grusell E, Dahlén G, Ruth M, Bergquist H, Bove M. The cultivable bacterial flora of the esophagus in subjects with esophagitis. Scand J Gastroenterol 2018; 53:650-656. [PMID: 29616839 DOI: 10.1080/00365521.2018.1457712] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The healthy human esophagus is colonized by bacteria similar to that of the oral mucosa. However, little is known about the microbiome of the esophagus in esophagitis or the possible role of bacteria in the inflammatory response. AIM To survey bacterial diversity and compare the microbiome of the esophagus in subjects with gastro-esophageal reflux disease (GERD) and eosinophilic esophagitis (EoE). MATERIAL AND METHODS Seventeen subjects diagnosed with GERD and 10 with EoE underwent endoscopic examination with brush sampling and biopsies from the oral cavity, upper and lower esophagus. The samples were cultivated on agar plates, and bacterial growth was identified to the genus or species level and semi-quantified. RESULTS Significantly higher numbers of bacterial groups or species were found in specimens from the lower esophagus in subjects with EoE compared to subjects with GERD (median 4 (range 1-7) vs. 2 (range 0-6), p < .0014). Sixteen vs. 14 different bacterial groups or species were found in subjects with GERD and EoE, respectively, mostly in sparse or very sparse amounts. Alfa-streptococci (viridans streptococci) were the most common bacteria in both groups. Streptococci were present in all of the EoE-subjects but only in approximately 75% in lower esophagus of the GERD-subjects, regardless of the sampling method. CONCLUSION Subjects with GERD had significantly less bacterial diversity in both oral and esophageal samples than EoE-subjects. Whether this discrepancy might be explained by an effect on the protective mucosal biofilm by the acidic content of the reflux in subjects with GERD remains unclear.
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Affiliation(s)
- Elisabeth Norder Grusell
- a Department of Otorhinolaryngology, Head and Neck Surgery , Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Gunnar Dahlén
- b Department of Oral Microbiology , Institute of Odontology, Sahlgrenska Academy at University of Gothenburg , Gothenburg , Sweden
| | - Magnus Ruth
- a Department of Otorhinolaryngology, Head and Neck Surgery , Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Henrik Bergquist
- a Department of Otorhinolaryngology, Head and Neck Surgery , Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Mogens Bove
- c Department of ENT and Maxillofacial Surgery , NÄL Medical Centre Hospital , Trollhättan , Sweden
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Luo J, Li Y, Xie J, Gao L, Liu L, Ou S, Chen L, Peng X. The primary biological network of Bifidobacterium in the gut. FEMS Microbiol Lett 2018; 365:4931718. [DOI: 10.1093/femsle/fny057] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/08/2018] [Indexed: 12/17/2022] Open
Affiliation(s)
- Jianming Luo
- Department of Food Science and Engineering, Jinan University, Guangzhou 510630, People's Republic of China
| | - Yuetong Li
- Department of Food Science and Engineering, Jinan University, Guangzhou 510630, People's Republic of China
| | - Jinli Xie
- Department of Food Science and Engineering, Jinan University, Guangzhou 510630, People's Republic of China
| | - Lijuan Gao
- Department of Food Science and Engineering, Jinan University, Guangzhou 510630, People's Republic of China
| | - Liu Liu
- Department of Food Science and Engineering, Jinan University, Guangzhou 510630, People's Republic of China
| | - Shiyi Ou
- Department of Food Science and Engineering, Jinan University, Guangzhou 510630, People's Republic of China
| | - Long Chen
- Department of Food Science and Engineering, Jinan University, Guangzhou 510630, People's Republic of China
| | - Xichun Peng
- Department of Food Science and Engineering, Jinan University, Guangzhou 510630, People's Republic of China
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