Bacteriotherapy with fecal pellets before chemotherapy reduces intestinal damage and systemic inflammation in response to cisplatin, according to new research from Moffitt Cancer Center that was published online by The Journal of Leukocyte Biology. Due to their cytotoxic activities, many chemotherapeutic agents cause extensive damage to the intestinal mucosa and have antibiotic activities. Humans are colonized with trillions of bacteria – known as commensal bacteria because there are benefits to having these bacteria in our bodies – that inhabit the gastrointestinal and respiratory tracts and our skin. The new study indicates that cisplatin induces significant changes in the repertoire of intestinal commensal bacteria, which worsen cisplatin-induced mucosal damage. Re-establishment of the microbiota through fecal-pellet gavage drives healing of intestinal damage, reducing bacterial translocation to the blood stream and, subsequently, decreasing systemic inflammation. Therefore, fecal microbiota transplant could paradoxically prevent life-threatening bacteremia in cancer patients treated with chemotherapy. Because similar bacteriotherapy is currently being used to treat recurrent C. difficile colitis, fecal transplant could become a feasible and safe approach in the treatment of chemotherapy-associated intestinal damage.
Perales-Puchalt A., Perez Sanz J., Payne KK, Svoronos N, Allegrezza MJ, Chaurio RA, Anadon C, Calmette J, Biswas S, Mine JA, Costich TL, Nickels L, Wickramasinghe J, Rutkowski MR, Conejo-Garcia JR (2018). Microbiota Reconstitution Restores Intestinal Integrity After Cisplatin Therapy. J. Leuk.Biol. DOI: 10.1002/JLB.5HI1117-446RR