Abstract
Chemotherapy-induced intestinal mucositis, a painful debilitating condition affecting up to 40–100% of patients undergoing chemotherapy, can reduce the patients’ quality of life, add health care costs and even postpone cancer treatment. In recent years, the relationships between intestinal microbiota dysbiosis and mucositis have drawn much attention in mucositis research. Chemotherapy can shape intestinal microbiota, which, in turn, can aggravate the mucositis through toll-like receptor (TLR) signaling pathways, leading to an increased expression of inflammatory mediators and elevated epithelial cell apoptosis but decreased epithelial cell differentiation and mucosal regeneration. This review summarizes relevant studies related to the relationships of mucositis with chemotherapy regimens, microbiota, TLRs, inflammatory mediators, and intestinal homeostasis, aiming to explore how gut microbiota affects the pathogenesis of mucositis and provides potential new strategies for mucositis alleviation and treatment and development of new therapies.
Highlights
Cancer is a major global public health burden
Treatment with Saccharomyces boulardii CNCM I-745 inhibited the expression of toll-like receptor (TLR)-2, TLR-4, MyD88, NF-κB, ERK1/2, phospho-p38, phospho-Jun N-terminal kinases (JNKs), TNF-α, IL-1β and C-X-C motif chemokine ligand 1 (CXCL-1) in the jejunum/ileum of mice treated with 5-FU (450 mg/kg) [54]. These results suggest that probiotics or at least CNCM I-745 can modulate TLRs/MyD88/NF-κB/mitogen-activated protein kinase (MAPKs) signaling pathways to inhibit the occurrence of mucositis [54]
Clinical studies have proved that Chemotherapy-induced intestinal mucositis (CIM) is accompanied by intestinal microbiota dysbiosis (IMD), which has been partly confirmed by animal experiments
Summary
Cancer is a major global public health burden. Statistically, there were approximately. Chemotherapy, radiotherapy and surgical operation are still the main modalities for the treatment of cancers despite continuous advances in medical therapies such as targeted therapy and immunotherapy. With the continuous technical advancement in microbial species identification through genomic sequencing, the relationship between gut microbiota and CIM has drawn much attention for research into CIM pathogenesis and treatment [11,12,13]. We have summarized relevant studies related to the relationship between gut microbiota and CIM in recent years, aiming to explore how gut microbiota affects the mucosal cellular behavior and CIM pathogenesis and provides potential new strategies for alleviation and treatment of CIM
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