Abstract
The advances in molecular biology and the emergence of Next Generation Sequencing (NGS) have revealed that microbiome composition is closely related with health and disease, including cancer. This relationship affects different levels of cancer such as development, progression, and response to treatment including immunotherapy. The efficacy of immune checkpoint inhibitors (ICIs) may be influenced by the concomitant use of antibiotics before, during or shortly after treatment with ICIs. Nevertheless, the linking mechanism between microbiote, host immunity and cancer is not clear and the role of microbiota manipulation and analyses in cancer management has not been clinically validated yet. Regarding the use of microbiome as biomarker to predict ICI efficacy it has been recently shown that the use of biochemical serum markers to monitor intestinal permeability and loss of barrier integrity, like citrulline, could be useful to monitor microbiota changes and predict ICI efficacy. There are still many unknowns about the role of these components, their relationship with the microbiota, with the use of antibiotics and the response to immunotherapy. The next challenge in microbiome research will be to identify individual microbial species that causally affect lung cancer phenotypes and response to ICI and disentangle the underlying mechanisms. Thus, further analyses in patients with lung cancer receiving treatment with ICIs and its correlation with the composition of the microbiota in different organs including the respiratory tract, peripheral blood and intestinal tract could be useful to predict the efficacy of ICIs and its modulation with antibiotic use.
Highlights
Lung cancer is the most common cancer and the most frequent cause of cancer-related deaths worldwide both in men and women [1]
As an example it was recently shown that the presence of a lung bacterial composition enriched in oral commensals is associated with a prevalence of T helper 17 (Th17) inflammation that seems to be key for a proper regulation of the lung immune response [35]
One would be the connection through molecular patterns associated with pathogens, such as lipopolysaccharides (LPS), which can stimulate toll-like receptors and activate genes that regulate inflammation and responses of the innate immune system. They would cause phenotypic changes in dendritic cells (DCs) and migration to mesenteric lymphoid nodes to promote the priming of T lymphocytes and the production of various regulatory cytokines (IL-10, TGF-β, IFNγ, and IL-6)
Summary
The advances in molecular biology and the emergence of Generation Sequencing (NGS) have revealed that microbiome composition is closely related with health and disease, including cancer. This relationship affects different levels of cancer such as development, progression, and response to treatment including immunotherapy. Further analyses in patients with lung cancer receiving treatment with ICIs and its correlation with the composition of the microbiota in different organs including the respiratory tract, peripheral blood and intestinal tract could be useful to predict the efficacy of ICIs and its modulation with antibiotic use
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