Dissecting host-microbiome interplay in hematopoietic stem cell transplantation (HSCT)-induced morbidities

Hematopoietic stem cell transplantation (HSCT) is a last-resort therapy for hematological malignancies. In this procedure, donor stem cells replace the hematopoietic system of the cancer patient and activate an immune reaction against remaining tumor cells. However, due to imperfect immunological matching between the donor and the recipient, HSCT often leads to severe side effects, including graft versus host disease (GvHD) and mucositis. These serious and life-threatening complications limit HSCT applicability and reduce patient survival. Thus, improving donor-recipient matching and ameliorating HSCT-related morbidities is of major significance in cancer research and therapy. Interestingly, it has been recently shown that the gut microbiota is not only affected by disease states but also critically impacts the development and function of the host immune system. Changes in the composition of the gut microbiota (dysbiosis) are associated with disease development, including autoimmunity, chronic inflammation and cancer. The microbiome has also been shown to have a causative role in certain disease phenotypes. As a close and bidirectional relationship exists between the gut microbiota and the host immune system, and since immune cell subsets in the hematopoietic stem cells graft influence the post-transplantation course, we hypothesize that the recipient’s pre- and post-transplant microbiota affects HSCT outcomes, that the donor gut microbiota may be predictive of HSCT complications, and that modulating the patient’s microbiota may reduce HSCT-related morbidities

Our recent publication on patterns of salivary microbiota injury and oral mucositis in recipients of allogeneic hematopoietic stem cell transplantation.

Shouval R*, Eshel A*, Dubovski B, Kuperman AA, Danylesko I, Fein JA, Fried S, Geva M, Kouniavski E, Neuman H, Armon-Omer A, Shahien R, Muller E, Noecker C, Borenstein E, Louzoun Y, Nagler A*, O Koren*. patterns of salivary microbiota injury and oral mucositis in recipients of allogeneic hematopoietic stem cell transplantation. Blood Adv. 2020, 4(13):2912-2917.