2023-08-29 11:56:24
by Laura Cuppini
A study by the Sant’Orsola Polyclinic proves the correlation between the outcome of a hematopoietic stem cell transplant and the presence of “good” bacteria
The “good” bacteria that live in our intestines are allies of the young patients being treated for haematological diseases who undergo a haematopoietic stem cell transplant (marrow transplant). This is demonstrated by a study conducted by the Pediatric Oncohematology department of the IRCCS Policlinico di Sant’Orsola, in collaboration with the Microbiomics Unit group of the University of Bologna. The work, published in the scientific journal Blood
is the first to analyze a large number of children (90), in which the quality of the microbiota (the set of microorganisms that populate our digestive system) was observed during hematopoietic stem transplantation.
Study numbers
Well, in children with a healthy microbiota a 25% higher probability of survival was observed: after four years of allogeneic (i.e. donor) transplantation, 88.9% of patients with a greater diversity in the intestinal microbiota were alive, compared to 62.7% in the group that had a less rich microbiota. Babies with healthy bacterial flora were also less likely to develop an immune reaction in which transplanted cells attack the recipient’s tissues, called graft versus host disease (GVHD).
Predict complications
«We have shown that the diversity of the intestinal microbiota before transplantation predicts survival – explains Riccardo Masetti, of the Pediatric Oncohematology of the Sant’Orsola Polyclinic (Regional reference center for hematopoietic stem cell transplantation) and first author of the study -. There is an ability of particular intestinal bacteria to modulate the immune system in a favorable direction and this is a very important variable when a completely new immune system is transferred to patients. Thanks to the study of the composition and diversity of the microbiota, we can predict the development of any complications that affect the outcome of the transplant”. For example, infections, disorders related to drug toxicity or graft-versus-host disease, which in severe forms can be life-threatening.
Microbiota transplantation
If the diversity and richness of the microbiota are lost, for example following chemotherapy treatments or prolonged exposure to antibiotic drugs, the probability of complications increases. «The results of these studies open up new and very important perspectives, such as those relating to the modulation of intestinal bacterial composition» Masetti underlines. For example, we speak of microbiota transplantation: the faeces taken from a healthy individual are transferred into the intestine of a patient to eliminate pathogenic microorganisms and restore a healthy composition. The goal is to create a team of “good” bacteria to support patients, for example during a bone marrow transplant. Already today, at the Sant’Orsola Polyclinic, doctors are trying to preserve the integrity of the intestinal microbiota in transplanted children by administering nutrition through a nasogastric tube, as an alternative to a drip.
Immune system
The intestinal microbiota is the set of bacteria that live in our intestines. Its close relationship with the cells of the immune system makes it a key element in the natural history of chronic, inflammatory, autoimmune and, more generally, immune-mediated diseases. The microbiota also performs other functions, such as protection against pathogens, the synthesis of some metabolites and vitamins essential for the body and the regulation of intestinal motility.
August 29, 2023 (change August 29, 2023 | 12:26 am)
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