Longitudinal relationship between the gut microbiota variation and diversity and gut graft-versus-host disease (GVHD) following pediatric allogeneic hematopoietic cell transplantation (HCT) - Case series

Ashley N Gray; Nicole H Tobin; Theodore B Moore; Fan Li; Grace M Aldrovandi

doi:10.1016/j.ijmm.2023.151580

Longitudinal relationship between the gut microbiota variation and diversity and gut graft-versus-host disease (GVHD) following pediatric allogeneic hematopoietic cell transplantation (HCT) - Case series

Int J Med Microbiol. 2023 May;313(3):151580. doi: 10.1016/j.ijmm.2023.151580. Epub 2023 Apr 25.

Authors

Ashley N Gray¹, Nicole H Tobin², Theodore B Moore³, Fan Li², Grace M Aldrovandi²

Affiliations

¹ Department of Pediatrics, Blood and Marrow Transplantation Program, Keck School of Medicine, University of Southern California, Children's Hospital Los Angeles, Los Angeles, CA, USA. Electronic address: agray@chla.usc.edu.
² Division of Pediatric Infectious Diseases, Department of Pediatrics, David Geffen School of Medicine at University of California, 675 Charles E Young Dr S, Room 4780 (MRL 4-780), Los Angeles, CA 90095, USA.
³ Division of Pediatric Hematology-Oncology, Department of Pediatrics, David Geffen School of Medicine at University of California, 10833 Le Conte Ave, Los Angeles, CA 90095, USA.

PMID: 37121094
DOI: 10.1016/j.ijmm.2023.151580

Abstract

Allogeneic Hematopoietic Cell Transplantation (HCT) offers children with life-threatening diseases a chance at survival. Complications from graft-versus-host disease (GVHD, Stages 0-4) represent a significant cause of morbidity and mortality which has been recently associated with gut dysbiosis the adult HCT population. Here, our objective was to conduct a prospective, longitudinal cohort study in nine pediatric allogeneic HCT participants by collecting longitudinally post-HCT stool specimens up to 1 year. Stool microbiota analyses showed that allogeneic HCT and antibiotic therapy lead to acute shifts in the diversity of the gut microbiota with those experiencing stages 3-4 gut GVHD having significantly greater microbiota variation over time when compared to control participants (p = 0.007). Pre-HCT microbiota diversity trended towards an inverse relationship with gut microbiota stability over time, however, this did not reach statistical significance (p = 0.05). Future large prospective studies are necessary to elucidate the mechanisms underlying these dynamic changes in the gut microbiota following pediatric allogeneic HCT.

Keywords: GI GVHD; GVHD; Gut microbiota; Hematopoietic stem cell transplantation; Pediatric transplantation; graft-versus-host disease.

MeSH terms

Adult
Child
Gastrointestinal Microbiome*
Graft vs Host Disease* / etiology
Graft vs Host Disease* / therapy
Hematopoietic Stem Cell Transplantation* / adverse effects
Humans
Longitudinal Studies
Prospective Studies