The Microbiome and Radiation Induced-Bowel Injury: Evidence for Potential Mechanistic Role in Disease Pathogenesis

• Published in: Nutrients Vol. 10; no. 10; p. 1405
• Main Authors: Kumagai, Tomoko, Rahman, Farooq, Smith, Andrew M
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 02.10.2018; MDPI AG
• Subjects: cancer management complications; Gastrointestinal Microbiome - radiation effects; Humans; Intestinal Diseases - etiology; Intestinal Diseases - microbiology; Intestines - injuries; Intestines - microbiology; Intestines - radiation effects; microbiota; Neoplasms - radiotherapy; pelvic radiation disease; probiotics; radiation enteritis; radiation enteropathy; Radiation Injuries - microbiology; radiation-induced bowel injury; radiotherapy; Review; microbiota; radiation enteropathy; radiation-induced bowel injury; radiotherapy; radiation enteritis; cancer management complications; pelvic radiation disease; probiotics
• ISSN: 2072-6643; 2072-6643
• DOI: 10.3390/nu10101405

Radiotherapy has played a major role in both the curative and palliative treatment of cancer patients for decades. However, its toxic effect to the surrounding normal healthy tissue remains a major drawback. In cases of intra-abdominal and/or pelvic malignancy, healthy bowel is inevitably included in the radiation field, causing undesirable consequences that subsequently manifest as radiation-induced bowel injury, which is associated with significant morbidity and mortality. The pathophysiology of radiation-induced bowel injury is poorly understood, although we now know that it derives from a complex interplay of epithelial injury and alterations in the enteric immune, nervous, and vascular systems in genetically predisposed individuals. Furthermore, evidence supporting a pivotal role for the gut microbiota in the development of radiation-induced bowel injury has been growing. In this review, we aim to appraise our current understanding of radiation-induced bowel injury and the role of the microbiome in its pathogenesis as well as prevention and treatment. Greater understanding of the relationship between the disease mechanism of radiation-induced bowel injury and gut microbiome might shed light on potential future prevention and treatment strategies through the modification of a patient's gut microbiome.