Page 73 - ARNM-3-3

Advances in Radiotherapy &

Nuclear Medicine

ORIGINAL RESEARCH ARTICLE
CS@LGG as a therapeutic biomaterial for acute

radiation-induced bowel injury alleviation

1†
1†
Xinyi Gu , Lu Yu , Xusheng Wang , Shengqi Yin , Yilin Zheng , Zhihao Zheng ,
1
1
1
1
1
Yaowei Zhang , Keli Chen , Yuqing Zhang , and Yi Ding *
2
1
1
1 Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou,
Guangdong, China
2 Huiqiao Medical Care, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong,
China
Abstract
Acute radiation-induced bowel injury is a serious and inevitable adverse effect of
pelvic radiotherapy, with few standardized therapies available in clinical practice.
Interestingly, fecal microbiota transplantation (FMT) has been shown to be an effective
therapeutic method. Among the probiotics, Lactobacillus rhamnosus GG (LGG) has the
most prominent effect. However, due to its poor tolerance and viability in vitro and its
potential to cause bacteremia in vivo, this study chose a natural and biosafe polymer
called chitosan (CS) to act as a carrier, avoiding the aforementioned limitations of FMT.
† These authors contributed equally
to this work. In this study, we successfully synthesized a curative probiotic biomaterial, named
CS@LGG, to protect the intestinal epithelium from radiation-induced damage. It
*Corresponding author:
Yi Ding repaired the intestinal barrier with increased expression of occludin, claudin-3, and
(dy512@smu.edu.cn) Ki-67, while decreasing γH2A.X. In addition, it enabled clearance of local and systemic
Citation: Gu X, Yu L, Wang X, pro-inflammatory factors, such as interleukin (IL)-6, IL1-β, and tumor necrosis factor
et al. CS@LGG as a therapeutic alpha. Surprisingly, this biomaterial demonstrated good biosafety in vitro and in vivo,
biomaterial for acute radiation- with a certain extent of tumor suppression. Furthermore, this study shed light on
induced bowel injury alleviation.
Adv Radiother Nucl Med. the possible mechanism underlying its therapeutic effect. RNA sequencing analysis
2025;3(3):65-82. indicated that overproduction of immunoglobulin A on local mucosa might be the
doi: 10.36922/ARNM025230026 core factor of damaged intestinal microenvironment leading to acute radiation-
Received: June 3, 2025 induced bowel injury. In conclusion, CS@LGG created in this work is a biosafe and
effective new probiotic biomaterial that holds promise in the treatment and relief of
Revised: August 12, 2025
acute radiation-induced bowel injury.
Accepted: August 21, 2025
Published online: September 10, Keywords: Biomaterial; Probiotics; Acute radiation-induced bowel injury; Fecal
2025
microbiota transplantation; Radiation damage protection
Copyright: © 2025 Author(s).
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution, 1. Introduction
and reproduction in any medium,
provided the original work is Acute radiation-induced bowel injury is a physical injury caused by radiotherapy for
properly cited. abdominal and pelvic malignancies. About 70–80% of patients who have received
1
Publisher’s Note: AccScience abdominal or pelvic radiotherapy have different degrees of radiation-induced bowel
Publishing remains neutral with damage. It mainly manifests as severe diarrhea, abdominal pain, hematochezia, and even
regard to jurisdictional claims in 2
published maps and institutional intestinal ulceration and perforation. In recent years, significant results from large-scale
3-5
affiliations. clinical studies, such as Polish Ⅱ, RAPIDO, and STELLAR, have unveiled short-course

Volume 3 Issue 3 (2025) 65 doi: 10.36922/ARNM025230026