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Global Translational Medicine Gut microbiota in Onco-Hematology

and G infections . In a situation where anemia is related the count of platelets that are circulating . Hence, it
[29]
[34]
to chronic inflammation, inflammatory cytokines prompt is vitally substantial to distinguish between malignant
the expression of hepcidin, sequentially altering iron thrombocytopenia and benign reactive conditions.
homeostasis. In addition, infections involving numerous
bacterial species have been shown to have an influence 3. The impact of gut microbiota on the
on hepcidin . Despite the lack of documented reports, efficacy and toxicity of cancer therapy
[30]
it is predicted that a direct link exists between the gut (immunotherapy and chemotherapy)
microbiota and hepcidin in anemia associated with chronic With the advancement in sequencing technology,
inflammation, indicating promising clinical significance.
Iron homeostasis is essential in relation to the metabolism understanding the role of specific components of the
of red blood cells and is also important in the regulation microbiota in graft-versus-host disease (GVHD) toxicity
has been somewhat recently recognized. A number of
of bacterial infections. Disorders associated with excessive investigations have revealed the beneficial role of the
amounts of iron, particularly chronic hemolysis and gut commensal called Blautia in patients with a high
hemochromatosis, cause patients to become susceptible abundance of this taxon, resulting in reduced GVHD-
to some bacterial infections. A randomized-controlled associated mortality .
[35]
[31]
study by Zimmerman et al. was performed among
African children to assess the effects of elevated amounts GVHD usually occurs when the cells of the donor, mainly
of iron in the colon and recognized a major decrease in the T-cells of the graft, cross-react with the patient’s major
Lactobacilli, a kind of beneficial bacterium, and elevated histocompatibility complex, where the GIT, skin, and other
[36]
levels of enterobacteria, which included Escherichia coli related sites generate a detrimental immune response .
[31]
and Salmonella species . Even though current studies This has, in turn, resulted in significant morbidity and
are in support of the role of iron in the mediation of gut mortality rates. Intriguingly, frequent sites associated
microbiota homeostasis, additional studies are needed to with acute GVHD represent the ones that are highly
fully elucidate this relationship. colonized by normal flora (bacterial flora) and GVHD
development; along with this, they are linked to Toll-like
2.2. Disorders associated with platelets receptor signaling, which is responsible for recognizing
As a result of the rapid turnover of blood components, microbes by binding to pathogen-associated molecular
certain elements, such as platelet concentrations, are patterns; this indeed suggests the involvement of microbial
known to be exclusively sensitive to the presence of influences [37-39] . It has been determined that this toxicity
microbial organisms. Infections have been associated has been modulated by the gut microbiota in investigations
with idiopathic thrombocytopenic purpura (ITP). For conducted toward therapy response, particularly for cancer
instance, there exists a significant amount of evidence therapy. In published studies that are related to allogeneic
that points towards the link between Helicobacter pylori stem cell transplantation, which is typically performed in
infection and ITP, whereby platelets get triggered by various hematological malignancies (leukemia, multiple
FcγIIA, the antibodies against H. pylori, or by means of myeloma [MM], Hodgkin’s lymphoma, non-Hodgkin’s
the interaction between H. pylori-bound von Willebrand lymphoma, and others), have been recently discovered
factor and platelet glycoprotein IB. More infections have that the compositional differences detected in the gut have
been associated with thrombocytopenia, including CMV been typically linked with differing rates of development in
and varicella zoster virus. CMV demonstrates an ability GVHD [40,41] . The role fulfilled by the gut microbiota toward
to infect both megakaryocytes and supporting stroma to toxicity has been placed understudies in settings of other
produce an acute ITP-like syndrome which frequently anticancer therapies. Various bacterial species may portray a
occurs in immunocompromised individuals . Severe protective role in opposition toxicity associated with cancer
[32]
congenital thrombocytopenia can also be caused as a immunotherapy which includes Bacteriodetes, which has
consequence of CMV and delayed recovery of the platelets been found in abundant amounts in colitis patients that
after the transplantation of the bone marrow. Patients are ipilimumab-induced, and Bifidobacterium which is able
diagnosed with hepatitis C tend to present a higher to reverse pathology-related issues in immunotherapy-
[42,43]
incidence of ITP than expected . Thrombocytopenia induced colitis (mouse model) .
[33]
caused by infection is commonly associated with reactive It is intriguing to note that some bacterial species may
thrombocytosis in conditions related to systemic infections. be linked to the favorable response against toxicity, such
Any form of inflammatory-related process (e.g., sepsis as Firmicutes found in the setting of immunotherapy and
or bacterial infection) that is perceived to elevate serum immunotherapy-induced-colitis ; therefore, uncoupling
[44]
levels of interleukins (especially interleukin-6) may elevate such adverse effects brought about by cancer therapy is

Volume 2 Issue 2 (2023) 3 https://doi.org/10.36922/gtm.0389