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Table 2 Studies investigated interactions between the gut microbiome and radiotherapy toxicity

From: Radiotherapy and the gut microbiome: facts and fiction

Study

Study subjects

Treatment

Bacterial identification

Key findings

Manichanh et al. [15]

10 patients undergoing pelvic RT

Pelvic RT 45–50 Gy/25 fractions/5 weeks

16 s RNA

Patients exhibiting diarrhea showed a progressive modification in microbial diversity

Nam et al. [16]

9 patients with gynecological cancer, data of 6 healthy controls

Pelvic RT 50.4 Gy/25 fractions/5 weeks

16 s RNA

Most patient suffered diarrhea symptom with dramatic change of gut microbial community after radiotherapy

Wang et al. [17]

20 patients undergoing pelvic cancer radiotherapy, 2 sequential stool samples were collected before and just after radiotherapy

Pelvic RT 50.4 Gy/ 25 fractions/5 weeks

16 s RNA

Microbial diversity, richness, and the Firmicutes/Bacteroidetes ratio were significantly altered prior to radiotherapy in patients who later developed diarrhea

Mitra et al. [18]

35 patients with locally advanced cervical cancer

Definitive radiation therapy, including external beam RT and brachytherapy

16 s RNA

Patients with high toxicity demonstrated different compositional changes during CRT in addition to compositional differences in Clostridia species

Gerassy-Vainberg et al. [51]

Female C57BL/6 J mice

4 fractions of 550 cGy with 24 h intervals

16 s RNA

Adherent microbiota from RP differed from those in uninvolved segments and was associated with tissue damage

Goudarzi et al. [52]

C57BL/6 J male mice

A whole-body dose of 0, 5 or 12 Gy X rays using an X-RAD 320 X-ray irradiator

16 s RNA and metabolomics

Statistically significant changes in the microbial-derived products such as pipecolic acid, glutaconic acid, urobilinogen and homogentisic acid

Riehl et al. [57]

FVB/N female mice and C57BL/6Jx129 COX-12/2, COX-22/2 mice

14 Gy total body at 0.96 cGy/min

Metabolomics

Lipopolysaccharide is radioprotective in the mouse intestine through a prostaglandin-dependent pathway

Riehl et al. [58]

C57BL/6 mice

12 Gy total body gamma irradiation

Metabolomics

TNFR1 and COX-2 expression to subepithelial fibroblasts plays an intermediate role in LPS-induced radioprotection in the intestine

Egan et al. [59]

Gene-targeted mice

8 Gy gamma irradiation

Metatranscriptomics

Selective preactivation of NF-kappa B through IKK in intestinal epithelial cells could provide a therapeutic modality that allows higher doses of radiation to be tolerated during cancer RT

  1. RT radiotherapy