Zusammenfassung
Hintergrund
Das intestinale Mikrobiom ist in den letzten 5 Jahren als ein wesentlicher Modulator der intestinalen und systemischen Immunregulation beschrieben worden.
Material und Methoden
In der vorliegenden Arbeit werden deshalb die experimentelle und klinische Evidenz in aktueller Literatur und eigenen Arbeiten für eine Modulation der Tumorimmuntherapie durch das Mikrobiom zusammengefasst.
Ergebnisse und Schlussfolgerung
Vor allem in der allogenen Stammzelltransplantation, aber auch bei der Gabe von Checkpointinhibitoren sind immunologische Nebenwirkungen erheblich mikrobiomabhängig. Auch die Tumorkontrolle und damit das langfristige Überleben können durch Mikrobiomverschiebungen stark beeinflusst werden. Eine exakte Entschlüsselung der zugrunde liegenden Mechanismen auf Stamm- und Metabolitenebene ist erforderlich, um in Zukunft gezielt durch Veränderungen des Mikrobioms die Wirkung von Immuntherapeutika zu verbessern und ihre Nebenwirkungen effektiver kontrollieren zu können.
Abstract
Background
In the last 5 years, the intestinal microbiome has been described as a major driver and modulator of intestinal but also systemic immunoregulation.
Materials and methods
Based on the literature and our own experience, we summarize the current knowledge of the role of the microbiome in various types of immunotherapy for the treatment of hematological and solid malignancies.
Results and conclusions
Immunological side effects of allogeneic stem cell transplantation but also treatment of solid cancers with checkpoint inhibitors are strongly controlled by intestinal microbiota. Furthermore, recent evidence indicates the contribution of intact microbiota and microbiota-dependent immunoregulation to efficacy and control of tumor growth by checkpoint inhibitors and cellular immunotherapy. Further research addressing microbiota strain-specific mechanisms and metabolites is needed to utilize these interactions for optimization of immunotherapy of cancer.
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E. Holler, D. Weber, D. Heudobler, D. Wolff und W. Herr geben an, dass kein Interessenkonflikt besteht.
Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.
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A. Stallmach, Jena
S. Schreiber, Kiel
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Holler, E., Weber, D., Heudobler, D. et al. Mikrobiom und Immuntherapien bei Tumorerkrankungen. Gastroenterologe 14, 185–189 (2019). https://doi.org/10.1007/s11377-019-0344-3
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DOI: https://doi.org/10.1007/s11377-019-0344-3