Effect of oral inflammation and microbiome dysbiosis on cGVHD
Kambara Y, Fujiwara H, Yamamoto A, et al. Oral Inflammation and Microbiome Dysbiosis Exacerbate Chronic Graft-Versus-Host Disease. Blood. 2024; (doi: 10.1182/blood.2024024540).
Study findings support the oral microbiome as a potential pathway for preventing or managing chronic graft-versus-host disease (cGVHD) following hematopoietic cell transplantation (HCT). The research drew a correlation between mucositis-induced oral dysbiosis and elevated risk for cGVHD, even in patients who received cyclophosphamide after their transplant. Using a mouse model of HCT, the study authors determined that oral dysbiosis mediated the movement of Enterococcaceae into regional lymph nodes, which in turn activated antigen-presenting cells that stimulated the expansion of donor-derived inflammatory T cells. Pathogenic bacteria also spread to the intestine, where ectopic colonies took shape, deepening the systemic inflammation. The success of interventions aimed at the oral microbiome, which effectively reduced cGVHD in mice, suggests that modulation of the microbiome during HCT may help to combat this complication.