The Microbiome and Radiation Induced-Bowel Injury: Evidence for Potential Mechanistic Role in Disease Pathogenesis
<p>Clinical course of patients undergoing radiotherapy to abdominopelvic region and consequential development of radiation-induced bowel injury over time.</p> "> Figure 2
<p>Schematic representation of radiation-induced intestinal injury. (<b>A</b>): In healthy gut, crypts are sterile with intact mucosa. Lgr5<sup>+</sup> stem cells proliferate and cells migrate upwards to provide differentiated epithelial cells of the villi. Bmi1<sup>+</sup> stem cells located at the +4 position remain quiescent. (<b>B</b>): In the acute phase of radiation-induced injury, there is loss of epithelial barrier integrity, leading to an influx of antigenic material, including microorganisms into the lamina propria. This induces inflammation orchestrated by macrophages, dendritic cells, and recruited neutrophils from the circulation. Further inflammation is caused by endothelial cell damage and the release of thrombin. Mitotically active Lgr5<sup>+</sup> cells undergo apoptosis where as Bmi1<sup>+</sup> cells at the +4 position are resistant to radiation insult and acquire an Lgr5<sup>+</sup> phenotype to act as a stem cell reservoir. (<b>C</b>): Despite epithelial barrier restoration, during the chronic phase of injury, there is an increase in the TGF-β that is secreted by macrophages and neutrophils, which promotes the differentiation of the fibroblast into myofibroblast, leading to collagen deposition and fibrogenesis.</p> ">
Abstract
:1. Introduction
2. Clinical Significance of Radiation-Induced Bowel Injury
3. Pathophysiology of Radiation-Induced Bowel Injury
3.1. Cellular Effect of Radiation
3.2. Radiation-Induced Acute Bowel Injury
3.3. Epithelial Cell Recovery
3.4. Radiation-Induced Chronic Bowel Injury
4. Microbiome and Radiation-Induced Bowel Injury
4.1. Importance of Microbiome in Healthy Gut
4.2. Gut Microbiome of Patients with Cancer
4.3. Effects of Radiation on Gut Microbiome and Incidence of Post-Radiation Diarrhea
4.4. Effects of Probiotics on Acute Radiation-Induced Bowel Injury
4.5. Possible Mechanism of Intestinal Radioprotection Provided by Microbiome
4.6. Effect of Radiation-Induced Dysbiosis and Probiotics on Chronic Radiation-Induced Bowel Injury
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Kumagai, T.; Rahman, F.; Smith, A.M. The Microbiome and Radiation Induced-Bowel Injury: Evidence for Potential Mechanistic Role in Disease Pathogenesis. Nutrients 2018, 10, 1405. https://doi.org/10.3390/nu10101405
Kumagai T, Rahman F, Smith AM. The Microbiome and Radiation Induced-Bowel Injury: Evidence for Potential Mechanistic Role in Disease Pathogenesis. Nutrients. 2018; 10(10):1405. https://doi.org/10.3390/nu10101405
Chicago/Turabian StyleKumagai, Tomoko, Farooq Rahman, and Andrew M. Smith. 2018. "The Microbiome and Radiation Induced-Bowel Injury: Evidence for Potential Mechanistic Role in Disease Pathogenesis" Nutrients 10, no. 10: 1405. https://doi.org/10.3390/nu10101405