Gut Pathogens (Jul 2024)

Gut microbiota shifts from onset to remission in immune checkpoint inhibitor-induced enterocolitis: a case report

  • Yuki Hirata,
  • Yoshiki Tanaka,
  • Haruka Yokota,
  • Hiroshi Ohno,
  • Koji Nishida,
  • Hikaru Shimizu,
  • Noboru Mizuta,
  • Kei Nakazawa,
  • Ryoji Koshiba,
  • Kazuki Kakimoto,
  • Takako Miyazaki,
  • Shiro Nakamura,
  • Hiroki Nishikawa

DOI
https://doi.org/10.1186/s13099-024-00630-y
Journal volume & issue
Vol. 16, no. 1
pp. 1 – 5

Abstract

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Abstract Background Immune checkpoint inhibitors (ICIs) are crucial in cancer treatment; however, they carry the risk of immune-related adverse events (irAEs), such as enteritis. Case presentation: This study investigated the role of the gut microbiota during the onset and remission of irAE enteritis in a patient with stage IV melanoma undergoing anti-PD-1 and anti-CTLA-4 therapy. Following commencement of ICI treatment, the patient developed severe diarrhea and was diagnosed with grade 3 irAE enteritis. Steroid and probiotic treatments provided swift symptom relief and remission, as confirmed by reduced fecal calprotectin levels and gastrointestinal imaging. Microbiota diversity analysis conducted via 16S rRNA gene sequencing identified a decrease in Streptococcus prevalence with improvement in enteritis symptoms. Conversely, genera Fusobacterium, Faecalibacterium, Bacteroides, Prevotella, and Bifidobacterium showed increased representation after remission. These genera are associated with anti-inflammatory properties and fibrous substrate degradation, aiding gut health. Immunological assessment demonstrated fluctuations in cytokine expression and the modulation of costimulatory molecules, aligning with therapeutic interventions and microbiota alterations. Conclusions Our findings indicate a significant correlation between gut microbiota and immune responses in irAE enteritis. This underscores the potential utility of microbiome profiling in predicting irAE occurrence and in providing treatment strategies, thereby promoting a more comprehensive approach to managing the adverse effects of ICIs.

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