Protective effect of intestinal Blautia against neutropenic fever in allogeneic transplant recipients Journal Article
| Authors: | Rashidi, A.; Peled, J. U.; Ebadi, M.; Rehman, T. U.; Elhusseini, H.; Marcello, L. T.; Halaweish, H.; Kaiser, T.; Holtan, S. G.; Khoruts, A.; Weisdorf, D. J.; Staley, C. |
| Article Title: | Protective effect of intestinal Blautia against neutropenic fever in allogeneic transplant recipients |
| Abstract: | BACKGROUND: Neutropenic fever (NF) occurs in >70% of hematopoietic cell transplant (HCT) recipients, without a documented cause in most cases. Antibiotics used to prevent and treat NF disrupt the gut microbiota; these disruptions predict a higher posttransplantation mortality rate. We hypothesized that specific features in the gut microbial community may mediate the risk of NF. METHODS: We searched a large gut microbiota database in allogeneic HCT recipients (12 546 stool samples; 1278 patients) to find pairs with NF (cases) versus without NF (controls) on the same day relative to transplantation and with a stool sample on the previous day. A total of 179 such pairs were matched as to the underlying disease and graft source. Several other important clinical variables were similar between the groups. RESULTS: The gut microbiota of cases on the day before NF occurrence had a lower abundance of Blautia than their matched controls on the same day after transplantation, suggesting a protective role for Blautia. Microbiota network analysis did not find any differences in community structure between the groups, suggesting a single-taxon effect. To identify putative mechanisms, we searched a gut microbiome and serum metabolome database of patients with acute leukemia receiving chemotherapy and identified 139 serum samples collected within 24 hours after a stool sample from the same patient. Greater Blautia abundances predicted higher levels of next-day citrulline, a biomarker of total enterocyte mass. CONCLUSIONS: These findings support a model in which Blautia protects against NF by improving intestinal health. Therapeutic restoration of Blautia may help prevent NF, thus reducing antibiotic exposures and transplantation-related deaths. © The Author(s) 2022. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. |
| Keywords: | transplantation, homologous; hematopoietic stem cell transplantation; antiinfective agent; anti-bacterial agents; graft versus host reaction; intestine flora; graft vs host disease; allotransplantation; hematopoietic cell transplantation; adverse event; metabolomics; microflora; microbiota; humans; human; blautia; neutropenic fever; gastrointestinal microbiome |
| Journal Title: | Clinical Infectious Diseases |
| Volume: | 75 |
| Issue: | 11 |
| ISSN: | 1058-4838 |
| Publisher: | Oxford University Press |
| Date Published: | 2022-12-01 |
| Start Page: | 1912 |
| End Page: | 1920 |
| Language: | English |
| DOI: | 10.1093/cid/ciac299 |
| PUBMED: | 35435976 |
| PROVIDER: | scopus |
| PMCID: | PMC10200328 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 January 2023 -- Source: Scopus |
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