Toward revision of antimicrobial therapies in hematopoietic stem cell transplantation: target the pathogens, but protect the indigenous microbiota

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• 作者：Alexander Khoruts^a ; ^{khoru001@umn.edu} ; Keli L. Hippen^b ; Amanda M. Lemire^b ; Shernan G. Holtan^c ; Dan Knights^d ; Jo-Anne H. Young^e
• 关键词：CDI ; Clostridium difficile infection ; GVHD ; graft-vs-host disease ; HCT ; hematopoietic stem cell transplantation ; ILC ; innate lymphoid cell ; iNKT ; invariant natural killer T cell ; TLR ; Toll-like receptor
• 刊名：Translational Research
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：179
• 期：Complete
• 页码：116-125
• 全文大小：576 K
• 卷排序：179

文摘

Host microbiota plays important roles in providing colonization resistance to pathogens and instructing development and function of the immune system. Antibiotic treatments intended to target pathogens further weaken the host defenses and may paradoxically increase the risk of systemic infections. This consequence is especially problematic in patients undergoing hematopoietic stem cell transplantation, where the mucosal defenses are already weakened by the conditioning regimens. This review discusses the roles that indigenous microbiota plays in protecting the host and maintaining immune homeostasis. In addition, we highlight possible strategies that are being developed to allow targeted antimicrobial therapy against pathogens, while minimizing the harm to indigenous microbiota.