Gut Microbiome Associated with the Psychoneurological Symptom Cluster in Patients with Head and Neck Cancers

• Type of Material: Article
• Authors: Jinbing Bai, Emory University; Deborah Bruner, Emory University; Veronika Fedirko, Emory University; Jonathan Beitler, Emory University; Chao Zhou, Yale University; Jianlei Gu, Yale University; Hongyu Zhao, Yale University; I-Hsin Lin, Memorial Sloan Kettering Cancer Center; Cynthia E. Chico, Emory University; Kristin Higgins, Emory University; Dong Shin, Emory University; Nabil Saba, Emory University; Andrew Miller, Emory University; Canhua Xiao, Emory University
• Language: English
• Date: 2020-09-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2020 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/cancers12092531
• Title of Journal or Parent Work: CANCERS
• Volume: 12
• Issue: 9
• Start Page: 1
• End Page: 18
• Grant/Funding Information: This research was funded by National Institute of Health/National Cancer Institute grant numbers P30CA138292 and R25CA203650; National Institute of Health/National Institute of Nursing Research grant numbers 1K99NR017897-01 and 4R00NR017897-03; Oncology Nursing Society and Yale University School of Nursing Pilot Grant. The APC was funded by Nell Hodgson Woodruff School of Nursing at Emory University.
• Keywords: psychoneurological symptoms; METABOLISM; BACTEROIDES; radiation therapy; PATHWAYS; Life Sciences & Biomedicine; MODULATION; Science & Technology; symptom cluster; head and neck cancer; COLONIZATION; BRAIN AXIS; RISK-FACTORS; Oncology; gut microbiome; RADIOTHERAPY; GENES; DYSFUNCTION
• Research Categories: Health Sciences, Rehabilitation and Therapy; Biology, Radiation; Health Sciences, Oncology

Abstract

Cancer patients experience a cluster of co-occurring psychoneurological symptoms (PNS) related to cancer treatments. The gut microbiome may affect severity of the PNS via neural, immune, and endocrine signaling pathways. However, the link between the gut microbiome and PNS has not been well investigated in cancer patients, including those with head and neck cancers (HNCs). This pilot study enrolled 13 patients with HNCs, who reported PNS using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (CTCAEs). Stool specimens were collected to analyze patients’ gut microbiome. All data were collected pre-and post-radiation therapy (RT). Associations between the bacterial abundances and the PNS clusters were analyzed using the linear discriminant analysis effect size; functional pathway analyses of 16S rRNA V3-V4 bacterial communities were conducted using Tax4fun. The high PNS cluster had a greater decrease in microbial evenness than the low PNS cluster from pre-to post-RT. The high and low PNS clusters showed significant differences using weighted UniFrac distance. Those individuals with the high PNS cluster were more likely to have higher abundances in phylum Bacteroidetes, order Bacteroidales, class Bacteroidia, and four genera (Ruminiclostridium9, Tyzzerella, Eubacterium_fissicatena, and DTU089), while the low PNS cluster had higher abundances in family Acidaminococcaceae and three genera (Lactococcus, Phascolarctobacterium, and Desulfovibrio). Both glycan metabolism (Lipopolysaccharide biosynthesis) and vitamin metabolism (folate biosynthesis and lipoic acid metabolism) were significantly different between the high and low PNS clusters pre-and post-RT. Our preliminary data suggest that the diversity and abundance of the gut microbiome play a potential role in developing PNS among cancer patients.