VIDEO: Microbiota diversity has 'huge impact' on GVHD pathophysiology

Editor’s note: This is an automatically generated transcript. Please notify editor@healio.com if there are concerns regarding accuracy of the transcription.

Microbiota diversity, as we are understanding it now, plays a huge impact in the pathophysiology of graft-versus-host-disease. As early as 2012, when the initial manuscripts came out, where we understood the role of beneficial gut bacteria and the role of short-chain fatty acids. Several strategies are currently already in place that most centers are trying to do, which include antimicrobial stewardship. So, trying to avoid specific antibiotics that are known to predispose patients to dysbiosis and being more judicious in the choices of antibiotics that are used. But additionally, several groups, ours including, are trying to target the gut microbiome to reduce graft-versus-host disease. I mentioned raffinose in adults, two mucosal electrodes in children and young adults. There's been a randomized control trial of fecal microbiota transplants, with somewhat mixed results, unfortunately. And then in addition to just thinking about microbes or bacteria, there's also a role of intestinal viruses. And there is a paper that has described changes in gut viruses and bacteria phages associated with graft-versus-host-disease. So our knowledge on this specific topic is expanding, and it's in an exponential way, actually. And I think there's just so much more that we need to learn about this. But already, we're thinking about this more, being more mindful of the types of antibiotics we're using, and using the ones that target anaerobes very carefully.