Lactose drives Enterococcus expansion to promote graft-versus-host disease

Author:

Stein-Thoeringer C. K.123ORCID,Nichols K. B.12ORCID,Lazrak A.12,Docampo M. D.12ORCID,Slingerland A. E.12ORCID,Slingerland J. B.12,Clurman A. G.4,Armijo G.12,Gomes A. L. C.12ORCID,Shono Y.12ORCID,Staffas A.12ORCID,Burgos da Silva M.12ORCID,Devlin S. M.5,Markey K. A.124ORCID,Bajic D.6,Pinedo R.7ORCID,Tsakmaklis A.89,Littmann E. R.110ORCID,Pastore A.1ORCID,Taur Y.11ORCID,Monette S.12ORCID,Arcila M. E.13,Pickard A. J.14ORCID,Maloy M.4,Wright R. J.1ORCID,Amoretti L. A.1ORCID,Fontana E.1,Pham D.15ORCID,Jamal M. A.15,Weber D.16,Sung A. D.17,Hashimoto D.18ORCID,Scheid C.8,Xavier J. B.19ORCID,Messina J. A.20ORCID,Romero K.21ORCID,Lew M.17ORCID,Bush A.17ORCID,Bohannon L.17ORCID,Hayasaka K.22,Hasegawa Y.18ORCID,Vehreschild M. J. G. T.8923,Cross J. R.14,Ponce D. M.24,Perales M. A.24ORCID,Giralt S. A.24ORCID,Jenq R. R.15ORCID,Teshima T.1822ORCID,Holler E.16,Chao N. J.17ORCID,Pamer E. G.1210ORCID,Peled J. U.124ORCID,van den Brink M. R. M.124ORCID

Affiliation:

1. Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

2. Weill Cornell Medical College, New York, NY, USA.

3. German Cancer Research Center (DKFZ), Heidelberg, Germany.

4. Adult Bone Marrow Transplantation Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

5. Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

6. Department of Internal Medicine II, Technical University of Munich, Munich, Germany.

7. Gnotobiotic Facility, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

8. Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany.

9. German Center for Infection Research, Partner site Bonn-Cologne, Cologne, Germany.

10. Department of Medicine, Section of Infectious Medicine and Global Health, University of Chicago, Chicago, IL, USA.

11. Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

12. Laboratory of Comparative Pathology, Memorial Sloan Kettering Cancer Center, The Rockefeller University, Weill Cornell Medicine, New York, NY, USA.

13. Diagnostic Molecular Pathology Laboratory, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

14. Donald B. and Catherine C. Marron Cancer Metabolism Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

15. Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

16. Internal Medicine III, University Clinic Regensburg, Regensburg, Germany.

17. Division of Hematologic Malignancies and Cellular Therapy, Department of Medicine, Duke University Medical Center, Durham, NC, USA.

18. Department of Hematology, Hokkaido University, Faculty of Medicine, Sapporo, Japan.

19. Computational and Systems Biology Program, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

20. Division of Infectious Diseases, Department of Medicine, Duke University, Durham, NC, USA.

21. Office of Clinical Research, Duke University School of Medicine, Durham, NC, USA.

22. Division of Laboratory and Transfusion Medicine, Hokkaido University Hospital, Sapporo, Japan.

23. Department of Internal Medicine, Infectious Diseases, Goethe University Frankfurt, University Hospital Frankfurt, Frankfurt am Main, Germany.

Abstract

Lactose can fuel GVHD Allogeneic hematopoietic cell transplantation (allo-HCT) is used to treat certain hematopoietic malignancies, but patients have a risk of developing graft-versus-host disease (GVHD). Stein-Thoeringer et al. performed a large-scale analysis of more than 1300 patients treated with allo-HCT across four clinical centers (see the Perspective by Zitvogel and Kroemer). High levels of bacteria from the Enterococcus genus were associated with greater incidence of GVHD and mortality. Lactose appears to provide a substrate for Enterococcus growth, and patients with a lactose-malabsorption genotype had a greater abundance of Enterococcus. A lactose-free diet limited Enterococcus growth, reduced the severity of GVHD, and improved survival in gnotobiotic mouse models. Science , this issue p. 1143 ; see also p. 1077

Funder

National Institutes of Health

National Institute on Aging

National Heart, Lung, and Blood Institute

National Cancer Institute

National Institute of Allergy and Infectious Diseases

German research Foundation

Publisher

American Association for the Advancement of Science (AAAS)

Subject

Multidisciplinary

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