Is There an Interplay between Environmental Factors, Microbiota Imbalance, and Cancer Chemotherapy-Associated Intestinal Mucositis?

Author:

Fernandes Camila1,Miranda Mahara Coelho Crisostomo2,Roque Cássia Rodrigues3,Paguada Ana Lizeth Padilla1,Mota Carlos Adrian Rodrigues1,Florêncio Katharine Gurgel Dias1ORCID,Pereira Anamaria Falcão1,Wong Deysi Viviana Tenazoa1ORCID,Oriá Reinaldo Barreto3,Lima-Júnior Roberto César Pereira1ORCID

Affiliation:

1. Department of Physiology and Pharmacology, and Drug Research and Development Center (NPDM), Faculty of Medicine, Federal University of Ceara, Rua Cel Nunes de Melo, 1000, Fortaleza 60430-270, Brazil

2. Graduate Program in Oncology, Haroldo Juaçaba Hospital, Cancer Institute of Ceara, Fortaleza 60430-230, Brazil

3. Laboratory of Tissue Healing, Ontogeny, and Nutrition, Department of Morphology, and Institute of Biomedicine, Faculty of Medicine, Federal University of Ceara, Fortaleza 60430-170, Brazil

Abstract

Interindividual variation in drug efficacy and toxicity is a significant problem, potentially leading to adverse clinical and economic public health outcomes. While pharmacogenetics and pharmacogenomics have long been considered the primary causes of such heterogeneous responses, pharmacomicrobiomics has recently gained attention. The microbiome, a community of microorganisms living in or on the human body, is a critical determinant of drug response and toxicity. Factors such as diet, lifestyle, exposure to xenobiotics, antibiotics use, illness, and genetics can influence the composition of the microbiota. Changes in the intestinal microbiota are particularly influential in drug responsiveness, especially in cancer chemotherapy. The microbiota can modulate an individual’s response to a drug, affecting its bioavailability, clinical effect, and toxicity, affecting treatment outcomes and patient quality of life. For instance, the microbiota can convert drugs into active or toxic metabolites, influencing their efficacy and side effects. Alternatively, chemotherapy can also alter the microbiota, creating a bidirectional interplay. Probiotics have shown promise in modulating the microbiome and ameliorating chemotherapy side effects, highlighting the potential for microbiota-targeted interventions in improving cancer treatment outcomes. This opinion paper addresses how environmental factors and chemotherapy-induced dysbiosis impact cancer chemotherapy gastrointestinal toxicity.

Funder

CNPq

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico

R.C.P. Lima-Júnior

Publisher

MDPI AG

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