Biology
Intestinal Blautia Is Associated with Reduced Death from Graft-versus-Host Disease

https://doi.org/10.1016/j.bbmt.2015.04.016Get rights and content
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Highlights

  • Intestinal bacteria diversity is associated with reduced mortality from GVHD.

  • Biomarker discovery analysis identified bacteria from the genus Blautia.

  • Increased Blautia was associated with reduced GVHD mortality in 2 independent cohorts.

  • Blautia abundance is not associated with known risk factors for GVHD.

  • Blautia is reduced after exposure to antibiotics with increased anaerobic coverage.

  • Blautia is also reduced after prolonged use of total parenteral nutrition.

Abstract

The relationship between intestinal microbiota composition and acute graft-versus-host disease (GVHD) after allogeneic blood/marrow transplantation (allo-BMT) is not well understood. Intestinal bacteria have long been thought to contribute to GVHD pathophysiology, but recent animal studies in nontransplant settings have found that anti-inflammatory effects are mediated by certain subpopulations of intestinal commensals. Hypothesizing that a more nuanced relationship may exist between the intestinal bacteria and GVHD, we evaluated the fecal bacterial composition of 64 patients 12 days after BMT. We found that increased bacterial diversity was associated with reduced GVHD-related mortality. Furthermore, harboring increased amounts of bacteria belonging to the genus Blautia was associated with reduced GVHD lethality in this cohort and was confirmed in another independent cohort of 51 patients from the same institution. Blautia abundance was also associated with improved overall survival. We evaluated the abundance of Blautia with respect to clinical factors and found that loss of Blautia was associated with treatment with antibiotics that inhibit anaerobic bacteria and receiving total parenteral nutrition for longer durations. We conclude that increased abundance of commensal bacteria belonging to the Blautia genus is associated with reduced lethal GVHD and improved overall survival.

Key Words

Intestinal bacteria
Graft-versus-host disease

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Financial disclosure: See Acknowledgments on page 1381.