Can Prebiotics Help Protect Against Immunotherapy-Induced Colitis?

Studies suggest the gut microbiome can influence immunotherapy side effects. Butyrate emerges as an intriguing candidate against inflammation in the colon.

9:07 AM

Author | Ian Demsky

colorful cells in intestine with yellow badge bottom right corner saying lab note in blue
Getty Images

Prebiotics are an intriguing potential approach to curbing some of the severe side effects that life-saving immunotherapy treatments can wreak on the gut, according to an analysis of recent studies and clinical trials by researchers at the University of Michigan Rogel Cancer Center.

Rather than trying to introduce beneficial strains of bacteria directly into a patient's digestive tract — via fecal transplant, enema or probiotic supplements, each of which have drawbacks — evidence points to prebiotics as a potentially safe and effective strategy. This would mean giving patients foods that are known to stimulate the growth of certain bacteria that can, in turn, produce larger amounts of protective metabolites.

"There are several advantages to a prebiotic approach," says hematology/oncology fellow Amy Chang, M.D., the lead author of a recent article on the topic in Trends in Cancer. "Compared to other methods, they're easy to administer, safe and inexpensive. One study showed that oat bran, for example, increased production of a metabolite called butyrate and resulted in improved symptoms for patients with bowel ailments similar to those seen in patients receiving immunotherapy."

Immune checkpoint inhibitors have emerged as a significant advance against a variety of cancer types. But severe side effects — especially inflammation and organ damage caused by the amplification of the body's immune response — can force treatments to be discontinued.

The researchers' review of existing studies and clinical trials raised the possibility that butyrate-promoting prebiotics may help reduce immunotherapy-induced inflammation in the colon, and might even be able to improve the effectiveness of the therapy by increasing patients' tolerance to it through the promotion of beneficial microbes.

The article builds on other research at U-M, including an ongoing clinical trial to explore whether butyrate can help reduce rates of acute graft-versus-host-disease of the intestine, a serious complication of bone marrow transplantation.

"The evidence that exists is compelling, and we believe well-designed clinical trials could help us evaluate the potential of prebiotics to improve outcomes for cancer patients treated with immune checkpoint inhibitors," says Chang, who worked closely with senior study authors Christopher Lao, M.D., M.P.H. and Muneesh Tewari, M.D., Ph.D., both of whom are members of the Rogel Cancer Center.

The researchers are preparing to open a pilot clinical trial to test a prebiotic dietary supplement in patients receiving immunotherapy.

Paper cited: "Targeting the Gut Microbiome to Mitigate Immunotherapy-Induced Colitis in Cancer," Trends in Cancer. DOI: 10.1016/j.trecan.2021.02.005


More Articles About: Lab Notes Vitamin Supplements Cancer Research Cancer: Cancer Types Clinical Trials All Research Topics Crohn's and Colitis Nutrition
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of healthcare news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]

734-764-2220

Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Subscribe
Featured News & Stories Blue image of a microscopic helix strand
Health Lab
Researchers discover urine based test to detect head and neck cancer
At-home test can detect tumor DNA fragments in urine samples, providing a non-invasive alternative to traditional blood-based biomarker tests
Dinero is back to being an active toddler following a kidney transplant
Health Lab
Formula prescription helps 2-year-old receive kidney transplant
Dinero's pediatric nephrology team developed a tailored formula to address his mineral deficiencies due to his chronic kidney disease, maintain nutritional health and avoid dialysis.
Photo of two silhouettes in a hallway
Health Lab
Most new doctors face some form of sexual harassment, even after #MeToo
Sexual harassment of all kinds is a common experience among first-year medical residents, also known as interns, especially those in surgical specialties, but it may be declining.
Researcher in white coat focuses gaze on microbes pictured in a twisting tube illustrating the gut
Health Lab
Fiber, genes and the gut microbiome: Study reveals possible triggers for inflammatory bowel disease
A new U-M study finds a complex interplay between diet, genes, and the gut microbiota that could explain why IBD develops.
Spilled pills next to a stethoscope and pile of cash
Health Lab
Drug pricing program improved prostate cancer treatment adherence
Socially vulnerable patients were more likely to stick with oral medications when treated at a hospital participating in 340B program, suggesting these hospitals may have more resources to help patients.
Four older women pose and smile
Health Lab
Unlocking the secrets of SuperAgers
People in their 80s and 90s with cognitive abilities similar to much younger people, called super agers, are taking part in a national study of their brain health.