Regulation of intestinal inflammation by microbiota following allogeneic bone marrow transplantation

• DOI: 10.1084/jem.20112408
• Publication Date: 2012-05-01T04:49:36Z
• Authors: Robert R. Jenq; Carles Ubeda; Ying Taur; Clarissa C. Menezes; Raya Khanin; Jarrod A. Dudakov; Chen Liu; Mallory L. West; Natalie V. Singer; Michele J. Equinda; Asia Gobourne; Lauren Lipuma; Lauren F. Young; Odette M. Smith; Arnab Ghosh; Alan M. Hanash; Jenna D. Goldberg; Kazutoshi Aoyama; Bruce R. Blazar; Eric G. Pamer; Marcel R.M. van d...
• Keywords: 0303 health sciences; Base Sequence; Enterocolitis; Dextran Sulfate; Molecular Sequence Data; Brief Definitive Report; Graft vs Host Disease; Biodiversity; Sequence Analysis, DNA; Gram-Positive Bacteria; Feces; Mice; 03 medical and health sciences; Species Specificity; RNA, Ribosomal, 16S; Animals; Humans; Metagenome; Transplantation, Homologous; Ampicillin; Phylogeny; Bone Marrow Transplantation

Despite a growing understanding of the link between intestinal inflammation and resident gut microbes, longitudinal studies of human flora before initial onset of intestinal inflammation have not been reported. Here, we demonstrate in murine and human recipients of allogeneic bone marrow transplantation (BMT) that intestinal inflammation secondary to graft-versus-host disease (GVHD) is associated with major shifts in the composition of the intestinal microbiota. The microbiota, in turn, can modulate the severity of intestinal inflammation. In mouse models of GVHD, we observed loss of overall diversity and expansion of Lactobacillales and loss of Clostridiales. Eliminating Lactobacillales from the flora of mice before BMT aggravated GVHD, whereas reintroducing the predominant species of Lactobacillus mediated significant protection against GVHD. We then characterized gut flora of patients during onset of intestinal inflammation caused by GVHD and found patterns mirroring those in mice. We also identified increased microbial chaos early after allogeneic BMT as a potential risk factor for subsequent GVHD. Together, these data demonstrate regulation of flora by intestinal inflammation and suggest that flora manipulation may reduce intestinal inflammation and improve outcomes for allogeneic BMT recipients.