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Impact of dietary fiber on GvHD outcomes in pre-clinical models and patients receiving allo-HSCT
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Paredes et al. hypothesized that increased dietary fiber could reduce the risk of GVHD in allo-HCT recipients by improving intestinal microbiome diversity and thereby beneficial microbial metabolites. They conducted a two-part study which investigated the correlation between dietary fiber intake and aGvHD outcomes in 173 patients undergoing allo-HSCT, and the mechanisms by which dietary fiber modulates aGvHD outcomes in preclinical mouse models. Their findings were presented by Paredes at the 66th ASH Annual Meeting and Exposition.1 |
| Key learnings |
| Higher dietary fiber intake was correlated with increased levels of Blautia (p < 0.001) and decreased levels of Enterococcus (p = 0.06) in patients undergoing allo-HSCT and improved OS vs lower fiber intake (p = 0.045). |
| In non-TCD patients (n = 101), fiber intake was associated with higher microbial α-diversity (p = 0.007) and β-diversity (p < 0.001). High fiber intake resulted in increased fecal butyrate and acetate (p < 0.001 each). |
| The cumulative incidence of aGvHD (p = 0.034) and GI-GvHD (p = 0.04) were lower in patients with high fiber intake. |
| In mouse models, 12% cellulose intake showed increased microbial diversity (p = 0.001), decreased Enterococcus (p = 0.044), a higher ratio of Treg vs Tconv cells (p = 0.0089), a higher level of cecal butyrate (p = 0.0382), and epithelial homeostasis gene expression. |
| The findings suggest that increasing dietary fiber may be used in the prevention of GvHD. |
Abbreviations: aGvHD, acute graft-versus-host disease; allo-HSCT, allogeneic hematopoietic stem cell transplantation; ASH, American Society of Hematology; GI-GvHD, gastrointestinal graft-versus-host disease; TCD, T cell depleted; Tconv, conventional T cells; Treg, regulatory T cells.
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