Abstract
Purpose
Irinotecan can cause high levels of diarrhea caused by toxic injury to the gastrointestinal microenvironment. Toll-like receptor 4 (TLR4) and the gut microbiome have previously been implicated in gastrointestinal toxicity and diarrhea; however, the link between these two factors has not been definitively determined. We used a tumor-bearing, intestinal epithelial cell (IEC) TLR4 knockout model (Tlr4ΔIEC) to assess microbiome changes following irinotecan treatment. We then determined if a fecal microbiota transplant (FMT) between Tlr4ΔIEC and wild-type (WT) mice altered irinotecan-induced gastrointestinal toxicity.
Methods
MC-38 colorectal cancer cells were injected into WT and Tlr4ΔIEC mice. Fecal samples were collected prior to tumor inoculation, prior to irinotecan treatment and at cull. 16S rRNA gene sequencing was used to assess changes in the microbiome. Next, FMT was used to transfer the microbiome phenotype between Tlr4ΔIEC and WT mice prior to irinotecan treatment. Gastrointestinal toxicity symptoms were assessed.
Results
In study 1, there were no compositional differences in the microbiome between Tlr4ΔIEC and WT mice at baseline. However, predicted functional capacity of the microbiome was different between WT and Tlr4ΔIEC at baseline and post-irinotecan. In study 2, Tlr4ΔIEC mice were protected from grade 3 diarrhea. Additionally, WT mice who did not receive FMT had more colonic damage in the colon compared to controls (P = 0.013). This was not seen in Tlr4ΔIEC mice or WT mice who received FMT (P > 0.05).
Conclusion
Tlr4ΔIEC and WT had no baseline compositional microbiome differences, but functional differences at baseline and following irinotecan. FMT altered some aspects of irinotecan-induced gastrointestinal toxicity.
Data availability
Available upon reasonable request.
Code availability
Not applicable.
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Acknowledgements
KRS, EEC, and JSYT were in receipt of an Australian Government Research Training Program Scholarship. KRS was in receipt of a Lion’s Medical Research Foundation Scholarship. Thank you to Courtney Subramaniam, Ghanyah Al-Qadami, Georgette Radford and Claire Vieyra for assistance with the mouse studies. Thank you to the University of Adelaide Laboratory Animal Services staff for their assistance with the Tlr4ΔIEC model development and breeding.
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These studies were approved by the Animal Ethics Committee of the University of Adelaide (M-2017-114, M-2020-028, M-2020-026), and complied with the National Health and Medical Research Council (Australia) Code of Practice for Animal Care in Research and Training (2013).
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Secombe, K.R., Crame, E.E., Tam, J.S.Y. et al. Intestinal toll-like receptor 4 knockout alters the functional capacity of the gut microbiome following irinotecan treatment. Cancer Chemother Pharmacol 89, 275–281 (2022). https://doi.org/10.1007/s00280-021-04382-3
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DOI: https://doi.org/10.1007/s00280-021-04382-3