Abstract
Purpose
Fatigue is the most distressing symptom for individuals with cancer. While numerous studies have investigated biological pathways that could underlie the mechanism of fatigue, the cause of fatigue remains unclear. This review aimed to investigate the association between gut microbial composition and fatigue in individuals with cancer.
Methods
Medline (PubMed), Embase (Elsevier), and CINAHL Complete (Ebscohost) were systemically searched on March 30, 2023, for articles investigating gut microbial composition (relative abundance, alpha diversity, and beta diversity) and fatigue in individuals with cancer; no limitations were placed on dates, participant age, nor cancer type/treatment.
Results
Microbial composition in the form of relative abundance was correlated with fatigue in six of the seven articles. A high relative abundance of g_Ruminoccocus was observed in individuals with low fatigue. An elevated relative abundance of g_Escherichia and f_Enterobacteriaceae was associated with high fatigue. However, other associations between fatigue and relative abundance composition, such as with g_Bifidobacterium and g_Faecalibacterium, had conflicting results. For alpha diversity and fatigue, the findings were contradictory; the association between beta diversity and fatigue was unclear due to conflicting results.
Conclusions
Pro-inflammatory bacteria, such as f_Enterobacteriaceae, were more commonly associated with higher fatigue scores, while anti-inflammatory or short-chain fatty acid producing bacteria, such as g_Ruminoccocus, were linked with lower fatigue scores in individuals with cancer. The relationship between alpha and beta diversity and fatigue was inconclusive. Further investigation is needed to clarify whether gut microbial changes play a correlative or causal role in the development of fatigue in individuals with cancer.
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Data Availability
This is a systematic review so no data availability statement is needed.
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Conceptualization: J.S, T.A; Literature Search: L.L; Study Screening, Quality Appraisal and Data Extraction: J.S, H.N; Data Analysis: J.S; Writing - original draft preparation: J.S; Writing – review and editing: H.N, L.L, T.A; Supervision: T.A.
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Slack, J., Noh, H., Ledbetter, L. et al. The association between the gut microbiome and fatigue in individuals living with cancer: a systematic review. Support Care Cancer 32, 267 (2024). https://doi.org/10.1007/s00520-024-08468-5
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DOI: https://doi.org/10.1007/s00520-024-08468-5