Prebiotics: A Potential Treatment Strategy for the Chemotherapy-damaged Gut?

Abstract

Mucositis, characterized by ulcerative lesions along the alimentary tract, is a common consequence of many chemotherapy regimens. Chemotherapy negatively disrupts the intestinal microbiota, resulting in increased numbers of potentially pathogenic bacteria, such as Clostridia and Enterobacteriaceae, and decreased numbers of “beneficial” bacteria, such as Lactobacilli and Bifidobacteria. Agents capable of restoring homeostasis in the bowel microbiota could, therefore, be applicable to mucositis. Prebiotics are indigestible compounds, commonly oligosaccharides, that seek to reverse chemotherapy-induced intestinal dysbiosis through selective colonization of the intestinal microbiota by probiotic bacteria. In addition, evidence is emerging that certain prebiotics contribute to nutrient digestibility and absorption, modulate intestinal barrier function through effects on mucin expression, and also modify mucosal immune responses, possibly via inflammasome-mediated processes. This review examines the known mechanisms of prebiotic action, and explores their potential for reducing the severity of chemotherapy-induced mucositis in the intestine.

Keywords:

• Animal models
• mucositis
• prebiotics
• chemotherapy

STATEMENT OF INTEREST

The authors declare they have no other conflicts of interest or financial agreements pertinent to this paper.

Funding

Professor Gordon S. Howarth is supported by a South Australian Health and Medical Research Institute Cancer Council South Australia Senior Research Fellowship.