PDF(Pubmed)
Abstract：
Intestinal parasitic infections (IPIs) can lead to significant morbidity and mortality in cancer patients. While they are unlikely to cause severe disease and are self-limiting in healthy individuals, cancer patients are especially susceptible to opportunistic parasitic infections. The gut microbiota plays a crucial role in various aspects of health, including immune regulation and metabolic processes. Parasites occupy the same environment as bacteria in the gut. Recent research suggests intestinal parasites can disrupt the normal balance of the gut microbiota. However, there is limited understanding of this co-infection dynamic among cancer patients in Malaysia. A study was conducted to determine the prevalence and relationship between intestinal parasites and gut microbiota composition in cancer patients. Stool samples from 134 cancer patients undergoing active treatment or newly diagnosed were collected and examined for the presence of intestinal parasites and gut microbiota composition. The study also involved 17 healthy individuals for comparison and control. Sequencing with 16S RNA at the V3-V4 region was used to determine the gut microbial composition between infected and non-infected cancer patients and healthy control subjects. The overall prevalence of IPIs among cancer patients was found to be 32.8%. Microsporidia spp. Accounted for the highest percentage at 20.1%, followed by Entamoeba spp. (3.7%), Cryptosporidium spp. (3.0%), Cyclospora spp. (2.2%), and Ascaris lumbricoides (0.8%). None of the health control subjects tested positive for intestinal parasites. The sequencing data analysis revealed that the gut microbiota diversity and composition were significantly different in cancer patients than in healthy controls (p < 0.001). A significant dissimilarity was observed in the bacterial composition between parasite-infected and non-infected patients based on Bray-Curtis (p = 0.041) and Jaccard (p = 0.021) measurements. Bacteria from the genus Enterococcus were enriched in the parasite-infected groups, while Faecalibacterium prausnitzii reduced compared to non-infected and control groups. Further analysis between different IPIs and non-infected individuals demonstrated a noteworthy variation in Entamoeba-infected (unweighted UniFrac: p = 0.008), Cryptosporidium-infected (Bray-Curtis: p = 0.034) and microsporidia-infected (unweighted: p = 0.026; weighted: p = 0.019; Jaccard: p = 0.031) samples. No significant dissimilarity was observed between Cyclospora-infected groups and non-infected groups. Specifically, patients infected with Cryptosporidium and Entamoeba showed increased obligate anaerobic bacteria. Clostridiales were enriched with Entamoeba infections, whereas those from Coriobacteriales decreased. Bacteroidales and Clostridium were found in higher abundance in the gut microbiota with Cryptosporidium infection, while Bacillales decreased. Additionally, bacteria from the genus Enterococcus were enriched in microsporidia-infected patients. In contrast, bacteria from the Clostridiales order, Faecalibacterium, Parabacteroides, Collinsella, Ruminococcus, and Sporosarcina decreased compared to the non-infected groups. These findings underscore the importance of understanding and managing the interactions between intestinal parasites and gut microbiota for improved outcomes in cancer patients.
摘要：
肠道寄生虫感染(IPI)可导致癌症患者的显著发病率和死亡率。虽然它们不太可能引起严重的疾病，并且在健康个体中具有自限性，癌症患者特别容易受到机会性寄生虫感染。肠道微生物群在健康的各个方面发挥着至关重要的作用。包括免疫调节和代谢过程。寄生虫与肠道中的细菌占据相同的环境。最近的研究表明，肠道寄生虫可以破坏肠道微生物群的正常平衡。然而,马来西亚癌症患者对这种合并感染动态的了解有限.进行了一项研究，以确定癌症患者肠道寄生虫和肠道菌群组成之间的患病率和关系。收集来自134名接受积极治疗或新诊断的癌症患者的粪便样品，并检查肠道寄生虫和肠道微生物群组成的存在。该研究还涉及17名健康个体进行比较和对照。在V3-V4区域用16SRNA测序用于确定感染和未感染癌症患者与健康对照受试者之间的肠道微生物组成。发现癌症患者中IPI的总体患病率为32.8％。微孢子虫。占比最高，为20.1%，其次是Entamoebaspp。（3.7%），隐孢子虫。（3.0%），环孢菌属。（2.2%），和蛔虫(0.8%)。没有一个健康对照受试者的肠道寄生虫检测呈阳性。测序数据分析显示，癌症患者的肠道微生物群多样性和组成与健康对照组有显著差异（p<0.001）。根据Bray-Curtis（p=0.041）和Jaccard（p=0.021）的测量，在寄生虫感染和未感染患者之间的细菌组成中观察到了显着差异。来自肠球菌属的细菌在寄生虫感染的群体中富集，与未感染组和对照组相比，普氏粪杆菌减少。不同IPI和未感染个体之间的进一步分析表明，Entamoeba感染的差异显着（未加权UniFrac：p=0.008），隐孢子虫感染（Bray-Curtis：p=0.034）和微孢子虫感染（未加权：p=0.026；加权：p=0.019；Jaccard：p=0.031）样品。在环孢菌感染组和未感染组之间没有观察到显著的差异。具体来说,感染隐孢子虫和内阿米巴的患者显示专性厌氧菌增多.梭菌富含内阿米巴感染，而来自科氏杆菌的则减少了。在隐孢子虫感染的肠道微生物群中发现了高丰度的拟杆菌和梭菌，而芽孢杆菌下降。此外,肠球菌属的细菌在微孢子虫感染的患者中富集。相比之下,梭菌属的细菌，粪杆菌,副杆菌属,Collinsella,Ruminococus,与未感染组相比，孢子虫下降。这些发现强调了理解和管理肠道寄生虫和肠道微生物群之间的相互作用对于改善癌症患者预后的重要性。
