免疫检查点(CTLA-4,PD-1和PD-L1)的发现及其对肿瘤疾病预后的影响为革命性肿瘤治疗的发展铺平了道路。这些治疗方法不能用“对抗”癌细胞的药物来对抗肿瘤,而是通过用淋巴细胞攻击癌细胞来支持和增强免疫系统对肿瘤生长的直接反应的能力。现在已经被广泛证明,足够的免疫反应的存在,主要由肿瘤块中存在的TILs(肿瘤浸润淋巴细胞)的数量所代表,决定性地影响对治疗的反应和疾病的预后.因此,免疫疗法的基础是,如果没有增加肿瘤部位淋巴细胞存在的能力,从而限制和消除某些肿瘤逃避机制,特别是通过抑制对转化细胞的反应的检查点的活性(在积极的生理条件下)表达的那些。免疫疗法已经处于实验阶段几十年了,其优异的结果使其成为许多肿瘤病理治疗的基石,特别是联合化疗和放疗时。尽管取得了这些成功,相当数量的患者(约50%)对治疗没有反应或早期出现耐药性.微生物群,其组成,我们调节它的能力可以对肿瘤治疗产生积极的影响,减少副作用,增加灵敏度和有效性。发表在高级期刊上的大量研究证实了某种微生物平衡,特别是能够产生短链脂肪酸(SCFA)的细菌的存在,尤其是丁酸,不仅对于减少放化疗治疗的副作用至关重要,而且对于更好地响应免疫治疗和,因此,更好的预后。这开辟了微生物群的有利调节可能成为标准肿瘤治疗的必要补充治疗的可能性。这篇简短的综述旨在强调使用精密益生菌的关键方面,比如丁酸梭菌,产生丁酸来改善对免疫检查点治疗的反应,因此,肿瘤疾病的预后。
The discovery of immune checkpoints (CTLA-4, PD-1, and PD-L1) and their impact on the prognosis of oncological diseases have paved the way for the development of revolutionary oncological treatments. These treatments do not combat tumors with drugs \"against\" cancer cells but rather support and enhance the ability of the immune system to respond directly to tumor growth by attacking the cancer cells with lymphocytes. It has now been widely demonstrated that the presence of an adequate immune response, essentially represented by the number of TILs (tumor-infiltrating lymphocytes) present in the tumor mass decisively influences the response to treatments and the prognosis of the disease. Therefore, immunotherapy is based on and cannot be carried out without the ability to increase the presence of lymphocytic cells at the tumor site, thereby limiting and nullifying certain tumor evasion mechanisms, particularly those expressed by the activity (under positive physiological conditions) of checkpoints that restrain the response against transformed cells. Immunotherapy has been in the experimental phase for decades, and its excellent results have made it a cornerstone of treatments for many oncological pathologies, especially when combined with chemotherapy and radiotherapy. Despite these successes, a significant number of patients (approximately 50%) do not respond to treatment or develop resistance early on. The microbiota, its composition, and our ability to modulate it can have a positive impact on oncological treatments, reducing side effects and increasing sensitivity and effectiveness. Numerous studies published in high-ranking journals confirm that a certain microbial balance, particularly the presence of bacteria capable of producing short-chain fatty acids (SCFAs), especially
butyrate, is essential not only for reducing the side effects of chemoradiotherapy treatments but also for a better response to immune treatments and, therefore, a better prognosis. This opens up the possibility that favorable modulation of the microbiota could become an essential complementary treatment to standard oncological therapies. This brief review aims to highlight the key aspects of using precision probiotics, such as Clostridium butyricum, that produce
butyrate to improve the response to immune checkpoint treatments and, thus, the prognosis of oncological diseases.