■本研究旨在辨别非小细胞肺癌(NSCLC)患者中与免疫治疗敏感相关的中医(TCM)证候分类,并描述肠道微生物群生物标志物和对NSCLC免疫疗法疗效的影响,以中医“肺与大肠处于内外关系”理论为基础。
■本研究队列包括在成都市第五人民医院肿瘤科接受治疗的晚期非小细胞肺癌患者。这些患者被分为不同的中医证型,随后服用免疫检查点抑制剂(ICIs)。特别是PD-1抑制剂。在治疗之前和之后从患者收集粪便样本。为了仔细检查肠道微生物群的微生物基因序列和物种的差异,采用16SrRNA扩增子测序技术。此外,收集外周血样本,分析包括通过流式细胞术评估T淋巴细胞亚群和骨髓抑制细胞亚群。随后,我们彻底分析了治疗前后免疫微环境的改变.
■晚期非小细胞肺癌患者的主要临床表现为脾肺气虚证和气阴虚证。值得注意的是,后者对ICIs的反应性增强,免疫微环境得到明显改善.在ICIs治疗之后,在三个菌株中鉴定出微生物丰度的显著差异:梭菌,落叶松科,和Lachnospirales,相互依赖的关系。在表现出PD-L1阳性表达和持久治疗益处的患者亚组中,该研究记录了CD3+%比率的显著增加,CD4+%,T淋巴细胞亚群中的CD4+/CD8+。相反,在CD8%的比率中观察到减少,Treg/CD4+,M-MDSC/MDSC,和G-MDSC/MDSC。
■梭菌菌株,落叶松科,和Lachnospiales作为潜在的生物标志物出现,表明在NSCLC治疗中肠道微生物群的组成。ICI的免疫疗法功效显着增强了显示持久治疗益处的患者和表达阳性PD-L1的患者。
UNASSIGNED: This study is aim to discern the Traditional Chinese Medicine (TCM) syndrome classifications relevant to immunotherapy sensitive in non-small cell lung cancer (NSCLC) patients, and to delineate intestinal microbiota biomarkers and impact that wield influence over the efficacy of NSCLC immunotherapy, grounded in the TCM theory of \"lung and large intestine stand in exterior-interior relationship.\"
UNASSIGNED: The study cohort consisted of patients with advanced NSCLC who received treatment at the Oncology Department of Chengdu Fifth People\'s Hospital. These patients were categorized into distinct TCM syndrome types and subsequently administered immune checkpoint inhibitors (ICIs), specifically PD-1 inhibitors. Stool specimens were collected from patients both prior to and following treatment. To scrutinize the differences in microbial gene sequences and species of the intestinal microbiota, 16S rRNA amplicon sequencing technology was employed. Additionally, peripheral blood samples were collected, and the analysis encompassed the assessment of T lymphocyte subsets and myeloid suppressor cell subsets via flow cytometry. Subsequently, alterations in the immune microenvironment pre- and post-treatment were thoroughly analyzed.
UNASSIGNED: The predominant clinical manifestations of advanced NSCLC patients encompassed spleen-lung Qi deficiency syndrome and Qi-Yin deficiency syndrome. Notably, the latter exhibited enhanced responsiveness to ICIs with a discernible amelioration of the immune microenvironment. Following ICIs treatment, significant variations in microbial abundance were identified among the three strains: Clostridia, Lachnospiraceae, and Lachnospirales, with a mutual dependency relationship. In the subset of patients manifesting positive PD-L1 expression and enduring therapeutic benefits, the study recorded marked increases in the ratios of CD3+%, CD4+%, and CD4+/CD8+ within the T lymphocyte subsets. Conversely, reductions were observed in the ratios of CD8%, Treg/CD4+, M-MDSC/MDSC, and G-MDSC/MDSC.
UNASSIGNED: The strains Clostridia, Lachnospiraceae, and Lachnospirales emerge as potential biomarkers denoting the composition of the intestinal microbiota in the NSCLC therapy. The immunotherapy efficacy of ICIs markedly accentuates in patients displaying durable treatment benefits and those expressing positive PD-L1.