title: Intestinal Blautia Is Associated with Reduced Death from Graft-versus-Host Disease.
abstract: The relationship between intestinal microbiota composition and acute graft-versus-host disease (GVHD) after allogeneic blood/marrow transplantation (allo-BMT) is not well understood. Intestinal bacteria have long been thought to contribute to GVHD pathophysiology, but recent animal studies in nontransplant settings have found that anti-inflammatory effects are mediated by certain subpopulations of intestinal commensals. Hypothesizing that a more nuanced relationship may exist between the intestinal bacteria and GVHD, we evaluated the fecal bacterial composition of 64 patients 12 days after BMT. We found that increased bacterial diversity was associated with reduced GVHD-related mortality. Furthermore, harboring increased amounts of bacteria belonging to the genus Blautia was associated with reduced GVHD lethality in this cohort and was confirmed in another independent cohort of 51 patients from the same institution. Blautia abundance was also associated with improved overall survival. We evaluated the abundance of Blautia with respect to clinical factors and found that loss of Blautia was associated with treatment with antibiotics that inhibit anaerobic bacteria and receiving total parenteral nutrition for longer durations. We conclude that increased abundance of commensal bacteria belonging to the Blautia genus is associated with reduced lethal GVHD and improved overall survival.
authors.affiliation: Adult BMT, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York. Electronic address: jenqr@mskcc.org.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Jenq
authors.affiliation: Weill Cornell Medical College, New York, New York; Infectious Diseases Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Ying
authors.initials: Y
authors.lastname: Taur
authors.affiliation: Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Devlin
authors.affiliation: Adult BMT, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
authors.forename: Doris M
authors.initials: DM
authors.lastname: Ponce
authors.affiliation: Adult BMT, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
authors.forename: Jenna D
authors.initials: JD
authors.lastname: Goldberg
authors.affiliation: Department of Immunology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Katya F
authors.initials: KF
authors.lastname: Ahr
authors.affiliation: Infectious Diseases Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Littmann
authors.affiliation: Department of Immunology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Lilan
authors.initials: L
authors.lastname: Ling
authors.affiliation: Department of Immunology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Asia C
authors.initials: AC
authors.lastname: Gobourne
authors.affiliation: Department of Immunology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Liza C
authors.initials: LC
authors.lastname: Miller
authors.affiliation: Department of Immunology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Docampo
authors.affiliation: Adult BMT, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
authors.forename: Jonathan U
authors.initials: JU
authors.lastname: Peled
authors.affiliation: Department of Immunology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Arpaia
authors.affiliation: Cell Metabolism Core, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Justin R
authors.initials: JR
authors.lastname: Cross
authors.affiliation: Department of Nutrition, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Tatanisha K
authors.initials: TK
authors.lastname: Peets
authors.affiliation: Department of Immunology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Lumish
authors.affiliation: Department of Immunology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Shono
authors.affiliation: Department of Immunology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Jarrod A
authors.initials: JA
authors.lastname: Dudakov
authors.affiliation: Department of Immunology, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Hendrik
authors.initials: H
authors.lastname: Poeck
authors.affiliation: Adult BMT, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Hanash
authors.affiliation: Adult BMT, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
authors.forename: Juliet N
authors.initials: JN
authors.lastname: Barker
authors.affiliation: Adult BMT, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Perales
authors.affiliation: Adult BMT, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
authors.forename: Sergio A
authors.initials: SA
authors.lastname: Giralt
authors.affiliation: Weill Cornell Medical College, New York, New York; Infectious Diseases Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: Eric G
authors.initials: EG
authors.lastname: Pamer
authors.affiliation: Adult BMT, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
authors.forename: Marcel R M
authors.initials: MR
authors.lastname: van den Brink
mesh_terms: D001419:Bacteria / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D006086:Graft vs Host Disease / Q000401:mortality*; D006801:Humans; D007413:Intestinal Mucosa / Q000378:metabolism; D007422:Intestines / Q000382:microbiology*; D008297:Male; D012307:Risk Factors; D016019:Survival Analysis
keywords: Graft-versus-host disease; Intestinal bacteria