title: Toward revision of antimicrobial therapies in hematopoietic stem cell transplantation: target the pathogens, but protect the indigenous microbiota.
abstract: Host microbiota plays important roles in providing colonization resistance to pathogens and instructing development and function of the immune system. Antibiotic treatments intended to target pathogens further weaken the host defenses and may paradoxically increase the risk of systemic infections. This consequence is especially problematic in patients undergoing hematopoietic stem cell transplantation, where the mucosal defenses are already weakened by the conditioning regimens. This review discusses the roles that indigenous microbiota plays in protecting the host and maintaining immune homeostasis. In addition, we highlight possible strategies that are being developed to allow targeted antimicrobial therapy against pathogens, while minimizing the harm to indigenous microbiota.
authors: Division of Gastroenterology, Department of Medicine, Center for Immunology and Biotechnology Institute, University of Minnesota, Minneapolis, Minn. Electronic address: khoru001@umn.edu.
authors: Alexander
authors: A
authors: Khoruts
authors: Division of Hematology/Oncology and Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, Minn.
authors: Keli L
authors: KL
authors: Hippen
authors: Division of Hematology/Oncology and Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, Minn.
authors: Amanda M
authors: AM
authors: Lemire
authors: Blood and Marrow Transplant Program, Department of Medicine, University of Minnesota, Minneapolis, Minn.
authors: Shernan G
authors: SG
authors: Holtan
authors: Department of Computer Science and Engineering, Biotechnology Institute, University of Minnesota, Minneapolis, Minn.
authors: Dan
authors: D
authors: Knights
authors: Division of Infectious Diseases, Department of Medicine, University of Minnesota, Minneapolis, Minn.
authors: Jo-Anne H
authors: JH
authors: Young
mesh_terms: D000818:Animals; D000890:Anti-Infective Agents / Q000494:pharmacology*; D064806:Dysbiosis / Q000276:immunology / Q000382:microbiology / Q000628:therapy; D041981:Gastrointestinal Tract / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D064307:Microbiota / Q000187:drug effects*
chemical_list: D000890:Anti-Infective Agents