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Lactose drives Enterococcus expansion to promote graft-versus-host disease
Open accessAbstract
Lactose can fuel GVHD: Allogeneic hematopoietic cell transplantation (allo-HCT) is used to treat certain hematopoietic malignancies, but patients have a risk of developing graft-versus-host disease (GVHD). Stein-Thoeringer et al. performed a large-scale analysis of more than 1300 patients treated with allo-HCT across four clinical centers (see the Perspective by Zitvogel and Kroemer). High levels of bacteria from the Enterococcus genus were associated with greater incidence of GVHD and mortality. Lactose appears to provide a substrate for Enterococcus growth, and patients with a lactose-malabsorption genotype had a greater abundance of Enterococcus. A lactose-free diet limited Enterococcus growth, reduced the severity of GVHD, and improved survival in gnotobiotic mouse models. Science , this issue p. 1143 ; see also p. 1077
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“Preclinical models have shown that commensal bacteria influence the pathophysiology of GVHD.10,17–20”
From Microbiota as Predictor of Mortality in Allogeneic Hematopoietic-Cell Transplantation (2020) · cites this paper as [20]
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“Enterococcus has been associated with the development of post-HCT graft-versus-host disease5.”
From A non-antibiotic-disrupted gut microbiome is associated with clinical responses to CD19-CAR-T cell cancer immunotherapy (2023) · cites this paper as [5]
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Metadata
- Authors
- Stein-Thoeringer, C. K., Nichols, K. B., Lazrak, A., Docampo, M. D., Slingerland, A. E., Slingerland, J. B., Clurman, A. G., Armijo, G., Gomes, A. L. C., Shono, Y., Staffas, A., Burgos da Silva, M., Devlin, S. M., Markey, K. A., Bajic, D., Pinedo, R., Tsakmaklis, A., Littmann, E. R., Pastore, A., Taur, Y., Monette, S., Arcila, M. E., Pickard, A. J., Maloy, M., Wright, R. J., Amoretti, L. A., Fontana, E., Pham, D., Jamal, M. A., Weber, D., Sung, A. D., Hashimoto, D., Scheid, C., Xavier, J. B., Messina, J. A., Romero, K., Lew, M., Bush, A., Bohannon, L., Hayasaka, K., Hasegawa, Y., Vehreschild, M. J. G. T., Cross, J. R., Ponce, D. M., Perales, M. A., Giralt, S. A., Jenq, R. R., Teshima, T., Holler, E., Chao, N. J., Pamer, E. G., Peled, J. U., & van den Brink, M. R. M.
- Affiliations
- Department of Immunology, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Memorial Sloan Kettering Cancer Center (US)
- Technical University of Munich (DE)
- University of Cologne (DE)
- The University of Texas MD Anderson Cancer Center (US)
- University Hospital Regensburg (DE)
- Duke Medical Center (US)
- Hokkaido University (JP)
- Duke University (US)
- Hokkaido University Hospital (JP)
- Goethe University Frankfurt (DE)
- ORCID
- Stein-Thoeringer, C. K.
- Nichols, K. B.
- Lazrak, A.
- Docampo, M. D.
- Slingerland, A. E.
- Slingerland, J. B.
- Clurman, A. G.
- Armijo, G.
- Gomes, A. L. C.
- Shono, Y.
- Staffas, A.
- Burgos da Silva, M.
- Devlin, S. M.
- Markey, K. A.
- Bajic, D.
- Pinedo, R.
- Tsakmaklis, A.
- Littmann, E. R.
- Pastore, A.
- Taur, Y.
- Monette, S.
- Arcila, M. E.
- Pickard, A. J.
- Maloy, M.
- Wright, R. J.
- Amoretti, L. A.
- Fontana, E.
- Pham, D.
- Jamal, M. A.
- Weber, D.
- Sung, A. D.
- Hashimoto, D.
- Scheid, C.
- Xavier, J. B.
- Messina, J. A.
- Romero, K.
- Lew, M.
- Bush, A.
- Bohannon, L.
- Hasegawa, Y.
- Vehreschild, M. J. G. T.
- Cross, J. R.
- Ponce, D. M.
- Perales, M. A.
- Giralt, S. A.
- Jenq, R. R.
- Teshima, T.
- Holler, E.
- Chao, N. J.
- Pamer, E. G.
- Peled, J. U.
- van den Brink, M. R. M.
- Venue
- Science
- Published
- 2019-11-29
- Volume
- 366
- Issue
- 6469
- Pages
- 1143-1149
- ISSN
- 0036-8075 (ISSN-L)
- 1095-9203
- PMC
- PMC7003985
- OpenAlex
- W2990824191
- Cited by
- 384
- References
- 55
- Citations by year
- 2026: 46 · 2025: 60 · 2024: 52 · 2023: 59 · 2022: 69 · 2021: 57 · 2020: 39 · 2019: 1
- FWCI
- 29.38
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Science (publishedVersion)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- PubMed Central (acceptedVersion)
- University of Regensburg Publication Server (University of Regensburg) (submittedVersion)
- Funders
- National Institutes of Health (1R01HL124112-01A)
- National Institute on Aging (P01-AG052359, 2P30AG028716-11)
- National Heart, Lung, and Blood Institute (R01-HL125571, R01-HL123340)
- National Cancer Institute (R01-CA228358, R01CA203950-01, R01 CA203950-01, P30 CA008748, P01-CA023766, R01-CA228308)
- National Institute of Allergy and Infectious Diseases (U01 AI124275, R01 AI032135)
- German research Foundation
- Topics
- Health Sciences › Medicine › Hematology › Hematopoietic Stem Cell Transplantation
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
- Keywords
- lactose, Enterococcus, graft-versus-host disease, allogeneic hematopoietic stem cell transplantation, lactose malabsorption, gut microbiota, lactose-free diet, bacterial growth substrates, post-transplant mortality, gnotobiotic mouse model
- MeSH terms
- Gastrointestinal Microbiome, Aged, Animals, Feces, Female, Graft vs Host Disease, Humans, Intestines, Lactose, Male, Middle Aged, RNA, Ribosomal, 16S, Transplantation, Homologous, Enterococcus, Sequence Analysis, RNA, Hematopoietic Stem Cell Transplantation, Mice, Microbiota, Dysbiosis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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