Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/133425
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Type: | Journal article |
Title: | Does chemotherapy-induced gastrointestinal mucositis affect the bioavailability and efficacy of anti-infective drugs? |
Author: | da Silva Ferreira, A.R. Märtson, A.-G. de Boer, A. Wardill, H.R. Alffenaar, J.-W. Harmsen, H.J.M. Tissing, W.J.E. |
Citation: | Biomedicines, 2021; 9(10):1389-1-1389-13 |
Publisher: | MDPI |
Issue Date: | 2021 |
ISSN: | 2227-9059 2227-9059 |
Statement of Responsibility: | Ana Rita da Silva Ferreira, Anne-Grete Märtson , Alyse de Boer, Hannah R. Wardill, Jan-Willem Alffenaar, Hermie J. M. Harmsen and Wim J. E. Tissing |
Abstract: | Antimicrobial prophylaxis is increasingly being used in patients with hematological malignancies receiving high-dose chemotherapy and hematopoietic stem cell transplantation (HSCT). However, few studies have focused on the potential impact of gastrointestinal mucositis (GI-M), a frequently observed side effect of chemotherapy in patients with cancer that affects the gastrointestinal microenvironment, on drug absorption. In this review, we discuss how chemotherapy leads to an overall loss of mucosal surface area and consequently to uncontrolled transport across the barrier. The barrier function is depending on intestinal luminal pH, intestinal motility, and diet. Another factor contributing to drug absorption is the gut microbiota, as it modulates the bioavailability of orally administrated drugs by altering the gastrointestinal properties. To better understand the complex interplay of factors in GI-M and drug absorption we suggest: (i) the longitudinal characterization of the impact of GI-M severity on drug exposure in patients, (ii) the development of tools to predict drug absorption, and (iii) strategies that allow the support of the gut microbiota. These studies will provide relevant data to better design strategies to reduce the severity and impact of GI-M in patients with cancer. |
Keywords: | cancer; chemotherapy; gastrointestinal mucositis; antibiotics; gut microbiota; drug pharmacokinetics |
Rights: | © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). |
DOI: | 10.3390/biomedicines9101389 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/114092 |
Published version: | http://dx.doi.org/10.3390/biomedicines9101389 |
Appears in Collections: | Medicine publications |
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hdl_133425.pdf | Published version | 559.03 kB | Adobe PDF | View/Open |
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