Gut microbiota controlling radiation-induced enteritis and intestinal regeneration

Cancer remains the second leading cause of mortality, with nearly 10 million deaths worldwide in 2020. In many cases, radiotherapy is used for its anticancer effects. However, radiation causes healthy tissue toxicity as a side effect. In intra-abdominal and pelvic malignancies, the healthy bowel is inevitably included in the radiation field, causing radiation-induced enteritis and dramatically affecting the gut microbiome. This condition is associated with significant morbidity and mortality that impairs cancer patients' and survivors' quality of life. This Review provides a critical overview of the main drivers in modulating the gut microenvironment in homeostasis, disease, and injury, focusing on gut microbial metabolites and microorganisms that influence epithelial regeneration upon radiation injury.

Automated summary

Cancer is the second leading cause of death worldwide, causing nearly 10 million deaths in 2020. Radiotherapy is commonly used for its anticancer effects, but it also leads to healthy tissue toxicity. In cases of abdominal and pelvic malignancies, the healthy bowel is unavoidably exposed to radiation, resulting in radiation-induced enteritis and significant impact on the gut microbiome. This review provides a critical analysis of the factors influencing the gut microenvironment in homeostasis, disease, and injury, focusing on the role of gut microbial metabolites and microorganisms in epithelial regeneration after radiation injury.