Talk:Checkpoint inhibitor induced colitis

Medicine: Gastroenterology / Hematology-oncology Low‑importance

	Medicine portal This article is within the scope of WikiProject Medicine, which recommends that medicine-related articles follow the Manual of Style for medicine-related articles and that biomedical information in any article use high-quality medical sources. Please visit the project page for details or ask questions at Wikipedia talk:WikiProject Medicine.MedicineWikipedia:WikiProject MedicineTemplate:WikiProject Medicinemedicine articles
Low	This article has been rated as Low-importance on the project's importance scale.
	This article is supported by the Gastroenterology task force (assessed as Low-importance).
	This article is supported by the Hematology-oncology task force (assessed as Low-importance).

Confusing flora section

This paragraph seems to be contradictory, saying that Faecalibacterium is both associated with survival and with colitis.

Amongst people treated with immune checkpoint inhibitors, those with Faecalibacterium genus and other Bacillota present in the colonic flora have longer progression-free survival and overall survival. In addition, a higher rate of checkpoint inhibitor induced colitis is associated with the presence of Faecalibacterium in the fecal microbiota.^[1]

The source says:

Compared with patients whose baseline microbiota was driven by Bacteroides (cluster B,n = 10), patients whose baseline microbiota was enriched with Faecalibacterium genus and other Firmicutes (cluster A,n = 12) had longer progression-free survival (P = 0.0039) and overall survival (P = 0.051).

This seems like Bacteroides is associated with colitis, not Faecalibacterium. However, I'm not familiar with the field and would appreciate someone double-checking this. Technical-tiresias (talk) 06:15, 24 November 2022 (UTC)[reply]

This is correct, as written. The concept here is that the checkpoint inhibitors stimulate the immune system by preventing deactivation via physiologic checkpoints; hopefully, this results in increased immune-mediated destruction of malignant cells. Individuals who experience a more robust immune response may experience more immune mediated colitis AND more destruction of tumor cells. It is believed that this is why checkpoint inhibitor colitis is associated with improved survival.

Similarly, Faecalibacterium and other Firmicutes are associated with more immune mediated colitis and improved survival (compared with Bacteroides). Individuals with more Bacteroides in their gut flora may have worse survival and may be less likely to get immune mediated colitis.

Does that make sense? Rytyho usa (talk) 07:30, 24 November 2022 (UTC)[reply]

References

^ Chaput, N.; Lepage, P.; Coutzac, C.; Soularue, E.; Le Roux, K.; Monot, C.; Boselli, L.; Routier, E.; Cassard, L.; Collins, M.; Vaysse, T.; Marthey, L.; Eggermont, A.; Asvatourian, V.; Lanoy, E.; Mateus, C.; Robert, C.; Carbonnel, F. (June 2017). "Baseline gut microbiota predicts clinical response and colitis in metastatic melanoma patients treated with ipilimumab". Annals of Oncology. 28 (6): 1368–1379. doi:10.1093/annonc/mdx108. PMID 28368458.

[Chaput-1] Chaput, N.; Lepage, P.; Coutzac, C.; Soularue, E.; Le Roux, K.; Monot, C.; Boselli, L.; Routier, E.; Cassard, L.; Collins, M.; Vaysse, T.; Marthey, L.; Eggermont, A.; Asvatourian, V.; Lanoy, E.; Mateus, C.; Robert, C.; Carbonnel, F. (June 2017). "Baseline gut microbiota predicts clinical response and colitis in metastatic melanoma patients treated with ipilimumab". Annals of Oncology. 28 (6): 1368–1379. doi:10.1093/annonc/mdx108. PMID 28368458.

[1]