Does Chemotherapy-Induced Gastrointestinal Mucositis Affect the Bioavailability and Efficacy of Anti-Infective Drugs?

da Silva Ferreira, Ana Rita, Martson, Anne-Grete ORCID: 0000-0001-6478-1959, de Boer, Alyse, Wardill, Hannah R, Alffenaar, Jan-Willem, Harmsen, Hermie JM and Tissing, Wim JE (2021) Does Chemotherapy-Induced Gastrointestinal Mucositis Affect the Bioavailability and Efficacy of Anti-Infective Drugs? BIOMEDICINES, 9 (10). 1389-.

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Official URL: http://dx.doi.org/10.3390/biomedicines9101389

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.

Item Type:	Article
Uncontrolled Keywords:	cancer, chemotherapy, gastrointestinal mucositis, antibiotics, gut microbiota, drug pharmacokinetics
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User:	Symplectic Admin
Date Deposited:	26 Jan 2022 10:11
Last Modified:	18 Jan 2023 21:14
DOI:	10.3390/biomedicines9101389
Open Access URL:	https://doi.org/10.3390/biomedicines9101389
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3147608