Gut microbiota: Impact on 5-fluorouracil efficacy and toxicity
Emily Kwun Kwan Lo, Hoi Kit Matthew Leung, Fangfei Zhang, Hani El‐Nezami
Abstract
Cancer is one of the most prevalent and deadly diseases worldwide. Despite medical advances, the survival rate of patients with cancer remains poor, and v many standard chemotherapeutic choices are associated with toxic side effects that substantially impair their quality of life. 5-Fluorouracil (5-Fu) is a widely used chemotherapeutic drug. Administration of 5-Fu is known to cause diarrhoea and intestinal mucositis. Butyrate is a short-chain fatty acid produced during the fermentation of dietary fibre by the gut microbiota. Butyrate may mitigate 5-Fu’s toxic effect of mucositis. In addition, butyrate enhanced the efficiency of 5-Fu. However, the pungent odour of butyrate renders it unpalatable to patients. The administration of butyrate-producing bacteria is a preferable alternative for patients seeking the positive effects of butyrate without an unpleasant taste. Furthermore, butyrate-producing bacteria could provide beneficial effects beyond butyrate production, including the restoration of microbial dysbiosis and anti-inflammatory effects. In this review, we provide an overview of the current research on butyrate-producing bacteria, concentrating on their possible effects and defence mechanism against 5-Fu toxicity, which indicates their potential applicability as an adjuvant treatment for patients with cancer.