Dominant Role of the Gut Microbiota in Chemotherapy Induced Neuropathic Pain

Sci Rep. 2019 Dec 30;9(1):20324. doi: 10.1038/s41598-019-56832-x.

Abstract

Chemotherapy induced peripheral neuropathy (CIPN), a toxic side effect of some cancer treatments, negatively impacts patient outcomes and drastically reduces survivor's quality of life (QOL). Uncovering the mechanisms driving chemotherapy-induced CIPN is urgently needed to facilitate the development of effective treatments, as currently there are none. Observing that C57BL/6 (B6) and 129SvEv (129) mice are respectively sensitive and resistant to Paclitaxel-induced pain, we investigated the involvement of the gut microbiota in this extreme phenotypic response. Reciprocal gut microbiota transfers between B6 and 129 mice as well as antibiotic depletion causally linked gut microbes to Paclitaxel-induced pain sensitivity and resistance. Microglia proliferated in the spinal cords of Paclitaxel treated mice harboring the pain-sensitive B6 microbiota but not the pain-resistant 129 microbiota, which exhibited a notable absence of infiltrating immune cells. Paclitaxel decreased the abundance of Akkermansia muciniphila, which could compromise barrier integrity resulting in systemic exposure to bacterial metabolites and products - that acting via the gut-immune-brain axis - could result in altered brain function. Other bacterial taxa that consistently associated with both bacteria and pain as well as microglia and pain were identified, lending support to our hypothesis that microglia are causally involved in CIPN, and that gut bacteria are drivers of this phenotype.

MeSH terms

  • Animals
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Biodiversity
  • Brain / drug effects
  • Brain / metabolism
  • Brain / pathology
  • Disease Models, Animal
  • Female
  • Gastrointestinal Microbiome* / drug effects
  • Humans
  • Male
  • Mice
  • Microglia / drug effects
  • Microglia / metabolism
  • Neuralgia / etiology*
  • Neuralgia / metabolism
  • Paclitaxel / adverse effects
  • Paclitaxel / pharmacology
  • Spinal Cord / drug effects
  • Spinal Cord / metabolism
  • Spinal Cord / pathology

Substances

  • Antineoplastic Agents
  • Paclitaxel