Talk:Checkpoint inhibitor induced colitis

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.

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)

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)

References