Gut microbiota in immunosuppressive therapy in patients after allogeneic hemoietic stem cell transplantation

Objective. To make associations between the composition of the gut microbiota and the dosage of immunosuppressive drugs in patients after allogeneic hematopoietic stem cell transplantation. Materials and methods . In this study, we studied the composition of the gut microbiota using the V3-V4 sequencing method of the 16S rRNA gene in 36 patients after allogeneic hematopoietic stem cell transplantation with various types of immunosuppression. Results . Use of Tacrolimus significantly reduced the abundance of bacteria like Bacteroidetes and particularly Bacteroidaceae family in stool samples compared to cyclosporine A; patients with higher Akkermansia abundance more often required immunosuppression dose reduction to maintain target serum levels, as confirmed by two multivariate methods, while patients with higher Faecalibacterium, Oscillibacter, and Hungatella density had a higher median cyclosporine A dose to maintain therapeutic concentrations. Conclusion. Additional studies are necessary to identify the relationship between gut microbiome and immunosuppressant drugs taking into account variable concentrations of calcineurin inhibitors, potential adverse events associated with insufficient or excessive serum drug levels, and the associations found between patients’ gut microbiome abundance and immunosuppressant dose