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2025-01-21T15:50:34.000Z

Impact of dietary fiber on GvHD outcomes in pre-clinical models and patients receiving allo-HSCT

Jan 21, 2025
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Learning objective: After reading this article, learners will be able to cite a new clinical development in graft-versus-host disease.

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Paredes et al. hypothesized that increased dietary fiber could reduce the risk of GVHD in allo-HCT recipients by improving intestinal microbiome diversity and thereby beneficial microbial metabolites.

They conducted a two-part study which investigated the correlation between dietary fiber intake and aGvHD outcomes in 173 patients undergoing allo-HSCT, and the mechanisms by which dietary fiber modulates aGvHD outcomes in preclinical mouse models. Their findings were presented by Paredes at the 66th ASH Annual Meeting and Exposition.1


Key learnings
Higher dietary fiber intake was correlated with increased levels of Blautia (p < 0.001) and decreased levels of Enterococcus (p = 0.06) in patients undergoing allo-HSCT and improved OS vs lower fiber intake (p = 0.045).
In non-TCD patients (n = 101), fiber intake was associated with higher microbial α-diversity (p = 0.007) and β-diversity (p < 0.001). High fiber intake resulted in increased fecal butyrate and acetate (p < 0.001 each).
The cumulative incidence of aGvHD (p = 0.034) and GI-GvHD (p = 0.04) were lower in patients with high fiber intake.
In mouse models, 12% cellulose intake showed increased microbial diversity (p = 0.001), decreased Enterococcus (p = 0.044), a higher ratio of Treg vs Tconv cells (p = 0.0089), a higher level of cecal butyrate (p = 0.0382), and epithelial homeostasis gene expression.
The findings suggest that increasing dietary fiber may be used in the prevention of GvHD. 

Abbreviations: aGvHD, acute graft-versus-host disease; allo-HSCT, allogeneic hematopoietic stem cell transplantation; ASH, American Society of Hematology; GI-GvHD, gastrointestinal graft-versus-host disease; TCD, T cell depleted; Tconv, conventional T cells; Treg, regulatory T cells.

  1. Paredes J. Increased fiber intake results in better overall survival and lower GI-aGVHD in allo-HCT recipients and pre-clinical GvHD models. Oral abstract #259. 66th American Society of Hematology (ASH) Annual Meeting and Exposition; Dec 7–10, 2024; San Diego, US.

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