Influence of high versus low intestinal concentration of gram-negative bacteria and endotoxin on the susceptibility of murine myelopoiesis in bone marrow and spleen to cytostatic treatment with Ara-C

The normal flora may contribute to the quantitative preponderance of myeloid cells under physiological conditions

Under physiological conditions, the innate immune cells derived from myeloid lineage absolutely outnumber the lymphoid cells. At present, two theories are attributed to the maintenance of haemopoiesis: the asymmetric cell division and the bone marrow hematopoietic microenvironment or "niche". However, the former only explains the self-renewal of haemopoietic stem cell (HSC) and the start of haemopoietic differentiation but fails to address the inducers of cell fate decisions; the latter has to admit that the hematopoietic cytokines, despite their significance in the maintenance of haemopoiesis, have no specific effect on lineage commitment. Given these flaws, the advantageous mechanism of myeloid haemopoiesis has not yet been uncovered in the current theories. The discoveries that bacterial components (lipopolysaccharide, LPS) and intestinal decontamination affect the mobilization of HSC trigger the interest in normal flora, which together with their components may have an effect on haemopoiesis. In the experiments in dogs and mice, researchers documented that the generation of myeloid cells has undergone changes in the bone marrow and periphery when antibiotics are used to regulate the normal intestinal flora and the concentration of its components. However, the same changes are not involved in lymphoid cells. Therefore, we hypothesize that in human body normal flora and its components are a driving force to maintain myeloid haemopoiesis under physiological conditions. To account for the selectiveness in haemopoiesis, these facts should be taken into consideration, such as HSC and mesenchymal stem cells (MSC) functionally expressed pattern recognition receptors (PRR), and both of them can self-migrate or be recruited by normal flora or its components into periphery. Dynamically monitoring the myeloid haemopoiesis may provide an important complementary program that precludes the abuse of antibiotics, which prevents diseases triggered by the imbalance of normal flora. Meanwhile, the regulation of normal flora and the use of purified microecological modulator may serve as valuable auxiliary treatments to mobilize HSC prior to the HSC transplantation as well as to promote hematopoietic recovery after transplantation or chemotherapy in the blood diseases.

Problems and priorities for controlling opportunistic pathogens with new antimicrobial strategies; an overview of current literature

An International Study Group on New Antimicrobial Strategies (ISGNAS) has been formed in response to the recognition that development of microbial resistance to antibiotics is becoming a serious, world-wide problem. The group met in 1993 for the first time to discuss the feasibility of developing rational alternatives to the use of antibiotics and prepared, as a result, a comprehensive overview of normal (physiological) mechanisms involved in the control of potentially pathogenic (oppotunistic) microorganisms. One objective of ISGNAS is to understand the conditions which allow opportunistic microbes present among the symbionts to cause an infection. There is a need for more coherent information concerning the habitat, growth requirements and host and pathogen properties which allow opportunistic pathogens to cause life-threatening infections. In particular, information is urgently being sought to understand the complexity of the interactions between the vast number of microbial species, and the interactions between the microbes and their host. Another goal is to inspire and enable basic and clinical research that will lead to the development of new therapies for regulating colonization, translocation and infection by opportunistic micro-organisms in patients during periods of decreased resistance. With a sufficient amount of knowledge of how healthy individuals keep opportunistic micro-organisms under control, it may become feasible for physicians to maintain host resistance and inter-microbial factors involved in the containment of opportunistic microbes. Therapies aimed at boostering natural resistance mechanisms will be of critical importance to individuals whose resistance has been compromised as a result of another clinical condition.

Modulation of the intestinal microflora by the non-absorbable antibiotic vancomycin leads to a reduction of the tumor load in liver and spleen in a leukemic rat model

Based on previous studies where it was shown that non-absorbable antibiotics can influence the normal hematopoiesis via changes in factors related to the intestinal microflora, the influence of vancomycin on the progression of acute myeloid leukemia was investigated in the BNML rat model. Oral vancomycin, which selectively reduces Gram-positive bacteria in the gut, leads to diminution of the leukemic load in liver and spleen by 30-60%. This 'antileukemic effect' is not dependent on Gram-negative bacteria as source for endotoxin. The presumed mechanism is a decrease of the leukemic growth fraction caused by alterations in the absorption of substances from intestinal Gram-positive bacteria.