Fig. 1: Akkermansia muciniphila (A. muciniphila) was depleted in C57BL/6 mice subjected to doxorubicin (DOX) and in breast cancer patients treated with anthracycline-based chemotherapy.

a Principal component analysis (PCA) score plot for the feces metabolome of breast cancer patients with or without anthracycline (AC, n = 14) or other chemotherapy therapy (nAC, n = 16). Each point represented a sample. b At the genus level, a heatmap showed the relative abundance of bacteria in breast cancer patients from AC (n = 14) and nAC groups (n = 16). c Relative abundance of A. muciniphila in the AC and nAC groups. d Receiver operating characteristic analysis with the area under curve (AUC) is used to determine the efficiency of A. muciniphila in distinguishing anthracycline utilization (n = 30). e, f PCA score plot for the feces metabolome of control mice (e) and DOX-treated mice (f) at the indicated time (n = 4). g At the genus level, relative abundance of bacteria (percentage of total bacteria) in mice treated with or without DOX at the indicated time (week0: before DOX administration; week1–4: on the first day following DOX administration during the specified week). Different colors represent different bacteria at the same level (n = 4). h Relative abundance of A. muciniphila in mice from the control and DOX groups (n = 4). i Pearson’s correlation analysis between A. muciniphila levels and cardiac injury markers of mice, including heart weight (HW)/(body weight) BW, LVEF, LVFS, serum lactate dehydrogenase (LDH), and creatine kinase-MB (CK-MB) (n = 4). j Prediction of altered KEGG pathways using PICRUSt2 analysis of the fecal microbiota for DOX groups at the indicated time. Data are presented as the mean ± SD. *P < 0.05, ***P < 0.001.