Microbiome Interactions in Radiation-Induced Intestinal Injury

Exposure of the intestinal tract to ionising radiation disrupts the epithelial barrier, triggers inflammation and induces profound shifts in the composition and function of the gut microbiome. Loss of mucosal integrity allows translocation of bacterial products, fuelling a cycle of oxidative stress, immune activation and further epithelial damage. At the same time, beneficial commensals that produce short-chain fatty acids and indole derivatives are depleted, compromising mucosal repair, immune regulation and epithelial proliferation. Restitution of a balanced microbial ecosystem has emerged as a promising strategy to mitigate radiation enteropathy. Advances in high-throughput sequencing and integrated ‘omics approaches have revealed precise microbial signatures that predict severity of diarrhoea, mucositis and systemic immune dysregulation. Experimental models and early clinical investigations demonstrate that targeted interventions—ranging from probiotic spore preparations and microbial metabolites to precision oral drug carriers—can restore barrier integrity, recalibrate local immunity and enhance host recovery after radiation exposure. These findings underscore the global significance of microbiome-based approaches for improving outcomes in radiotherapy patients and for managing accidental or occupational radiation incidents.

Research from Nature Portfolio

One recent advance employs a naturally derived microcarrier system to deliver a selective radioprotector across the entire small intestine. By encapsulating amifostine within Spirulina platensis microalgae particles, investigators achieved uniform drug accumulation throughout the gut, markedly reducing radiation-induced epithelial apoptosis and preserving mucosal architecture. This oral formulation also maintained microbial diversity and functional metagenomic profiles, preventing dysbiosis without impeding antitumour effects. The approach offers a convenient, scalable platform for intestinal radioprotection with potential for rapid clinical translation.

Microbiome Interactions in Radiation-Induced Intestinal Injury publication trend

The graph below shows the total number of articles in microbiome interactions in radiation-induced intestinal injury across all publications each year (not limited to Nature Index journals).

Technical terms

Microbiome: The collective community of microorganisms, including bacteria, viruses, fungi and archaea, residing in a specific environment such as the human gut.

Dysbiosis: An imbalance in the composition or function of the microbiome that can contribute to disease states.

Short-chain fatty acids (SCFAs): Metabolites such as acetate, propionate and butyrate, produced by microbial fermentation of dietary fibres, which support epithelial health and immune regulation.

cGAS-STING pathway: An intracellular DNA-sensing cascade that triggers type I interferon and pro-inflammatory cytokine production upon detection of cytosolic DNA.

Fecal microbiota transplantation (FMT): The transfer of processed stool from a healthy donor to a recipient’s gastrointestinal tract to restore microbial balance.

References

1. Selenium Attenuates Radiation Colitis by Regulating cGAS‐STING Signaling. Advanced Science (2024).
2. Oral administration of probiotic spore ghosts for efficient attenuation of radiation-induced intestinal injury. Journal of Nanobiotechnology (2024).
3. Akkermansia muciniphila protects the intestine from irradiation-induced injury by secretion of propionic acid. Gut Microbes (2023).
4. The Microbiome and Radiation Induced-Bowel Injury: Evidence for Potential Mechanistic Role in Disease Pathogenesis. Nutrients (2018).
5. Gut Microbial Dysbiosis May Predict Diarrhea and Fatigue in Patients Undergoing Pelvic Cancer Radiotherapy: A Pilot Study. PLOS ONE (2015).
6. Gut microbiota-derived indole 3-propionic acid protects against radiation toxicity via retaining acyl-CoA-binding protein. Microbiome (2020).
7. Microalgae-based oral microcarriers for gut microbiota homeostasis and intestinal protection in cancer radiotherapy. Nature Communications (2022).