Authors
Yuhui Cao, Xi Zhang, Jie Tan, Yuqi Wang, Qian Guo, Yuan Gao, Jinzhi Chen, Yulong Chen, Keting Tong, Zijian Fu, Linlin Ma, Caixia Wu, Fei Li, Xiaoxi Pang, Meng Liu, Huaiqiu Zhu
Published in
Microbiology spectrum. Pages e0323725. Jul 10, 2026. Epub Jul 10, 2026.
Abstract
The dynamic characteristics of gut microbiome and metabolome during radiopharmaceutical therapy and their correlation with treatment response have not been well clarified. Herein, we conducted a prospective longitudinal study on papillary thyroid carcinoma patients receiving initial radioactive iodine (RAI) treatment. Three fecal samples from each patient were sequentially collected at the day before (Day0), 3 days upon (Day3), and 30 days upon (Day30) receiving RAI (totally 75 samples) for 16S rRNA amplicon sequencing and metabolome profiling. The results revealed transient fluctuations of gut microbiota and metabolites during RAI treatment, as shown by probiotic Blautia and anti-inflammatory and antioxidant metabolites first decreased on Day3 and then increased on Day30, while the opposite trends of opportunistic pathogens Streptococcus were observed. Meanwhile, correlation analysis showed a complex interplay between the temporal alterations of Blautia and the anti-inflammatory and antioxidant metabolites. Furthermore, the variability of intestinal flora and metabolites at multiple time points corresponded to the response to RAI treatment. In conclusion, our findings indicated that internal irradiation could lead to transient fluctuations of gut microbiota and metabolites, suggesting that probiotics might be beneficial for patients receiving RAI. Additionally, we provided a new perspective to screen for noninvasive biomarkers corresponding to the response to RAI treatment.
This study provides the first longitudinal profiling demonstrating that radioactive iodine (RAI) therapy induces transient yet dynamic fluctuations in both the gut microbiome and metabolome. Key beneficial bacteria and anti-inflammatory metabolites were significantly reduced immediately after treatment, followed by a recovery trend. Moreover, patients with different treatment responses showed diverse microbial and metabolic profiles. These findings highlight the potential for probiotic based interventions to maintain gut ecological homeostasis and suggest novel non invasive microbial biomarkers for predicting RAI efficacy.This study is registered with ClinicalTrials.gov as ChiCTR2100053810.
PMID:
42430188
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.
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