# The gut microbiota: an emerging therapeutic target for ICI-associated myocarditis

**Authors:** Ziyin Huang, Xiaofei Mei, Yafeng Zhou

PMC · DOI: 10.3389/fcimb.2026.1752485 · Frontiers in Cellular and Infection Microbiology · 2026-02-19

## TL;DR

This paper explores how gut microbiota could be used to treat or prevent heart inflammation caused by cancer immunotherapy.

## Contribution

It highlights the potential of gut microbiota modulation as a novel therapeutic approach for ICI-associated myocarditis.

## Key findings

- Gut microbiota influence immune responses and adverse events in cancer immunotherapy.
- Modulating gut microbiota may help prevent or treat ICI-associated myocarditis.
- Microbiota transplantation and probiotics are potential clinical strategies.

## Abstract

Gut microbiota and their metabolites are essential for a wide range of human physiological processes, including inflammation, immunity, and homeostasis. The intricate interplay between gut microbiota and the host immune system profoundly influences both the therapeutic response and the immune-related adverse events (irAEs) in cancer patients undergoing immune checkpoint inhibitors (ICIs) therapy. Prior evidence has established the rationale for modulating the gut microbiota to improve the incidence and prognosis of ICI-associated myocarditis. In the future, we may prevent or treat ICI-associated myocarditis by regulating the gut microbiota through methods such as microbiota transplantation, antibiotic regimens, or probiotic supplements. But there is still a considerable distance between research and clinical practice.

## Linked entities

- **Diseases:** myocarditis (MONDO:0004496)

## Full-text entities

- **Genes:** IL2RA (interleukin 2 receptor subunit alpha) [NCBI Gene 3559] {aka CD25, IDDM10, IL2R, IMD41, TCGFR, p55}, CXCL9 (C-X-C motif chemokine ligand 9) [NCBI Gene 4283] {aka CMK, Humig, MIG, SCYB9, crg-10}, FOXP3 (forkhead box P3) [NCBI Gene 50943] {aka AIID, DIETER, IPEX, JM2, PIDX, XPID}, PDCD1 (programmed cell death 1) [NCBI Gene 5133] {aka ADMIO4, AIMTBS, CD279, PD-1, PD1, SLEB2}, IL10 (interleukin 10) [NCBI Gene 3586] {aka CSIF, GVHDS, IL-10, IL10A, TGIF}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, IFNG (interferon gamma) [NCBI Gene 3458] {aka IFG, IFI, IMD69}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, CD4 (CD4 molecule) [NCBI Gene 920] {aka CD4mut, IMD79, Leu-3, OKT4D, T4}, CD8A (CD8 subunit alpha) [NCBI Gene 925] {aka CD8, CD8alpha, IMD116, Leu2, p32}, TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, CTLA4 (cytotoxic T-lymphocyte associated protein 4) [NCBI Gene 1493] {aka ALPS5, CD, CD152, CELIAC3, CTLA-4, GRD4}, CXCL10 (C-X-C motif chemokine ligand 10) [NCBI Gene 3627] {aka C7, IFI10, INP10, IP-10, SCYB10, crg-2}
- **Diseases:** cardiotoxic (MESH:D066126), dermatitis (MESH:D003872), autoimmune cardiomyopathies (MESH:D009202), pneumonia (MESH:D011014), Myocarditis (MESH:D009205), myocardial inflammatory infiltration (MESH:D017254), autoimmune damage (MESH:D001327), cancer (MESH:D009369), inflammation (MESH:D007249), myocardial fibrosis (MESH:D005355), hepatitis (MESH:D056486), cardiac injury (MESH:D006331), multi-organ (MESH:D000092124), heart failure (MESH:D006333), cardiovascular disease (MESH:D002318), colitis (MESH:D003092)
- **Chemicals:** sulphadoxine (MESH:D013413), I3A (MESH:C486592), Vancomycin (MESH:D014640), metronidazole (MESH:D008795), Neomycin Sulfate (MESH:D009355), indole-3-aldehyde (MESH:C012381), tryptophan (MESH:D014364), trimethoprim (MESH:D014295), Primaxin (MESH:D000077728), penicillin (MESH:D010406), Flexispira (-)
- **Species:** Mus musculus (house mouse, species) [taxon 10090], Limosilactobacillus reuteri (species) [taxon 1598], gut metagenome (species) [taxon 749906], Homo sapiens (human, species) [taxon 9606], Bacteroides fragilis (species) [taxon 817], Bacteria Latreille et al. 1825 (Bacteria stick insect, genus) [taxon 629395]

## Full text

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## References

38 references — full list in the complete paper: https://tomesphere.com/paper/PMC12960580/full.md

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Source: https://tomesphere.com/paper/PMC12960580