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Dietary fibre supplementation enhances radiotherapy tumour control and alleviates intestinal radiation toxicity.

Then, Chee Kin; Paillas, Salome; Moomin, Aliu; Misheva, Mariya D.; Moir, Rachel A.; Hay, Susan M.; Bremner, David; Roberts, Kristine S.; Smith, Ellen E.; Heidari, Zeynab; Sescu, Daniel; Wang, Xuedan; Suárez-Bonnet, Alejandro; Hay, Nadine; Murdoch, Sarah L.; Saito, Ryoichi; Collie-Duguid, Elaina S.R.; Richardson, Shirley; Priestnall, Simon L.; Wilson, Joan M.; Gurumurthy, Mahalakshmi; Royle, Justine S.; Samuel, Leslie M.; Ramsay, George; Vallis, Katherine A.; Foster, Kevin R.; McCullagh, James S.O.; Kiltie, Anne E.


Chee Kin Then

Salome Paillas

Aliu Moomin

Mariya D. Misheva

Rachel A. Moir

Susan M. Hay

David Bremner

Kristine S. Roberts

Ellen E. Smith

Zeynab Heidari

Daniel Sescu

Xuedan Wang

Alejandro Suárez-Bonnet

Nadine Hay

Sarah L. Murdoch

Ryoichi Saito

Elaina S.R. Collie-Duguid

Shirley Richardson

Simon L. Priestnall

Joan M. Wilson

Mahalakshmi Gurumurthy

Justine S. Royle

Leslie M. Samuel

George Ramsay

Katherine A. Vallis

Kevin R. Foster

James S.O. McCullagh

Anne E. Kiltie


Non-toxic approaches to enhance radiotherapy outcomes are beneficial, particularly in ageing populations. Based on preclinical findings showing that high-fibre diets sensitised bladder tumours to irradiation by modifying the gut microbiota, along with clinical evidence of prebiotics enhancing anti-cancer immunity, we hypothesised that dietary fibre and its gut microbiota modification can radiosensitise tumours via secretion of metabolites and/or immunomodulation. We investigated the efficacy of high-fibre diets combined with irradiation in immunoproficient C57BL/6 mice bearing bladder cancer flank allografts. Psyllium plus inulin significantly decreased tumour size and delayed tumour growth following irradiation compared to 0.2% cellulose and raised intratumoural CD8+ cells. Post-irradiation, tumour control positively correlated with Lachnospiraceae family abundance. Psyllium plus resistant starch radiosensitised the tumours, positively correlating with Bacteroides genus abundance and increased caecal isoferulic acid levels, associated with a favourable response in terms of tumour control. Psyllium plus inulin mitigated the acute radiation injury caused by 14 Gy. Psyllium plus inulin increased caecal acetate, butyrate and propionate levels, and psyllium alone and psyllium plus resistant starch increased acetate levels. Human gut microbiota profiles at the phylum level were generally more like mouse 0.2% cellulose profiles than high fibre profiles. These supplements may be useful in combination with radiotherapy in patients with pelvic malignancy.


THEN, C.K., PAILLAS, S., MOOMIN, A., et al. 2024. Dietary fibre supplementation enhances radiotherapy tumour control and alleviates intestinal radiation toxicity. Microbiome [online], 12, article number 89. Available from:

Journal Article Type Article
Acceptance Date Apr 2, 2024
Online Publication Date May 14, 2024
Publication Date Dec 31, 2024
Deposit Date May 20, 2024
Publicly Available Date May 20, 2024
Journal Microbiome
Electronic ISSN 2049-2618
Publisher Springer
Peer Reviewed Peer Reviewed
Volume 12
Article Number 89
Keywords Radiotherapy; Dietary fibre; Gut microbiota; Short-chain fatty acids; Isoferulic acid; Cancer; Immunomodulation
Public URL
Additional Information This article has been published with separate supporting information. This supporting information has been incorporated into a single file on this repository and can be found at the end of the file associated with this output.


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