Yang RL, Lu Q, Liang EM, Luo HC. Strengthening causal inference and analytical rigor in the Wumei Pills-Lactobacillus reuteri-intestinal stem cell axis for chemotherapy-induced mucositis. World J Stem Cells 2026; 18(1): 114114 [DOI: 10.4252/wjsc.v18.i1.114114]
Corresponding Author of This Article
Hong-Cheng Luo, MD, Division of Vascular Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, No. 102 Pok Fu Lam Road, Hong Kong 999077, China. drlhc96@163.com
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Medicine, Research & Experimental
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Letter to the Editor
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 26, 2026 (publication date) through Jan 26, 2026
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World Journal of Stem Cells
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1948-0210
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Yang RL, Lu Q, Liang EM, Luo HC. Strengthening causal inference and analytical rigor in the Wumei Pills-Lactobacillus reuteri-intestinal stem cell axis for chemotherapy-induced mucositis. World J Stem Cells 2026; 18(1): 114114 [DOI: 10.4252/wjsc.v18.i1.114114]
World J Stem Cells. Jan 26, 2026; 18(1): 114114 Published online Jan 26, 2026. doi: 10.4252/wjsc.v18.i1.114114
Strengthening causal inference and analytical rigor in the Wumei Pills-Lactobacillus reuteri-intestinal stem cell axis for chemotherapy-induced mucositis
Rui-Li Yang, Qing Lu, Er-Min Liang, Hong-Cheng Luo
Rui-Li Yang, Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong 999077, China
Qing Lu, School of Medicine, Shanghai Jiao Tong University, Shanghai 200025, China
Er-Min Liang, Department of Respiratory Medicine, Anting Hospital of Jiading District, Shanghai 201805, China
Hong-Cheng Luo, Division of Vascular Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Hong Kong 999077, China
Co-first authors: Rui-Li Yang and Qing Lu.
Co-corresponding authors: Er-Min Liang and Hong-Cheng Luo.
Author contributions: Yang RL and Lu Q wrote the original draft, they contributed equally to this manuscript and are co-first authors; Liang EM and Luo HC provided supervision, critical revisions, and final approval of the manuscript. Liang EM and Luo HC contributed equally to this manuscript and are co-corresponding authors. All authors have read and approved the final version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hong-Cheng Luo, MD, Division of Vascular Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, No. 102 Pok Fu Lam Road, Hong Kong 999077, China. drlhc96@163.com
Received: September 15, 2025 Revised: November 4, 2025 Accepted: December 10, 2025 Published online: January 26, 2026 Processing time: 129 Days and 20 Hours
Core Tip
Core Tip: In this methodological critique, we highlight six key areas to bolster the evidence that Wumei Pills (WMP) and Lactobacillus reuteri mitigate chemotherapy-induced mucositis via intestinal stem cell activation. We urge the authors to incorporate tissue-level inflammation indices (myeloperoxidase, interleukin-1β, immune cell infiltration) rather than relying solely on serum cytokines and lipopolysaccharide. We also suggest causality-verification experiments (probiotic depletion or fecal microbiota transplantation) to confirm the WMP-microbiota-intestinal stem cell linkage. The letter recommends more rigorous validation of Wnt/β-catenin signaling (e.g., demonstrating β-catenin nuclear translocation and downstream target gene activation), stronger study design practices (sample size calculation, blinded outcome assessment, accounting for cage effects, and false-discovery rate adjustments), dose-response and safety evaluations for WMP/Lactobacillus reuteri, and expanded experimental conditions to test the robustness of the therapeutic effect across different biological contexts. These improvements will help substantiate the mechanistic claims and translational potential of this promising gut microbiota-mediated therapy.
