Goettert, S.; Thiele-Orberg, E.; Fan, K.; Heinrich, P.; Matthe, D.; Khalid, O.; Klostermeier, L.; Suriano, C.; Strieder, N.; Gebhard, C.; Vonbrunn, E.; Mamilos, A.; Hirsch, D.; Meedt, E.; Kleigrewe, K.; Hiergeist, A.; Glaesner, J.; Ghimire, S.; Joachim, L.; Voll, F.; Neuhaus, K.; Perl, M.; Pielmeier, F.; Janssen, K.-P.; Ruland, J.; Kreutz, M.; Weber, D.; Schmidl, C.; Koehler, N.; Tschurtschenthaler, M.; Hoffmann, P.; Edinger, M.; Wolff, D.; Bassermann, F.; Rehli, M.; Haller, D.; Evert, M.; Hildner, K.; Buettner-Herold, M.; Herr, W.; Gessner, A.; Heidegger, S.; Holler, E.; Poeck, H.

Changes in the intestinal microbiome and microbiota-derived metabolites predict clinical outcomes after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Here, we report that desaminotyrosine (DAT), a product of bacterial flavonoid metabolism, correlates with improved overall survival and reduced relapse rates in allo-HSCT patients. In preclinical mouse models, treatment with synthetic DAT prevents graft-versus-host disease by protecting the intestinal barrier and promoting intestinal regeneration and contributes to graft-vs.-leukemia responses. DATs beneficial effects on intestinal regeneration remain effective despite broad-spectrum antibiotics-induced dysbiosis, also when administered by fecal microbiota transfer with flavonoid-degrading F. plautii. Mechanistically, DAT promotes mTORC1-dependent activation and proliferation of intestinal stem cells, with concomitant engagement of the innate immune receptor STING required to mitigate metabolic stress and maintain an undifferentiated stem cell state independently of type-I interferon responses. Additionally, DAT can skew T cells towards an effector phenotype to modulate graft-versus-leukemia responses. Our data uncover DATs dual, tissue- and immune-modulating properties and underscore its potential in precision microbiome-based therapies to improve tissue regeneration and minimize immune-mediated side effects.