Serial analysis of the gut and respiratory microbiome in cystic fibrosis in infancy: interaction between intestinal and respiratory tracts and impact of nutritional exposures.
Serial analysis of the gut and respiratory microbiome in cystic fibrosis in infancy: interaction between intestinal and respiratory tracts and impact of nutritional exposures.
复制标题
作者：
Madan JC;Koestler DC;Stanton BA;Davidson L;Moulton LA;Housman ML;Moore JH;Guill MF;Morrison HG;Sogin ML;Hampton TH;Karagas MR;Palumbo PE;Foster JA;Hibberd PL;O'Toole GA
微生物群落在囊性纤维化（CF）肺部的慢性定植所导致的肺部损伤是呼吸衰竭的近端原因。虽然已经努力记录儿童和成人CF患者肺部的微生物组，但对于婴儿体内正在形成的微生物群落却知之甚少。我们研究了CF婴儿从出生到21个月的呼吸道和肠道微生物群的发育情况。与呼吸道相比，肠道中占主导地位的菌属不同，但有些细菌是重叠的，表明存在以韦荣球菌属和链球菌属为主的核心微生物群。细菌多样性随时间显著增加，有证据表明呼吸道中细菌多样性的增加更为迅速。两个部位随时间增加或减少的细菌之间有高度的一致性；特别是肠道中增加的菌属（16个菌属中的14个）在呼吸道中也增加。对于7个菌属，肠道定植预示着它们在呼吸道中的出现。对呼吸道样本的聚类分析表明了与母乳喂养相关的细菌分布情况，对于肠道样本，即使在对样本采集时间进行调整后，固体食物的引入也会影响细菌分布。此外，饮食的改变也会导致呼吸道微生物群的改变，这表明营养与呼吸道微生物群落的发育之间存在联系。我们的研究结果表明，营养因素和肠道定植模式是CF婴儿呼吸道微生物群微生物发育的决定因素，并为通过改变饮食或益生菌策略对CF进行早期干预提供了机会。
虽然一直致力于评估儿童和成人囊性纤维化（CF）患者的微生物组，以了解这些微生物的慢性定植如何导致肺部损伤，但对于CF婴儿呼吸道和肠道微生物群落的早期发育情况却知之甚少。我们的研究结果表明，肠道定植预示着微生物对呼吸道的定植，并证明了营养在呼吸道微生物群落发育中的作用。因此，有针对性的饮食或益生菌策略可能是改变CF肺部定植进程从而改善患者预后的有效手段。
Pulmonary damage caused by chronic colonization of the cystic fibrosis (CF) lung by microbial communities is the proximal cause of respiratory failure. While there has been an effort to document the microbiome of the CF lung in pediatric and adult patients, little is known regarding the developing microflora in infants. We examined the respiratory and intestinal microbiota development in infants with CF from birth to 21 months. Distinct genera dominated in the gut compared to those in the respiratory tract, yet some bacteria overlapped, demonstrating a core microbiota dominated by Veillonella and Streptococcus. Bacterial diversity increased significantly over time, with evidence of more rapidly acquired diversity in the respiratory tract. There was a high degree of concordance between the bacteria that were increasing or decreasing over time in both compartments; in particular, a significant proportion (14/16 genera) increasing in the gut were also increasing in the respiratory tract. For 7 genera, gut colonization presages their appearance in the respiratory tract. Clustering analysis of respiratory samples indicated profiles of bacteria associated with breast-feeding, and for gut samples, introduction of solid foods even after adjustment for the time at which the sample was collected. Furthermore, changes in diet also result in altered respiratory microflora, suggesting a link between nutrition and development of microbial communities in the respiratory tract. Our findings suggest that nutritional factors and gut colonization patterns are determinants of the microbial development of respiratory tract microbiota in infants with CF and present opportunities for early intervention in CF with altered dietary or probiotic strategies. While efforts have been focused on assessing the microbiome of pediatric and adult cystic fibrosis (CF) patients to understand how chronic colonization by these microbes contributes to pulmonary damage, little is known regarding the earliest development of respiratory and gut microflora in infants with CF. Our findings suggest that colonization of the respiratory tract by microbes is presaged by colonization of the gut and demonstrated a role of nutrition in development of the respiratory microflora. Thus, targeted dietary or probiotic strategies may be an effective means to change the course of the colonization of the CF lung and thereby improve patient outcomes.