The Respiratory Microbiome in Chronic Hypersensitivity Pneumonitis Is Distinct from That of Idiopathic Pulmonary Fibrosis.
The Respiratory Microbiome in Chronic Hypersensitivity Pneumonitis Is Distinct from That of Idiopathic Pulmonary Fibrosis.
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DOI：
10.1164/rccm.202002-0460oc
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发表时间：
2021-02-01
影响因子：
24.7
通讯作者：
Molyneaux PL
中科院分区：
文献类型：
--
作者：
Invernizzi R;Wu BG;Barnett J;Ghai P;Kingston S;Hewitt RJ;Feary J;Li Y;Chua F;Wu Z;Wells AU;George PM;Renzoni EA;Nicholson AG;Rice A;Devaraj A;Segal LN;Byrne AJ;Maher TM;Lloyd CM;Molyneaux PL
理论基础：慢性过敏性肺炎(CHP)是一种反复暴露于吸入性抗原并致敏后发生的疾病。肺部微生物群越来越多地与呼吸系统疾病有关，但到目前为止，还没有研究调查CHP下呼吸道微生物群落的组成。目的：比较慢性肺炎性心脏病(CHP)、特发性肺纤维化(IPF)和正常对照组的呼吸道微生物群特征。方法：我们前瞻性地招募了确诊为慢性肺心病的受试者(n = 110例)、诊断为特发性肺纤维化的受试者(n = 45例)和对照组(n = 28例)。对受试者进行BAL，提取细菌DNA，用定量聚合酶链式反应进行定量，并对16S核糖体RNA基因进行测序，以确定下呼吸道细菌群落的特征。测量和主要结果：CHP和IPF受试者下呼吸道的微生物谱明显不同。在门的水平上，IPF患者和CHP患者的普遍微生物区系包括菌丝菌、拟杆菌属、变形杆菌和放线杆菌。然而，在IPF中，Firmicuts占主导地位，而同一组中分配给变形杆菌的阅读百分比显著低于CHP受试者的百分比。在属水平上，CHP增加了葡萄球菌的负担，IPF增加了放线菌和韦龙杆菌的负担。CHP组下呼吸道细菌负荷高于对照组，但低于IPF组。与IPF相比，CHP的细菌负荷和存活率之间没有关联。结论：慢性肺炎组患者下呼吸道的微生物谱与IPF组不同，值得注意的是，慢性肺炎组患者的细菌负荷不能预测生存。
Rationale: Chronic hypersensitivity pneumonitis (CHP) is a condition that arises after repeated exposure and sensitization to inhaled antigens. The lung microbiome is increasingly implicated in respiratory disease, but, to date, no study has investigated the composition of microbial communities in the lower airways in CHP. Objectives: To characterize and compare the airway microbiome in subjects with CHP, subjects with idiopathic pulmonary fibrosis (IPF), and control subjects. Methods: We prospectively recruited individuals with a CHP diagnosis (n = 110), individuals with an IPF diagnosis (n = 45), and control subjects (n = 28). Subjects underwent BAL and bacterial DNA was isolated, quantified by quantitative PCR and the 16S ribosomal RNA gene was sequenced to characterize the bacterial communities in the lower airways. Measurements and Main Results: Distinct differences in the microbial profiles were evident in the lower airways of subjects with CHP and IPF. At the phylum level, the prevailing microbiota of both subjects with IPF and subjects with CHP included Firmicutes, Bacteroidetes, Proteobacteria, and Actinobacteria. However, in IPF, Firmicutes dominated, whereas the percentage of reads assigned to Proteobacteria in the same group was significantly lower than the percentage found in subjects with CHP. At the genus level, the Staphylococcus burden was increased in CHP, and Actinomyces and Veillonella burdens were increased in IPF. The lower airway bacterial burden in subjects with CHP was higher than that in control subjects but lower than that of those with IPF. In contrast to IPF, there was no association between bacterial burden and survival in CHP. Conclusions: The microbial profile of the lower airways in subjects with CHP is distinct from that of IPF, and, notably, the bacterial burden in individuals with CHP fails to predict survival.