Maturation of the Infant Respiratory Microbiota, Environmental Drivers, and Health Consequences. A Prospective Cohort Study.
Maturation of the Infant Respiratory Microbiota, Environmental Drivers, and Health Consequences. A Prospective Cohort Study.
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DOI：
10.1164/rccm.201703-0554oc
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发表时间：
2017-12-15
影响因子：
24.7
通讯作者：
Bogaert, Debby
中科院分区：
文献类型：
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作者：
Bosch, Astrid A T M;de Steenhuijsen Piters, Wouter A A;Bogaert, Debby
理由：围产期和产后影响被认为是生命早期呼吸道微生物群组成的重要驱动因素。我们假设婴儿期呼吸道微生物群的组成和发育正在影响微生物群的稳定性，从而随着时间的推移对呼吸道感染 (RTI) 产生抵抗力。 目的：调查常见的环境驱动因素，包括出生方式、喂养类型、抗生素暴露和拥挤条件，与呼吸道微生物群的成熟和稳定性以及生命第一年连续发生 RTI 的风险相关。方法：在一个由 112 名婴儿组成的前瞻性随访队列中，我们对鼻咽部进行了特征分析。通过 16S-rRNA 基因扩增子测序，从出生起纵向了解微生物群（11 个连续样本时刻，每个受试者最多 3 个 RTI 样本；总共，n=1,121 个样本）。测量和主要结果：使用基于微生物群的机器学习算法，我们发现，与参考组相比，在生命第一年经历更多 RTI 的儿童从生命第一个月起就已经表现出异常的微生物发育轨迹（0-2 RTIs/年）。微生物群成熟过程的改变与微生物群落稳定性的降低、棒状杆菌和多洛西颗粒的长期减少、莫拉氏菌在生命早期的富集、随后奈瑟氏菌和普雷沃氏菌的富集相一致。呼吸道微生物群成员这些异常发育轨迹的独立驱动因素是分娩方式、婴儿喂养、拥挤和最近的抗生素使用。结论：我们的结果表明，环境驱动因素影响微生物群的发育，从而影响呼吸道感染的抵抗力。这支持了这样的观点，即微生物群是生命早期环境风险因素和生命第一年对 RTI 易感性之间的中介。
RATIONALE: Perinatal and postnatal influences are presumed important drivers of the early-life respiratory microbiota composition. We hypothesized that the respiratory microbiota composition and development in infancy is affecting microbiota stability and thereby resistance against respiratory tract infections (RTIs) over time.OBJECTIVES: To investigate common environmental drivers, including birth mode, feeding type, antibiotic exposure, and crowding conditions, in relation to respiratory tract microbiota maturation and stability, and consecutive risk of RTIs over the first year of life.METHODS: In a prospectively followed cohort of 112 infants, we characterized the nasopharyngeal microbiota longitudinally from birth on (11 consecutive sample moments and the maximum three RTI samples per subject; in total, n=1,121 samples) by 16S-rRNA gene amplicon sequencing.MEASUREMENTS AND MAIN RESULTS: Using a microbiota-based machine-learning algorithm, we found that children experiencing a higher number of RTIs in the first year of life already demonstrate an aberrant microbial developmental trajectory from the first month of life on as compared with the reference group (0-2 RTIs/yr). The altered microbiota maturation process coincided with decreased microbial community stability, prolonged reduction of Corynebacterium and Dolosigranulum, enrichment of Moraxella very early in life, followed by later enrichment of Neisseria and Prevotella spp. Independent drivers of these aberrant developmental trajectories of respiratory microbiota members were mode of delivery, infant feeding, crowding, and recent antibiotic use.CONCLUSIONS: Our results suggest that environmental drivers impact microbiota development and, consequently, resistance against development of RTIs. This supports the idea that microbiota form the mediator between early-life environmental risk factors for and susceptibility to RTIs over the first year of life.