Determining Host-microbiome guided oro-nasal fistula healing

确定宿主微生物组引导口鼻瘘愈合

• 批准号: 10545072
• 负责人: Steven L Goudy
• 金额: $ 19.52万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-01-01 至 2023-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10545072
• 关键词: Address; Affect; Antibiotics; Bacteria; Biopsy; Body Surface; Cells; Child; Cleft Palate; Communication; Communities; Craniofacial Abnormalities; Data; Development; Eating; Enterococcus faecalis; Environmental Risk Factor; Event; Exogenous Factors; Fistula; Gene Expression; Genes; Germ-Free; Gut Mucosa; HIV Infections; Homeostasis; Human; Hydrogels; Immune; Impairment; Innovative Therapy; Intestines; Knowledge; Live Birth; Low Prevalence; Measures; Metagenomics; Microbe; Mission; Modality; Modeling; Molecular; Mucous Membrane; Mus; Nasal cavity; Nose; Operative Surgical Procedures; Oral; Oral Surgical Procedures; Oral cavity; Patients; Population; Preparation; Prions; Probiotics; Process; Public Health; Regulator Genes; Research; Science; Signal Pathway; Signal Transduction; Site; Skin; Speech; Structure; Surgeon; Surgical wound; Technology; Testing; Tissue Donors; Tissues; Transcript; United States National Institutes of Health; commensal bacteria; congenital anomaly; craniofacial; disorder risk; experimental study; feeding; gene network; healing; host microbiome; improved; infection risk; intestinal injury; microbial community; microbiome; microbiome analysis; microbiome composition; microbiota; mouse model; novel therapeutic intervention; novel therapeutics; oral commensal; oral microbiome; palate repair; prevent; probiotic supplementation; recruit; regenerative; regenerative therapy; repaired; transcriptome sequencing; wound; wound bed; wound care; wound healing

SUMMARY Cleft palate formation is one of the most common craniofacial anomalies in children and occurs in 1:1000 live births. Patients undergo multiple surgeries during their lifetime and, for many, the first surgery is the repair of their cleft palate. However, 60% of cleft palate patients suffer poor wound healing following surgery which leads to the development of an oro-nasal fistula (ONF) characterized by a continued communication between the oral and nasal cavities. The primary approach to repair an ONF is by using human donor tissue, which acts only as a physical barrier and carries the risks of disease associated with human donor tissue, such as prions or HIV infection. Therefore, there is an urgent need to develop new therapeutic strategies to improve wound healing after cleft palate surgical repair, and to reduce the cases of ONF. Wound healing has been studied extensively on the skin and particularly following intestinal injury. Intestinal wound healing efficiency is highly sensitive to environmental factors, especially the microbiome, where specific microbial community structures or supplementation with probiotic bacteria enhances the wound healing process. However, little is known about how the oral microbiome affects ONF wound healing. We directly address this gap in the knowledge and show preliminary data that creating an ONF in a murine model results in marked changes in the microbiome composition, with the complete disappearance of certain microbes, and blooms of other bacterial taxa. Based on this premise, in Aim 1, we will create ONF wounds in germ-free mice, or in conventionally raised mice treated with antibiotics, and assess healing rates and changes in the oral microbiome composition. We expect to show the influence of disrupting the oral microbiome on healing processes and ONF formation. In Aim 2, we will use a hydrogel to re-introduce commensal oral microbes lost following surgery to the site of the oral wound and assess healing rates. We expect to show that repletion of oral commensal bacteria to the wound site can promote wound healing processes. In addition, by assessing transcript enrichment by RNA-seq within ONFs in germ-free, antibiotic treated mice, and after the repletion of oral commensal bacteria, we expect to identify gene networks that function in healing within ONFs that are sensitive to the commensal oral microbiome. Thus, our overall hypothesis is that the oral commensal microbiome exerts positive modulatory influences on oral wound healing and may limit ONF formation. Discovering specific bacterial taxa within the oral cavity or wound tissue that positively influence healing will be essential information for the characterization of an eubiotic oral microbiome for wound healing. Our experiments will also generate critical information for clinicians about the prudent use of antibiotics after cleft palate surgery and the effects of depleting the oral microbiome during healing. We will also substantiate the approach of the repletion of the oral commensal bacteria using hydrogel technology as the vehicle to enhance oral wound healing. Together, these studies will yield critical data to inform new therapeutic modalities to lower the prevalence of ONFs following cleft palate surgery.

总结