The fungal microbiome in chronic rhinosinusitis: richness, diversity, postoperative changes and patient outcomes
The fungal microbiome in chronic rhinosinusitis: richness, diversity, postoperative changes and patient outcomes
复制标题
DOI：
10.1002/alr.21297
复制
发表时间：
2014-04-01
影响因子：
6.4
通讯作者：
Wormald, Peter-John
中科院分区：
文献类型：
--
作者：
Cleland, Edward John;Bassioni, Ahmed;Wormald, Peter-John
我们对慢性鼻窦炎（CRS）真菌的认识受到以前使用的检测技术的限制。本研究使用高度敏感的培养独立分子技术检测CRS患者和对照组微生物组的真菌成分。本研究的目的包括真菌丰富度、流行度、丰度、时间变化及其与患者预后的关系。方法对23例CRS患者和11例对照组进行鼻窦拭子采集。收集于术中、术后6周和12周进行。从拭子中提取DNA，通过18S核糖体DNA （rDNA）真菌标记编码FLX扩增子焦磷酸测序确定真菌结果。结果所有患者均可见真菌。共检测到207个真菌属，对照组和CRS组的平均丰富度分别为8.18和12.14。所有手术患者均检出马拉色菌，且数量最多。术后真菌丰富度下降（p < 0.05），与镰刀菌和新宇宙孢子菌患病率下降有关（p < 0.05）。术后新宇宙孢子体的数量也较少（p < 0.05）。与生活质量没有相关性。结论本研究首次利用高灵敏度焦磷酸测序技术揭示了CRS患者鼻窦真菌的真实多样性和丰富度的术后变化。马拉色菌是一个以前未在鼻窦中发现的属，它的存在引起了极大的兴趣，鉴于它与特应性疾病的关联，它作为一种疾病调节剂的潜力应该得到进一步的研究。
BackgroundOur understanding of fungi in chronic rhinosinusitis (CRS) has been limited by previously employed detection techniques. This study examines the fungal component of the microbiome in CRS patients and controls using a highly sensitive culture-independent molecular technique. The aims of this study include the characterization of fungal richness, prevalence, abundance, temporal changes, and their relationship with patient outcomes.MethodsSwabs were collected from the sinuses of 23 CRS patients and 11 controls. Collection occurred intraoperatively, and at 6 and 12 weeks postoperatively. DNA was extracted from the swabs and fungal outcomes were determined through 18S ribosomal DNA (rDNA) fungal tag-encoded FLX amplicon pyrosequencing.ResultsFungi were ubiquitous to all patients. A total of 207 fungal genera were detected, with a mean sample richness of 8.18 and 12.14 in the control and CRS groups, respectively. Malassezia was detected in all patients at surgery and was also the most abundant. Postoperatively, fungal richness decreased (p < 0.05) and was associated with declines in the prevalence of Fusarium and Neocosmospora (p < 0.05). Neocosmospora was also less abundant postoperatively (p < 0.05). No correlations were found with quality of life.ConclusionThis is the first study to use a highly sensitive pyrosequencing technique to reveal the true diversity of fungi in the sinuses of CRS patients and postoperative changes in richness. The presence of Malassezia, a genus not previously described in the sinuses, is of great interest, and its potential as a disease modifier should see further investigation given its association with atopic disease.