Division of Neonatology, Department of Pediatrics, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA.
mBio. 2012 Aug 21;3(4). doi: 10.1128/mBio.00251-12. Print 2012.
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.
囊性纤维化 (CF) 肺部的微生物群落慢性定植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科和成年 CF 患者肺部的微生物组，但对于 CF 婴儿发育中的微生物群知之甚少。我们检查了从出生到 21 个月的 CF 婴儿的呼吸道和肠道微生物群发育情况。与呼吸道相比，肠道中优势的属明显不同，但也有一些细菌重叠，表现出以韦荣球菌和链球菌为主的核心微生物群。细菌多样性随时间显著增加，呼吸道中多样性的获得速度更快。在两个部位中，随着时间的推移而增加或减少的细菌具有高度一致性；特别是，在肠道中增加的 14/16 个属也在呼吸道中增加。对于 7 个属，肠道定植预示着它们出现在呼吸道中。对呼吸道样本的聚类分析表明，与母乳喂养相关的细菌存在特定模式，对于肠道样本，即使在调整样本采集时间后，引入固体食物也会出现这种情况。此外，饮食的变化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展之间存在联系。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。
虽然人们一直致力于评估儿科和成年 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的最早发育知之甚少。我们的研究结果表明，呼吸道微生物的定植是由肠道定植预示的，并证明了营养在呼吸道微生物群发育中的作用。因此，有针对性的饮食或益生菌策略可能是改变 CF 肺部定植过程并改善患者预后的有效方法。
