Australian Centre for Ecogenomics, School of Chemistry and Molecular Biosciences, University of Queensland, St. Lucia, QLD, Australia.
Am J Respir Crit Care Med. 2013 Mar 15;187(6):640-7. doi: 10.1164/rccm.201209-1680OC. Epub 2013 Jan 17.
Bronchiolitis obliterans syndrome (BOS) is the primary limiting factor for long-term survival after lung transplantation, and has previously been associated with microbial infections.
To cross-sectionally and longitudinally characterize microbial communities in allografts from transplant recipients with and without BOS using a culture-independent method based on high-throughput sequencing.
Allografts were sampled by bronchoalveolar lavage, and microbial communities were profiled using 16S rRNA gene amplicon pyrosequencing. Community profiles were compared using the weighted Unifrac metric and the relationship between microbial populations, BOS, and other covariates was explored using PERMANOVA and logistic regression.
Microbial communities in transplant patients fell into two main groups: those dominated by Pseudomonas or those dominated by Streptococcus and Veillonella, which seem to be mutually exclusive lung microbiomes. Aspergillus culture was also negatively correlated with the Pseudomonas-dominated group. The reestablishment of dominant populations present in patients pretransplant, notably Pseudomonas in individuals with cystic fibrosis, was negatively correlated with BOS.
Recolonization of the allograft by Pseudomonas in individuals with cystic fibrosis is not associated with BOS. In general, reestablishment of pretransplant lung populations in the allograft seems to have a protective effect against BOS, whereas de novo acquisition of microbial populations often belonging to the same genera may increase the risk of BOS.
闭塞性细支气管炎综合征（BOS）是肺移植后长期生存的主要限制因素，先前与微生物感染有关。
采用基于高通量测序的非培养方法，对有和无 BOS 的肺移植受者的同种异体移植物中的微生物群落进行横断面和纵向特征描述。
通过支气管肺泡灌洗对同种异体移植物进行采样，并采用 16S rRNA 基因扩增子焦磷酸测序对微生物群落进行分析。使用加权 Unifrac 度量对群落图谱进行比较，并使用 PERMANOVA 和逻辑回归探索微生物种群、BOS 与其他协变量之间的关系。
移植患者的微生物群落分为两组：一组以假单胞菌为主，另一组以链球菌和韦荣球菌为主，这两组似乎是相互排斥的肺部微生物组。曲霉培养也与假单胞菌为主的群体呈负相关。在移植前就存在于患者体内的优势种群（特别是囊性纤维化患者中的假单胞菌）的重新定植与 BOS 呈负相关。
囊性纤维化患者同种异体移植物中假单胞菌的再定植与 BOS 无关。通常，同种异体移植物中预先存在的肺部种群的重新建立似乎对 BOS 具有保护作用，而新获得的微生物种群通常属于同一属，可能会增加 BOS 的风险。
