Deshmukh Hitesh S, Liu Yuhong, Menkiti Ogechukwu R, Mei Junjie, Dai Ning, O'Leary Claire E, Oliver Paula M, Kolls Jay K, Weiser Jeffrey N, Worthen G Scott
1] Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA. [2] Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Division of Neonatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Nat Med. 2014 May;20(5):524-30. doi: 10.1038/nm.3542. Epub 2014 Apr 20.
Neonatal colonization by microbes, which begins immediately after birth, is influenced by gestational age and the mother's microbiota and is modified by exposure to antibiotics. In neonates, prolonged duration of antibiotic therapy is associated with increased risk of late-onset sepsis (LOS), a disorder controlled by neutrophils. A role for the microbiota in regulating neutrophil development and susceptibility to sepsis in the neonate remains unclear. We exposed pregnant mouse dams to antibiotics in drinking water to limit transfer of maternal microbes to the neonates. Antibiotic exposure of dams decreased the total number and composition of microbes in the intestine of the neonates. This was associated with decreased numbers of circulating and bone marrow neutrophils and granulocyte/macrophage-restricted progenitor cells in the bone marrow of antibiotic-treated and germ-free neonates. Antibiotic exposure of dams reduced the number of interleukin-17 (IL-17)-producing cells in the intestine and production of granulocyte colony-stimulating factor (G-CSF). Granulocytopenia was associated with impaired host defense and increased susceptibility to Escherichia coli K1 and Klebsiella pneumoniae sepsis in antibiotic-treated neonates, which could be partially reversed by administration of G-CSF. Transfer of a normal microbiota into antibiotic-treated neonates induced IL-17 production by group 3 innate lymphoid cells (ILCs) in the intestine, increasing plasma G-CSF levels and neutrophil numbers in a Toll-like receptor 4 (TLR4)- and myeloid differentiation factor 88 (MyD88)-dependent manner and restored IL-17-dependent resistance to sepsis. Specific depletion of ILCs prevented IL-17- and G-CSF-dependent granulocytosis and resistance to sepsis. These data support a role for the intestinal microbiota in regulation of granulocytosis, neutrophil homeostasis and host resistance to sepsis in neonates.
微生物在新生儿出生后立即开始的定植受胎龄和母亲微生物群的影响,并因接触抗生素而改变。在新生儿中,抗生素治疗时间延长与迟发性败血症(LOS)风险增加有关,LOS是一种由中性粒细胞控制的疾病。微生物群在调节新生儿中性粒细胞发育和败血症易感性方面的作用仍不清楚。我们让怀孕的母鼠饮用含抗生素的水,以限制母体微生物向新生儿的转移。母鼠接触抗生素会减少新生儿肠道中微生物的总数和组成。这与抗生素处理的新生儿和无菌新生儿骨髓中循环和骨髓中性粒细胞以及粒细胞/巨噬细胞限制性祖细胞数量减少有关。母鼠接触抗生素会减少肠道中产生白细胞介素-17(IL-17)的细胞数量和粒细胞集落刺激因子(G-CSF)的产生。粒细胞减少与抗生素处理的新生儿宿主防御受损和对大肠杆菌K1和肺炎克雷伯菌败血症易感性增加有关,给予G-CSF可部分逆转这种情况。将正常微生物群转移到抗生素处理的新生儿中可诱导肠道中3型天然淋巴细胞(ILC)产生IL-17,以Toll样受体4(TLR4)和髓样分化因子88(MyD88)依赖的方式增加血浆G-CSF水平和中性粒细胞数量,并恢复对败血症的IL-17依赖性抗性。特异性耗尽ILC可预防IL-17和G-CSF依赖性粒细胞增多以及对败血症的抗性。这些数据支持肠道微生物群在调节新生儿粒细胞增多、中性粒细胞稳态和宿主对败血症抗性方面的作用。