Manchester Fungal Infection Group, Division of Infection Immunity and Respiratory Medicine, School of Biological Sciences, University of Manchester, Manchester, United Kingdom; Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust (Wythenshawe), Manchester, United Kingdom; School of Biological Sciences, Manchester Institute of Biotechnology, University of Manchester, Manchester, United Kingdom.
Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust (Wythenshawe), Manchester, United Kingdom.
J Allergy Clin Immunol. 2018 Aug;142(2):407-414. doi: 10.1016/j.jaci.2017.09.039. Epub 2017 Nov 6.
Allergic diseases caused by fungi are common. The best understood conditions are allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitization. Our knowledge of the fungal microbiome (mycobiome) is limited to a few studies involving healthy individuals, asthmatics, and smokers. No study has yet examined the mycobiome in fungal lung disease.
The main aim of this study was to determine the mycobiome in lungs of individuals with well-characterized fungal disease. A secondary objective was to determine possible effects of treatment on the mycobiome.
After bronchoscopy, ribosomal internal transcribed spacer region 1 DNA was amplified and sequenced and fungal load determined by real-time PCR. Clinical and treatment variables were correlated with the main species identified. Bronchopulmonary aspergillosis (n = 16), severe asthma with fungal sensitization (n = 16), severe asthma not sensitized to fungi (n = 9), mild asthma patients (n = 7), and 10 healthy control subjects were studied.
The mycobiome was highly varied with severe asthmatics carrying higher loads of fungus. Healthy individuals had low fungal loads, mostly poorly characterized Malasezziales. The most common fungus in asthmatics was Aspergillus fumigatus complex and this taxon accounted for the increased burden of fungus in the high-level samples. Corticosteroid treatment was significantly associated with increased fungal load (P < .01).
The mycobiome is highly variable. Highest loads of fungus are observed in severe asthmatics and the most common fungus is Aspergillus fumigatus complex. Individuals receiving steroid therapy had significantly higher levels of Aspergillus and total fungus in their bronchoalveolar lavage.
由真菌引起的过敏性疾病很常见。人们最了解的情况是变应性支气管肺曲霉病和真菌致敏引起的严重哮喘。我们对真菌微生物组（真菌组）的了解仅限于少数涉及健康个体、哮喘患者和吸烟者的研究。尚无研究检查真菌性肺病中的真菌组。
本研究的主要目的是确定特征明确的真菌病患者肺部的真菌组。次要目的是确定治疗对真菌组的可能影响。
支气管镜检查后，扩增和测序核糖体内部转录间隔区 1 DNA，并通过实时 PCR 确定真菌负荷。将临床和治疗变量与主要鉴定的物种相关联。研究了支气管肺曲霉病（n=16）、真菌致敏性严重哮喘（n=16）、非真菌致敏性严重哮喘（n=9）、轻度哮喘患者（n=7）和 10 名健康对照者。
真菌组变化很大，严重哮喘患者的真菌负荷较高。健康个体的真菌负荷较低，主要是特征不明显的 Malasezziales。哮喘患者最常见的真菌是烟曲霉复合体，该分类群占高水平样本中真菌负担增加的原因。皮质类固醇治疗与真菌负荷增加显著相关（P<0.01）。
真菌组变化很大。在严重哮喘患者中观察到最高的真菌负荷，最常见的真菌是烟曲霉复合体。接受类固醇治疗的个体在其支气管肺泡灌洗液中具有明显更高水平的曲霉和总真菌。
