Department of Biology, San Diego State University, San Diego, California, USA
Viral Information Institute at San Diego State University, San Diego, California, USA.
mBio. 2019 Apr 16;10(2):e00431-19. doi: 10.1128/mBio.00431-19.
Pulmonary exacerbations are the leading cause of death in cystic fibrosis (CF) patients. To track microbial dynamics during acute exacerbations, a CF rapid response (CFRR) strategy was developed. The CFRR relies on viromics, metagenomics, metatranscriptomics, and metabolomics data to rapidly monitor active members of the viral and microbial community during acute CF exacerbations. To highlight CFRR, a case study of a CF patient is presented, in which an abrupt decline in lung function characterized a fatal exacerbation. The microbial community in the patient's lungs was closely monitored through the multi-omics strategy, which led to the identification of pathogenic shigatoxigenic (STEC) expressing Shiga toxin. This case study illustrates the potential for the CFRR to deconstruct complicated disease dynamics and provide clinicians with alternative treatments to improve the outcomes of pulmonary exacerbations and expand the life spans of individuals with CF. Proper management of polymicrobial infections in patients with cystic fibrosis (CF) has extended their life span. Information about the composition and dynamics of each patient's microbial community aids in the selection of appropriate treatment of pulmonary exacerbations. We propose the cystic fibrosis rapid response (CFRR) as a fast approach to determine viral and microbial community composition and activity during CF pulmonary exacerbations. The CFRR potential is illustrated with a case study in which a cystic fibrosis fatal exacerbation was characterized by the presence of shigatoxigenic The incorporation of the CFRR within the CF clinic could increase the life span and quality of life of CF patients.
肺脏恶化是囊性纤维化（CF）患者死亡的主要原因。为了追踪急性恶化期间的微生物动态，开发了 CF 快速反应（CFRR）策略。CFRR 依赖病毒组学、宏基因组学、宏转录组学和代谢组学数据，在 CF 急性恶化期间快速监测病毒和微生物群落的活跃成员。为了突出 CFRR，提出了 CF 患者的病例研究，其中肺功能的突然下降特征为致命恶化。通过多组学策略密切监测患者肺部的微生物群落，从而鉴定出表达志贺毒素的致病性产志贺毒素大肠杆菌（STEC）。该病例研究说明了 CFRR 有潜力解构复杂的疾病动态，并为临床医生提供替代治疗方法，以改善肺脏恶化的结果并延长 CF 个体的寿命。对囊性纤维化（CF）患者的多微生物感染进行适当管理已延长了他们的寿命。了解每位患者微生物群落的组成和动态有助于选择适当的肺脏恶化治疗方法。我们提出囊性纤维化快速反应（CFRR）作为一种快速方法，用于确定 CF 肺脏恶化期间病毒和微生物群落的组成和活性。通过一个 CF 致命恶化的病例研究说明了 CFRR 的潜力，该恶化的特征是存在产志贺毒素的大肠杆菌。将 CFRR 纳入 CF 诊所内可能会延长 CF 患者的寿命并提高其生活质量。
