Stapleton Amanda L, Shaffer Amber D, Morris Alison, Li Kelvin, Fitch Adam, Methé Barbara A
Department of Otolaryngology, University of Pittsburgh Medical Center (UPMC) Children's Hospital of Pittsburgh, Pittsburgh, PA.
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, PA.
Int Forum Allergy Rhinol. 2021 Jan;11(1):31-39. doi: 10.1002/alr.22597. Epub 2020 Jun 22.
This study aimed to compare the microbiota of pediatric patients with chronic rhinosinusitis (CRS) who are undergoing adenoidectomy to treat their disease with that of healthy control patients.
Patients undergoing adenoidectomy-only for obstructive sleep apnea (n = 50) and CRS (n = 37) were recruited. Preoperative 22-item Sino-Nasal Outcome Test (SNOT-22) or Sinus and Nasal Quality of Life Survey (SN-5) were collected. Each patient had samples collected from their nasopharynx (adenoid bed) and nasal cavity (sinus) at the onset of surgery. 16S ribosomal ribonucleic acid (rRNA) gene sequencing was subsequently performed to obtain per sample taxonomic abundances. Statistical analyses included permutational multivariate analysis of variance (PERMANOVA), alpha (within sample) diversity measures, and changes in taxonomic abundance.
Moraxella was the most abundant organism. Nasopharyngeal swabs demonstrated higher alpha diversity compared to the nasal cavity. The diversity was not different based on CRS vs obstructive history. There was an increase in diversity with increasing age, and eczema contributed to a greater difference in diversity between the nasopharynx and nasal cavity. Diversity was not affected by adenoid size; however, use of nasal steroids, inhaled steroids, and antihistamines influenced diversity in both the nasopharynx and nasal cavity. Nasopharyngeal samples were higher in relative abundance for Fusobacterium, Prevotella, Porphyromonas, and Campylobacter compared to the nasal cavity.
The nasopharynx and nasal cavity differed in both microbiota composition and diversity. In contrast, no significant difference in composition or diversity were found in CRS vs control patients. Ecological changes in the nasopharyngeal and sinus site may contribute to the etiology for adenoid hypertrophy in both healthy controls and CRS patients.
本研究旨在比较接受腺样体切除术治疗慢性鼻-鼻窦炎（CRS）的儿科患者与健康对照患者的微生物群。
招募仅因阻塞性睡眠呼吸暂停接受腺样体切除术的患者（n = 50）和CRS患者（n = 37）。收集术前22项鼻-鼻窦结局测试（SNOT-22）或鼻窦和鼻腔生活质量调查（SN-5）。每位患者在手术开始时从鼻咽（腺样体床）和鼻腔（鼻窦）采集样本。随后进行16S核糖体核糖核酸（rRNA）基因测序以获得每个样本的分类丰度。统计分析包括置换多变量方差分析（PERMANOVA）、α（样本内）多样性测量以及分类丰度的变化。
莫拉克斯氏菌是最丰富的微生物。鼻咽拭子显示出比鼻腔更高的α多样性。基于CRS与阻塞性病史，多样性没有差异。随着年龄增长多样性增加，湿疹导致鼻咽和鼻腔之间的多样性差异更大。多样性不受腺样体大小影响；然而，使用鼻用类固醇、吸入性类固醇和抗组胺药会影响鼻咽和鼻腔的多样性。与鼻腔相比，鼻咽样本中梭杆菌属、普雷沃氏菌属、卟啉单胞菌属和弯曲杆菌属的相对丰度更高。
鼻咽和鼻腔在微生物群组成和多样性方面存在差异。相比之下，CRS患者与对照患者在组成或多样性方面未发现显著差异。鼻咽和鼻窦部位的生态变化可能是健康对照者和CRS患者腺样体肥大病因的一部分。
