Department of Pediatric Pulmonology, Medical University of Lodz, Lodz, Poland.
Department of Internal Medicine, Asthma and Allergy, Medical University of Lodz, Lodz, Poland.
Pediatr Allergy Immunol. 2021 Apr;32(3):489-500. doi: 10.1111/pai.13417. Epub 2020 Dec 18.
Innate immunity response to local dysbiosis seems to be one of the most important immunologic backgrounds of chronic rhinosinusitis (CRS) and concomitant asthma. We aimed to assess clinical determinants of upper-airway dysbiosis and its effect on nasal inflammatory profile and asthma risk in young children with CRS.
We recruited one hundred and thirty-three children, aged 4-8 years with doctor-diagnosed CRS with or without asthma. The following procedures were performed in all participants: face-to-face standardized Sinus and Nasal Quality of Life questionnaire, skin prick test, taste perception testing, nasopharynx swab, and sampling of the nasal mucosa. Upper-airway dysbiosis was defined separately by asthma-specific microbiome composition and reduced biodiversity. Multivariate methods were used to define the risk factors for asthma and upper-airway dysbiosis and their specific inflammatory profile of nasal mucosa.
The asthma-specific upper-airway microbiome composition reflected by the decreased ratio of Patescibacteria/Actinobacteria independently of atopy increased the risk of asthma (OR:8.32; 95%CI: 2.93-23.6). This asthma-specific microbiome composition was associated with ≥ 7/week sweet consumption (OR:2.64; 95%C:1.11-6.28), reduced biodiversity (OR:3.83; 95%CI:1.65-8.87), the presence of Staphylococcus strains in the nasopharynx (OR:4.25; 95%CI:1.12-16.1), and lower expression of beta-defensin 2, IL-5, and IL-13 in the nasal mucosa. The reduced biodiversity was associated with frequent antibiotic use and with a higher nasal expression of IL-17 and T1R3 (sweet taste receptor). In asthmatic children, reduced sweet taste perception was observed.
Specific upper-airway dysbiosis related to frequent sweet consumption, frequent antibiotic courses, and altered nasal immune function increases the risk of asthma in young children with CRS.
局部微生态失调引起的固有免疫反应似乎是慢性鼻-鼻窦炎（CRS）和伴发哮喘的最重要免疫学背景之一。我们旨在评估上呼吸道微生态失调的临床决定因素及其对患有 CRS 的幼儿鼻腔炎症谱和哮喘风险的影响。
我们招募了 133 名年龄在 4-8 岁的儿童，这些儿童均经医生诊断患有 CRS 伴或不伴哮喘。所有参与者均接受了以下程序：面对面的标准化鼻窦和鼻生活质量问卷、皮肤点刺试验、味觉感知测试、鼻咽拭子和鼻黏膜取样。上呼吸道微生态失调通过哮喘特异性微生物组组成和生物多样性降低来定义。采用多变量方法来确定哮喘和上呼吸道微生态失调的危险因素及其鼻腔黏膜的特定炎症谱。
独立于过敏症，由减少的 Patescibacteria/Actinobacteria 比值反映的哮喘特异性上呼吸道微生物组组成增加了哮喘的风险（OR：8.32；95%CI：2.93-23.6）。这种哮喘特异性微生物组组成与每周≥7 次甜食摄入（OR：2.64；95%CI：1.11-6.28）、生物多样性降低（OR：3.83；95%CI：1.65-8.87）、鼻咽部存在葡萄球菌株（OR：4.25；95%CI：1.12-16.1）以及鼻黏膜中β-防御素 2、IL-5 和 IL-13 的表达降低有关。生物多样性降低与频繁使用抗生素以及鼻黏膜中 IL-17 和 T1R3（甜味受体）的表达增加有关。在哮喘儿童中，观察到甜味感知能力降低。
与频繁食用甜食、频繁使用抗生素和改变的鼻腔免疫功能相关的特定上呼吸道微生态失调增加了患有 CRS 的幼儿哮喘的风险。
