Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, NC, USA. .
Center for Esophageal Diseases and Swallowing, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC; Center for Gastrointestinal Biology and Disease, Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, NC. .
J Gastrointestin Liver Dis. 2021 Mar 12;30(1):17-24. doi: 10.15403/jgld-3049.
Changes in the esophageal microbiome have been reported in children with eosinophilic esophagitis (EoE), but few data exist for adults. We aimed to determine whether the esophageal microbiome differs in adults with and without EoE.
In a prospective cohort study, adults undergoing outpatient endoscopy were enrolled as incident EoE cases or non-EoE controls. Clinical, endoscopic, and histologic data were collected. An esophageal biopsy was utilized for microbiome analysis. Bacterial DNA was extracted and the V3-V4 region of the 16S rRNA gene was amplified and sequenced. Analyses were performed comparing microbiome features for cases and controls, and within cases for disease features, with correction for multiple hypothesis testing.
A total of 24 incident EoE cases (mean age 40 years; 63% male; 100% white; 97 eos/hpf) and 25 controls (mean age 48, 36% male; 76% white; 1 eos/hpf) were analyzed. Principal coordinate analysis ordination failed to distinguish cases from controls. There were no microbiome differences within EoE cases based on clinical phenotype, presence of atopy, or endoscopic features. Use of proton pump inhibitors (PPIs), however, was significantly associated with 5 taxa including SR1 at the phylum level and Burkholderia at the genus level.
There were no significant differences in the esophageal microbiome between newly diagnosed EoE cases and non-EoE controls in adults, or within EoE cases based on clinical features. However, given the strong rationale for the esophageal microbiome in EoE pathogenesis, future studies should explicitly consider the presence of PPIs as a confounding feature.
嗜酸细胞性食管炎（EoE）患儿的食管微生物组发生了变化，但成人的数据很少。我们旨在确定 EoE 成人与非 EoE 成人的食管微生物组是否存在差异。
在一项前瞻性队列研究中，招募接受门诊内镜检查的成年人作为新发 EoE 病例或非 EoE 对照组。收集临床、内镜和组织学数据。利用食管活检进行微生物组分析。提取细菌 DNA，扩增和测序 16S rRNA 基因的 V3-V4 区。通过比较病例和对照的微生物组特征，以及在病例中进行疾病特征的比较，进行分析，并对多个假设检验进行校正。
共分析了 24 例新发 EoE 病例（平均年龄 40 岁；63%为男性；100%为白人；每高倍镜视野 100 个嗜酸性粒细胞）和 25 例对照（平均年龄 48 岁，36%为男性；76%为白人；每高倍镜视野 1 个嗜酸性粒细胞）。主坐标分析排序未能区分病例和对照。根据临床表型、特应性存在或内镜特征，EoE 病例内的微生物组无差异。然而，质子泵抑制剂（PPIs）的使用与 5 个分类群显著相关，包括门水平的 SR1 和属水平的 Burkholderia。
在成年新发 EoE 病例与非 EoE 对照组之间，或在基于临床特征的 EoE 病例内，食管微生物组无显著差异。然而，鉴于食管微生物组在 EoE 发病机制中的重要作用，未来的研究应明确考虑 PPI 的存在作为混杂因素。
