Immunological Out-patients Center of Silesia Medical Care, Katowice Poland; Lower Silesian Oncology Pulmonology and Hematology Center, Wroclaw, Poland.
Hirszfeld Institute of Immunology and Experimental Therapy, Wroclaw, Poland.
Pol Merkur Lekarski. 2022 Oct 21;50(299):287-293.
The microbiome as a broad term defines the most dynamic ecological system in which, apart from the biocenosis, there is unique niche for its development, equally dynamic, because host-derived, contrary to physical environment in ecology. Although for years, antibodies, was recognized as a key element of the mucosal barrier, there is still no progress in comprehensive linking microbes and humoral elements. Which organism is a pathogen and which is a commensal - there are still no exact answers (and criteria). Also the discrepancy between experimental research, using more and more sophisticated techniques -showing the existence of nearly 900 bacterial species in our mouth was observed. On the contrary, bacterial infections caused by novel species have not been recognised in patients with humoral immunodeficiencies, apart from the capsular cocci and H. influenzae. Research on human virome, including CMV, is also focused on the cellular immunity, but in many situations in the clinic the humoral compartment are the exclusive, still effective, barrier against viral replication.
The aim of study was to perform an integrated microbiome analysis (microbiota and host) for strict linking various microbiota constelation and end-stage clinical manifestation in humoral immunodeficiency.
This cross-study based on own clinical experience reveal crucial gap in the literature.
It indicate the natural competition: why the sentinel microorganism in humoral deficiency - S. pneumoniae dominates in some patients, and in others - Viridans Group Streptococci. Crucial role of high specific IgM level in several CVID complication was described. Furthermore, respiratory microbiota translocation with cancer regression and influence of therapeutic regimen on clinical sequel (predominantly infectious or malignant) were presented. The studies indicates numerous methodological and microecological classification difficulties, which are the source of inadequate, often contradictory conclusions from experimental research.
Microecology describe ecosystem that consists of all the organisms and the abiotic physical environment with which they interact: i.e. biocenosis and biotope but clinical immunology -microorganisms in biotic (cellular) niche in host. Unfortunately, these studies are focused on the anecdotal "healthy" biocenosis (healthy microbiome), without analyzing other elements of the niche, for example cancer. Overall, focusing on the gut microbiota clearly restrict our knowledge on the manifestation of humoral deficiencies in respiratory system. The work is a summary of the search for representative clinical models and microbiological methods (diagnostic chain) in clinical immunology practice.
微生物组作为一个广义术语定义了最动态的生态系统，除了生物群落外，还有独特的小生境供其发展，同样是动态的，因为它是由宿主衍生的，与生态学中的物理环境相反。尽管多年来，抗体被认为是黏膜屏障的关键要素，但在全面联系微生物和体液元素方面仍没有进展。哪种生物是病原体，哪种是共生体——仍然没有确切的答案（和标准）。此外，实验研究之间的差异——观察到我们口腔中存在近 900 种细菌物种——也表明了这一点。相反，除了荚膜球菌和流感嗜血杆菌外，在体液免疫缺陷患者中，新型细菌感染引起的细菌感染尚未被识别。包括 CMV 在内的人类病毒组研究也侧重于细胞免疫，但在许多临床情况下，体液隔室是针对病毒复制的唯一、仍然有效的屏障。
本研究的目的是对微生物组（微生物群和宿主）进行综合分析，以严格联系各种微生物群丛与体液免疫缺陷的终末临床表现。
这项基于自身临床经验的交叉研究揭示了文献中的关键差距。
它表明存在自然竞争：为什么在体液缺陷中的哨兵微生物——肺炎链球菌在某些患者中占主导地位，而在另一些患者中——则是草绿色链球菌。描述了高特异性 IgM 水平在几种 CVID 并发症中的关键作用。此外，还介绍了呼吸道微生物群的易位与癌症消退以及治疗方案对临床后果（主要是感染性或恶性）的影响。该研究表明存在许多方法学和微观生态分类困难，这些困难是实验研究得出不充分、经常相互矛盾的结论的根源。
微生物生态学描述了由所有生物体和与它们相互作用的非生物物理环境组成的生态系统：即生物群落和生境，但临床免疫学——宿主中的生物（细胞）小生境中的微生物。不幸的是，这些研究专注于偶发的“健康”生物群落（健康微生物组），而没有分析小生境的其他元素，例如癌症。总的来说，专注于肠道微生物群明显限制了我们对呼吸道体液缺陷表现的认识。这项工作是对临床免疫学实践中代表性临床模型和微生物学方法（诊断链）的搜索总结。
