Di Pierro Francesco, Iqtadar Somia, Mumtaz Sami Ullah, Bertuccioli Alexander, Recchia Martino, Zerbinati Nicola, Khan Amjad
Scientific & Research Department, Velleja Research, 20100 Milan, Italy.
Digestive Endoscopy, Fondazione Poliambulanza, 25133 Brescia, Italy.
Microorganisms. 2022 Sep 28;10(10):1926. doi: 10.3390/microorganisms10101926.
Anatomical and physiological considerations indicate that the oral cavity is a primary source of the lung microbiota community, and recent studies have shown that the microbiota in the lungs contributes to immunological homeostasis, potentially altering the organ's susceptibility to viral infection, including SARS-CoV-2. It has been proposed that, in the case of viral infection, lung Gram-negative bacteria could promote the cytokine cascade with a better performance than a microbiota mainly constituted by Gram-positive bacteria. Recent observations also suggest that -rich oral microbiotas would dominate the oral cavity of SARS-CoV-2-infected patients. In comparison, -rich microbiotas would dominate the oral cavity of healthy people. To verify if the modulation of the oral microbiota could have an impact on the current coronavirus disease, we administered for 14 days a well-recognized and oral-colonizing probiotic ( K12) to hospitalized COVID-19 patients. The preliminary results of our randomized and controlled trial seem to prove the potential role of this oral strain in improving the course of the main markers of pathology, as well as its ability to apparently reduce the death rate from COVID-19. Although in a preliminary and only circumstantial way, our results seem to confirm the hypothesis of a direct involvement of the oral microbiota in the construction of a lung microbiota whose taxonomic structure could modulate the inflammatory processes generated at the pulmonary and systemic level by a viral infection.
解剖学和生理学方面的考虑表明，口腔是肺部微生物群落的主要来源，最近的研究表明，肺部的微生物群有助于免疫稳态，可能会改变器官对病毒感染（包括SARS-CoV-2）的易感性。有人提出，在病毒感染的情况下，肺部革兰氏阴性菌比主要由革兰氏阳性菌组成的微生物群更能促进细胞因子级联反应。最近的观察结果还表明，富含某种菌群的口腔微生物群在感染SARS-CoV-2的患者口腔中占主导地位。相比之下，富含另一种菌群的微生物群在健康人的口腔中占主导地位。为了验证口腔微生物群的调节是否会对当前的冠状病毒病产生影响，我们对住院的COVID-19患者连续14天给予一种广为人知的口腔定植益生菌（K12）。我们随机对照试验的初步结果似乎证明了这种口腔菌株在改善主要病理指标病程方面的潜在作用，以及它明显降低COVID-19死亡率的能力。尽管只是初步的且仅为间接证据，但我们的结果似乎证实了关于口腔微生物群直接参与构建肺部微生物群的假设，其分类结构可能调节病毒感染在肺部和全身水平产生的炎症过程。
