Department of Microbiology and Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an, China.
Department of Microbiology, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, China.
Front Cell Infect Microbiol. 2022 Oct 21;12:1033427. doi: 10.3389/fcimb.2022.1033427. eCollection 2022.
Due to the inability to be cultured , the biological characteristics and pathogenicity of remain unclear. Intestinal microflora disorder is related to the occurrence and development of various pulmonary diseases. This work explores the pathogenesis of pneumocystis pneumonia (PCP) in acquired immune deficiency syndrome (AIDS) patients from a microbiome perspective, to provide better strategies for the diagnosis, treatment, and prevention of PCP.
Subjects were divided into three groups: human immunodeficiency virus (HIV)-infected patients combined with PCP, HIV-infected patients without PCP, and HIV-negative. Stool and bronchoalveolar lavage fluid (BALF) samples were collected, total DNA was extracted, and 16S rRNA high-throughput sequencing was performed using an Illumina MiSeq platform. PICRUSt and BugBase were used to predict microflora functions, and correlation analysis of intestinal and lung bacterial flora was conducted.
Compared with the HIV- group, prevotella and another 21 genera in the intestinal microbiome were statistically different in the HIV+ group; 25 genera including Escherichia-Shigella from HIV+PCP+ group were statistically different from HIV+PCP- group. The abundance of Genera such as Porphyromonas was positively or negatively correlated with CD16/CD56+ (μL). Compared with the HIV- group, identification efficiency based on area under the curve (AUC) >0.7 for the HIV+ group identified seven genera in the gut microbiota, including Enterococcus (total AUC = 0.9519). Compared with the HIV+PCP- group, there were no bacteria with AUC >0.7 in the lung or intestine of the HIV+PCP+ group. The number of shared bacteria between BALF and fecal samples was eight species in the HIV- group, 109 species in PCP- patients, and 228 species in PCP+ patients, according to Venn diagram analysis. Changes in various clinical indicators and blood parameters were also closely related to the increase or decrease in the abundance of intestinal and pulmonary bacteria, respectively.
HIV infection and PCP significantly altered the species composition of lung and intestinal microbiomes, HIV infection also significantly affected intestinal microbiome gene functions, and PCP exacerbated the changes. The classification model can be used to distinguish HIV+ from HIV- patients, but the efficiency of bacterial classification was poor between PCP+ and PCP- groups. The microbiomes in the lung and gut were correlated to some extent, providing evidence for the existence of a lung-gut axis, revealing a potential therapeutic target in patients with HIV and PCP.
由于无法培养，的生物学特性和致病性尚不清楚。肠道微生物失调与各种肺部疾病的发生和发展有关。本工作从微生物组学的角度探讨获得性免疫缺陷综合征（AIDS）患者肺孢子菌肺炎（PCP）的发病机制，为 PCP 的诊断、治疗和预防提供更好的策略。
将研究对象分为三组：人类免疫缺陷病毒（HIV）感染合并 PCP 的患者、HIV 感染无 PCP 的患者和 HIV 阴性的患者。收集粪便和支气管肺泡灌洗液（BALF）样本，提取总 DNA，采用 Illumina MiSeq 平台进行 16S rRNA 高通量测序。使用 PICRUSt 和 BugBase 预测微生物群功能，并进行肠道和肺部细菌菌群的相关性分析。
与 HIV-组相比，HIV+组肠道微生物组中普雷沃氏菌属和另外 21 个属有统计学差异；与 HIV+PCP-组相比，HIV+PCP+组中有 25 个属，包括埃希氏菌-志贺氏菌属，有统计学差异。卟啉单胞菌属等属的丰度与 CD16/CD56+呈正相关或负相关（μL）。与 HIV-组相比，基于 AUC>0.7 的识别效率可在肠道微生物组中识别出 HIV+组中的 7 个属，包括肠球菌（总 AUC=0.9519）。与 HIV+PCP-组相比，HIV+PCP+组的肺部或肠道中没有 AUC>0.7 的细菌。根据 Venn 图分析，HIV-组 BALF 和粪便样本之间共有 8 种细菌，PCP-患者有 109 种，PCP+患者有 228 种。各种临床指标和血液参数的变化也与肠道和肺部细菌丰度的增加或减少密切相关。
HIV 感染和 PCP 显著改变了肺部和肠道微生物组的物种组成，HIV 感染也显著影响了肠道微生物组的基因功能，而 PCP 则加剧了这些变化。分类模型可用于区分 HIV+和 HIV-患者，但 PCP+和 PCP-组之间的细菌分类效率较差。肺部和肠道的微生物组在一定程度上是相关的，为肺-肠轴的存在提供了证据，揭示了 HIV 和 PCP 患者的潜在治疗靶点。
