Indiana University School of Medicine, Riley Children's Hospital, 340 10th Street, Indianapolis, IN 46202, United States of America.
University of Illinois Chicago, 1200 West Harrison Street, Chicago, Illinois 60607, United States of America.
J Cyst Fibros. 2023 Nov;22(6):1010-1016. doi: 10.1016/j.jcf.2023.08.001. Epub 2023 Aug 17.
In cystic fibrosis (CF), pathophysiologic changes in the gastrointestinal tract lead to malnutrition and altered gut microbiome. Microbiome alterations have been linked to linear growth, gut inflammation and respiratory manifestations. Elucidating these gut microbiome alterations may provide insight into future nutritional management in CF.
Infants were followed for 12-months at four sites in the United States (US-CF) and Australia (AUS-CF). 16S rRNA gene sequencing was performed on longitudinal stool samples. Associations between microbial abundance and age, antibiotic prophylaxis, malnutrition, and breast feeding were evaluated using generalized linear mixed models. Taxonomic and predictive functional features were compared between groups.
Infants with CF (N = 78) were enrolled as part of a larger study. AUS-CF infants had higher mean weight-for-age z-scores than US-CF infants (p = 0.02). A subset of participants (CF N = 40, non-CF disease controls N = 10) provided stool samples for microbiome analysis. AUS-CF infants had lower stool alpha diversity compared to US-CF infants (p < 0.001). AUS-CF infants had higher relative abundance of stool Proteobacteria compared to US-CF infants which was associated with antibiotic prophylaxis (p < 0.001). Malnutrition (weight-for-age <10th percentile) was associated with depleted Lactococcus (p < 0.001). Antibiotic prophylaxis (p = 0.002) and malnutrition (p = 0.012) were linked with predicted decreased activity of metabolic pathways responsible for short chain fatty acid processing.
In infants with CF, gut microbiome composition and diversity differed between the two continents. Gut microbial diversity was not linked to growth. The relationship between malnutrition and antibiotic prophylaxis with reduced SCFA fermentation could have implications for gut health and function and warrants additional investigation.
在囊性纤维化（CF）中，胃肠道的病理生理变化导致营养不良和肠道微生物组改变。微生物组的改变与线性生长、肠道炎症和呼吸道表现有关。阐明这些肠道微生物组的改变可能为 CF 的未来营养管理提供思路。
在美国（US-CF）和澳大利亚（AUS-CF）的四个地点对婴儿进行了为期 12 个月的随访。对纵向粪便样本进行 16S rRNA 基因测序。使用广义线性混合模型评估微生物丰度与年龄、抗生素预防、营养不良和母乳喂养之间的关系。比较了不同组之间的分类和预测功能特征。
作为一项更大研究的一部分，招募了患有 CF 的婴儿（N=78）。AUS-CF 婴儿的体重年龄 Z 评分平均值高于 US-CF 婴儿（p=0.02）。一部分参与者（CF N=40，非 CF 疾病对照组 N=10）提供了粪便样本进行微生物组分析。AUS-CF 婴儿的粪便 alpha 多样性低于 US-CF 婴儿（p<0.001）。AUS-CF 婴儿粪便中 Proteobacteria 的相对丰度高于 US-CF 婴儿，这与抗生素预防有关（p<0.001）。营养不良（体重低于第 10 百分位数）与 Lactococcus 减少有关（p<0.001）。抗生素预防（p=0.002）和营养不良（p=0.012）与负责短链脂肪酸处理的代谢途径活性降低有关。
在 CF 婴儿中，两个大陆的肠道微生物组组成和多样性存在差异。肠道微生物多样性与生长无关。营养不良和抗生素预防与减少 SCFA 发酵之间的关系可能对肠道健康和功能有影响，值得进一步研究。
