Division of Pediatric Pulmonology & Allergy and Cystic Fibrosis Center, Department of Pediatrics III, University of Heidelberg, Im Neuenheimer Feld 430, Heidelberg 69120, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, Heidelberg 69120, Germany.
Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, Heidelberg 69120, Germany; Department of Infectiology and Microbiology, University Hospital Schleswig Holstein, Lübeck 23538, Germany.
J Cyst Fibros. 2024 Mar;23(2):226-233. doi: 10.1016/j.jcf.2023.12.011. Epub 2024 Jan 10.
Cystic fibrosis (CF) is characterized by highly viscous mucus obstructing the lower and upper airways, chronic neutrophil inflammation and infection resulting not only in lung destruction but also in paranasal sinus involvement. The pathogenesis of CF-associated chronic rhinosinusitis (CRS) is still not well understood, and it remains unclear how the microbiome in the upper airways (UAW) influences paranasal sinus inflammation.
In a cross-sectional study in pediatric patients with CF under stable disease conditions, we examined the microbiome in relation to inflammation by comparing nasal swabs (NS) and nasal lavage (NL) as two UAW sampling methods. The microbiota structure of both NS and NL was determined by 16S rRNA gene amplicon sequencing. In addition, pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) and proteases (SLPI, TIMP-1, NE/A1-AT complex) as well as neutrophil elastase activity were measured in NL.
Simultaneous NS and NL samples were collected from 36 patients with CF (age range: 7 - 19 years). The microbiome of NS samples was shown to be significantly lower in α-diversity and evenness compared to NL samples. NS samples were particularly found to be colonized with Staphylococcus species. NL microbiome was shown to correlate much better with the sinonasal inflammation status than NS microbiome. Especially the detection of Moraxella in NL was associated with increased inflammatory response.
Our results show that the NL microbiome reflects sinonasal inflammation better than NS and support NL as a promising tool for simultaneous assessment of the UAW microbiome and inflammation in children with CF.
囊性纤维化（CF）的特征是粘性很高的黏液阻塞下呼吸道和上呼吸道，慢性中性粒细胞炎症和感染不仅导致肺部破坏，还导致副鼻窦受累。CF 相关慢性鼻鼻窦炎（CRS）的发病机制仍不清楚，上呼吸道（UAW）微生物组如何影响副鼻窦炎症也不清楚。
在稳定疾病状态下的儿科 CF 患者的横断面研究中，我们通过比较鼻拭子（NS）和鼻冲洗（NL）这两种 UAW 采样方法，研究了微生物组与炎症的关系。通过 16S rRNA 基因扩增子测序来确定 NS 和 NL 的微生物群结构。此外，还测量了 NL 中的促炎细胞因子（IL-1β、IL-6、IL-8、TNF-α）和蛋白酶（SLPI、TIMP-1、NE/A1-AT 复合物）以及中性粒细胞弹性蛋白酶活性。
从 36 名 CF 患者（年龄范围：7-19 岁）中同时采集 NS 和 NL 样本。与 NL 样本相比，NS 样本的微生物组多样性和均匀度明显较低。NS 样本特别被发现定植有葡萄球菌属。NL 微生物组与鼻窦炎症状态的相关性比 NS 微生物组好得多。NL 中莫拉菌的检测尤其与炎症反应增加相关。
我们的结果表明，NL 微生物组比 NS 更能反映鼻窦炎症，支持 NL 作为一种有前途的工具，用于同时评估 CF 儿童的 UAW 微生物组和炎症。
