Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Biomedical Sciences, Graduate School of Chonnam National University, Gwangju, Republic of Korea.
PLoS One. 2024 Aug 28;19(8):e0309446. doi: 10.1371/journal.pone.0309446. eCollection 2024.
Although gastroesophageal reflux has been recognized as one of the risk factors of nontuberculous mycobacterial pulmonary disease (NTM-PD) progression, the effect of reflux on the lower respiratory tract microbiota has not been studied in detail. We investigated the composition of the lower respiratory tract microbiota in patients with clinically suspected NTM-PD, comparing them based on the presence of reflux. Forty-seven patients suspected of having NTM-PD were enrolled and assigned according to presence of reflux (n = 22) and non- reflux (n = 25). We performed a pepsin ELISA assay to identify the presence of reflux and 16S ribosomal RNA gene amplicon sequencing to evaluate the microbiota in bronchoalveolar lavage fluid. There were no significant differences in the diversity or composition of the lower respiratory microbiota between the NTM-PD and non-NTM-PD groups. Bacterial richness was observed in the non-reflux group than in the reflux group [P = 0.03] and a cluster in the reflux group was observed. The reflux group showed a predominance for Pseudomonas aeruginosa or Staphylococcus aureus among the NTM-PD group and for P. aeruginosa, Haemophilus influenzae, Klebsiella pneumoniae, or Eikenella species among the non-NTM-PD group. The non-reflux groups presented diverse patterns. A linear discriminant analysis and volcano plot demonstrated that P. aeruginosa, H. haemolyticus, Selenomonas artemidis, and Dolosigranulum pigrum were specifically associated with the NTM-PD reflux group, while P. aeruginosa was specifically associated with the non-NTM-PD reflux group. These observations confirm that the lower respiratory microbiota is consistently altered by reflux but not in NTM-PD.
虽然胃食管反流已被认为是非结核分枝杆菌肺病（NTM-PD）进展的危险因素之一，但反流对下呼吸道微生物群的影响尚未详细研究。我们调查了临床疑似 NTM-PD 患者的下呼吸道微生物群组成，根据反流的存在对其进行了比较。共纳入 47 例疑似 NTM-PD 患者，并根据反流（n = 22）和非反流（n = 25）进行分组。我们通过胃蛋白酶 ELISA 检测来确定反流的存在，并通过 16S 核糖体 RNA 基因扩增子测序来评估支气管肺泡灌洗液中的微生物群。NTM-PD 和非 NTM-PD 组之间下呼吸道微生物群的多样性或组成均无显著差异。非反流组的细菌丰富度高于反流组[P = 0.03]，且在反流组观察到一个聚类。反流组中 NTM-PD 组以铜绿假单胞菌或金黄色葡萄球菌为主，而非 NTM-PD 组中以铜绿假单胞菌、流感嗜血杆菌、肺炎克雷伯菌或爱肯菌属为主。非反流组呈现出多样化的模式。线性判别分析和火山图表明，铜绿假单胞菌、溶血嗜血杆菌、马氏球菌和猪巨吻棘头虫与 NTM-PD 反流组特异性相关，而铜绿假单胞菌与非 NTM-PD 反流组特异性相关。这些观察结果证实，下呼吸道微生物群确实受到反流的影响，但与 NTM-PD 无关。
