Unité de Parasitologie-Mycologie, Département de Prévention, Diagnostic et Traitement des Infections, Hôpitaux Universitaires Henri Mondor, Assistance Publique des Hôpitaux de Paris (APHP), Créteil, France.
Dynamyc UR 7380, USC Anses, Ecole Nationale Vétérinaire d'Alfort (ENVA), Faculté de Santé, Univ. Paris-Est Créteil (UPEC), Créteil, France.
Mycopathologia. 2024 Sep 12;189(5):82. doi: 10.1007/s11046-024-00887-6.
Cystic fibrosis (CF) is a genetic disorder characterized by chronic microbial colonization and inflammation of the respiratory tract (RT), leading to pulmonary exacerbation (PEx) and lung damage. Although the lung bacterial microbiota has been extensively studied, the mycobiome remains understudied. However, its importance as a contributor to CF pathophysiology has been highlighted. The objective of this review is to provide an overview of the current state of knowledge regarding the mycobiome, as described through NGS-based studies, in patients with CF (pwCF).Several studies have demonstrated that the mycobiome in CF lungs is a dynamic entity, exhibiting a lower diversity and abundance than the bacterial microbiome. Nevertheless, the progression of lung damage is associated with a decrease in fungal and bacterial diversity. The core mycobiome of the RT in pwCFs is mainly composed of yeasts (Candida spp., Malassezia spp.) and molds with lower abundance. Some fungi (Aspergillus, Scedosporium/Pseudallescheria) have been demonstrated to play a role in PEx, while the involvement of others (Candida, Pneumocystis) remains uncertain. The "climax attack" ecological model has been proposed to explain the complexity and interplay of microbial populations in the RT, leading to PEx and lung damage. NGS-based studies also enable the detection of intra- and interkingdom correlations between fungi and bacteria. Further studies are required to ascertain the biological and pathophysiological relevance of these correlations. Finally, with the recent advent of CFTR modulators, our understanding of the pulmonary microbiome and mycobiome in pwCFs is about to change.
囊性纤维化（CF）是一种遗传性疾病，其特征为呼吸道（RT）的慢性微生物定植和炎症，导致肺部恶化（PEx）和肺损伤。尽管肺部细菌微生物群已得到广泛研究，但真菌微生物组仍研究不足。然而，其作为 CF 病理生理学的一个贡献者的重要性已经得到强调。本综述的目的是提供一个关于 CF 患者（pwCF）中基于 NGS 的研究描述的真菌微生物组的当前知识状态的概述。
几项研究表明，CF 肺部的真菌微生物组是一个动态实体，其多样性和丰度均低于细菌微生物组。然而，肺损伤的进展与真菌和细菌多样性的减少有关。CF 患者 RT 中的核心真菌微生物组主要由酵母（Candida spp.、Malassezia spp.）和丰度较低的霉菌组成。一些真菌（Aspergillus、Scedosporium/Pseudallescheria）已被证明在 PEx 中发挥作用，而其他真菌（Candida、Pneumocystis）的作用仍不确定。“高潮攻击”生态模型已被提出，以解释 RT 中微生物群的复杂性和相互作用，导致 PEx 和肺损伤。基于 NGS 的研究还可以检测真菌和细菌之间的种内和种间相关性。需要进一步的研究来确定这些相关性的生物学和病理生理学意义。最后，随着 CFTR 调节剂的最近出现，我们对 pwCF 肺部微生物组和真菌微生物组的理解即将发生变化。
