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Tytuł pozycji:

Aerodigestive sampling reveals altered microbial exchange between lung, oropharyngeal, and gastric microbiomes in children with impaired swallow function.

Tytuł :
Aerodigestive sampling reveals altered microbial exchange between lung, oropharyngeal, and gastric microbiomes in children with impaired swallow function.
Autorzy :
Duvallet C; Department of Biological Engineering, MIT, Cambridge, Massachusetts, United States of America.; Center for Microbiome Informatics and Therapeutics, MIT, Cambridge, Massachusetts, United States of America.
Larson K; Aerodigestive Center, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America.
Snapper S; Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America.
Iosim S; Aerodigestive Center, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America.
Lee A; Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America.
Freer K; Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America.
May K; Division of Pulmonary Medicine, Boston Children's Hospital, Boston, Massachusetts, United States of America.
Alm E; Department of Biological Engineering, MIT, Cambridge, Massachusetts, United States of America.; Center for Microbiome Informatics and Therapeutics, MIT, Cambridge, Massachusetts, United States of America.
Rosen R; Aerodigestive Center, Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, Massachusetts, United States of America.
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Źródło :
PloS one [PLoS One] 2019 May 20; Vol. 14 (5), pp. e0216453. Date of Electronic Publication: 2019 May 20 (Print Publication: 2019).
Typ publikacji :
Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
Język :
English
Imprint Name(s) :
Original Publication: San Francisco, CA : Public Library of Science
MeSH Terms :
Bacteria*/classification
Bacteria*/genetics
Deglutition*
Gastrointestinal Microbiome*
Gastroesophageal Reflux/*microbiology
Lung/*microbiology
Pneumonia, Aspiration/*microbiology
Adolescent ; Bronchoscopy ; Child ; Child, Preschool ; Cross-Sectional Studies ; Female ; Gastroesophageal Reflux/complications ; Gastroscopy ; Humans ; Infant ; Male ; Pneumonia, Aspiration/etiology ; Prospective Studies ; RNA, Bacterial/genetics ; RNA, Ribosomal, 16S/genetics
References :
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Grant Information :
P30 DK034854 United States DK NIDDK NIH HHS; R01 DK097112 United States DK NIDDK NIH HHS
Substance Nomenclature :
0 (RNA, Bacterial)
0 (RNA, Ribosomal, 16S)
Entry Date(s) :
Date Created: 20190521 Date Completed: 20200113 Latest Revision: 20201214
Update Code :
20210623
PubMed Central ID :
PMC6527209
DOI :
10.1371/journal.pone.0216453
PMID :
31107879
Czasopismo naukowe
Background: Children with oropharyngeal dysphagia have impaired airway protection mechanisms and are at higher risk for pneumonia and other pulmonary complications. Aspiration of gastric contents is often implicated as a cause for these pulmonary complications, despite being supported by little evidence. The goal of this study is to determine the relative contribution of oropharyngeal and gastric microbial communities to perturbations in the lung microbiome of children with and without oropharyngeal dysphagia and aspiration.
Methods: We conducted a prospective cohort study of 220 patients consecutively recruited from a tertiary aerodigestive center undergoing simultaneous esophagogastroduodenoscopy and flexible bronchoscopy. Bronchoalveolar lavage, gastric and oropharyngeal samples were collected from all recruited patients and 16S sequencing was performed. A subset of 104 patients also underwent video fluoroscopic swallow studies to assess swallow function and were categorized as aspiration/no aspiration. To ensure the validity of the results, we compared the microbiome of these aerodigestive patients to the microbiome of pediatric patients recruited to a longitudinal cohort study of children with suspected GERD; patients recruited to this study had oropharyngeal, gastric and/or stool samples available. The relationships between microbial communities across the aerodigestive tract were described by analyzing within- and between-patient beta diversities and identifying taxa which are exchanged between aerodigestive sites within patients. These relationships were then compared in patients with and without aspiration to evaluate the effect of aspiration on the aerodigestive microbiome.
Results: Within all patients, lung, oropharyngeal and gastric microbiomes overlap. The degree of similarity is the lowest between the oropharynx and lungs (median Jensen-Shannon distance (JSD) = 0.90), and as high between the stomach and lungs as between the oropharynx and stomach (median JSD = 0.56 for both; p = 0.6). Unlike the oropharyngeal microbiome, lung and gastric communities are highly variable across people and driven primarily by person rather than body site. In patients with aspiration, the lung microbiome more closely resembles oropharyngeal rather than gastric communities and there is greater prevalence of microbial exchange between the lung and oropharynx than between gastric and lung sites (p = 0.04 and 4x10-5, respectively).
Conclusions: The gastric and lung microbiomes display significant overlap in patients with intact airway protective mechanisms while the lung and oropharynx remain distinct. In patients with impaired swallow function and aspiration, the lung microbiome shifts towards oropharyngeal rather than gastric communities. This finding may explain why antireflux surgeries fail to show benefit in pediatric pulmonary outcomes.
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