哮喘儿童上呼吸道微生物群和哮喘控制丧失的关系
2020/01/07
摘要
气道微生物组在哮喘的病理生理中具有重要作用。但是，关于哮喘儿童的气道微生物组，哮喘控制丧失和严重发作之间的关系，人们所知甚少。本文我们报告了微生物群的动态模式和组成与哮喘发作有关。在一年两个时间点的临床试验中，我们纵向收集了鼻腔吹气样本（n = 319）：哮喘控制以及早期失去哮喘控制（黄色区域（YZ））的情况下的随机化。结果显示其微生物群在RD以共性棒状杆菌+多毛颗粒群簇占优势的受试者中YZ的发生率最低（p = 0.005），并且至少有2次发生YZ的时间较长（p = 0.03）。气道微生物群已从随机化转变为YZ。从随机化的棒状杆菌+多毛颗粒群簇转变为YZ时的莫拉氏菌簇引起严重哮喘急性发作的风险最大（p = 0.04）。棒状杆菌在YZ的相对丰度与严重发作成反比（p = 0.002）。
The upper-airway microbiota and loss of asthma control among asthmatic children.
Zhou Y, Jackson D, Bacharier LB, Mauger D, Boushey H, Castro M, Durack J, Huang Y, Lemanske RF Jr, Storch GA, Weinstock GM, Wylie K, Covar R, Fitzpatrick AM, Phipatanakul W, Robison RG, Beigelman A.
Abstract
The airway microbiome has an important role in asthma pathophysiology. However, little is known on the relationships between the airway microbiome of asthmatic children, loss of asthma control, and severe exacerbations. Here we report that the microbiota's dynamic patterns and compositions are related to asthma exacerbations. We collected nasal blow samples (n = 319) longitudinally during a clinical trial at 2 time-points within one year: randomization when asthma is under control, and at time of early loss of asthma control (yellow zone (YZ)). We report that participants whose microbiota was dominated by the commensal Corynebacterium + Dolosigranulum cluster at RD experience the lowest rates of YZs (p = 0.005) and have longer time to develop at least 2 episodes of YZ (p = 0.03). The airway microbiota have changed from randomization to YZ. A switch from the Corynebacterium + Dolosigranulum cluster at randomization to the Moraxella- cluster at YZ poses the highest risk of severe asthma exacerbation (p = 0.04). Corynebacterium's relative abundance at YZ is inversely associated with severe exacerbation (p = 0.002).
气道微生物组在哮喘的病理生理中具有重要作用。但是，关于哮喘儿童的气道微生物组，哮喘控制丧失和严重发作之间的关系，人们所知甚少。本文我们报告了微生物群的动态模式和组成与哮喘发作有关。在一年两个时间点的临床试验中，我们纵向收集了鼻腔吹气样本（n = 319）：哮喘控制以及早期失去哮喘控制（黄色区域（YZ））的情况下的随机化。结果显示其微生物群在RD以共性棒状杆菌+多毛颗粒群簇占优势的受试者中YZ的发生率最低（p = 0.005），并且至少有2次发生YZ的时间较长（p = 0.03）。气道微生物群已从随机化转变为YZ。从随机化的棒状杆菌+多毛颗粒群簇转变为YZ时的莫拉氏菌簇引起严重哮喘急性发作的风险最大（p = 0.04）。棒状杆菌在YZ的相对丰度与严重发作成反比（p = 0.002）。
(中日友好医院呼吸与危重症医学科 王瑞茵 摘译 林江涛 审校)
(Nat Commun. 2019 Dec 16;10(1):5714. doi: 10.1038/s41467-019-13698-x.)
(Nat Commun. 2019 Dec 16;10(1):5714. doi: 10.1038/s41467-019-13698-x.)
The upper-airway microbiota and loss of asthma control among asthmatic children.
Zhou Y, Jackson D, Bacharier LB, Mauger D, Boushey H, Castro M, Durack J, Huang Y, Lemanske RF Jr, Storch GA, Weinstock GM, Wylie K, Covar R, Fitzpatrick AM, Phipatanakul W, Robison RG, Beigelman A.
Abstract
The airway microbiome has an important role in asthma pathophysiology. However, little is known on the relationships between the airway microbiome of asthmatic children, loss of asthma control, and severe exacerbations. Here we report that the microbiota's dynamic patterns and compositions are related to asthma exacerbations. We collected nasal blow samples (n = 319) longitudinally during a clinical trial at 2 time-points within one year: randomization when asthma is under control, and at time of early loss of asthma control (yellow zone (YZ)). We report that participants whose microbiota was dominated by the commensal Corynebacterium + Dolosigranulum cluster at RD experience the lowest rates of YZs (p = 0.005) and have longer time to develop at least 2 episodes of YZ (p = 0.03). The airway microbiota have changed from randomization to YZ. A switch from the Corynebacterium + Dolosigranulum cluster at randomization to the Moraxella- cluster at YZ poses the highest risk of severe asthma exacerbation (p = 0.04). Corynebacterium's relative abundance at YZ is inversely associated with severe exacerbation (p = 0.002).
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二甲双胍的使用与哮喘急性发作风险的关系，一项基于索赔的队列研究
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严重哮喘的随机对照试验：通过表型或定型进行选择
