早期鼻腔微生物群的纵向变化与儿童哮喘的风险
2021/08/24
摘要
目的：尽管气道微生物群是一个高度动态的生态学，但儿童早期气道微生物群的纵向变化在哮喘发展中的作用尚不清楚。我们的目的是调查早期鼻腔微生物群的纵向变化与哮喘发病风险的关系。
方法：在这项前瞻性，以人群位基础的出生队列研究中，我们随访了从出生到7岁的儿童。通过在2,13和24个月时使用16s核糖体RNA基因测试鼻微生物群。我们应用无监督及其学习方法识别2-13个月（主要暴露）和2-24个月（次要暴露）期间的纵向鼻腔微生物群特征，并检查这些特征与7岁时医生诊断哮喘风险的相关性。
结果：在704名儿童的分析队列中，57名（8%）后来发展为哮喘。我们在2至13个月期间确定了4种不同的纵向鼻微生物群特征。在多变量分析中，与2-13个月的持续性莫拉菌优势特征相比，持续性莫拉菌稀疏特征与哮喘风险显著升高相关（校正比值比，2.74；95%CI，1.2-6.27）。在2至24个月期间鼻微生物群的纵向变化与哮喘风险之间观察到类似的关联。
结论：儿童早期鼻腔微生物群纵向模式改变的儿童患哮喘的风险很高。我们的数据指导儿童哮喘一级预防策略的制定（例如，早期识别风险儿童和改变微生物群）。这些观察结果为哮喘的风险调整（例如，微生物群修改）提高了新的途径。
Longitudinal Changes in Early Nasal Microbiota and the Risk of Childhood Asthma
Laura Toivonen, Sinikka Karppinen , Linnea Schuez-Havupalo , Matti Waris , Qiushui He , Kristi L Hoffman , Joseph F Petrosino, Orianne Dumas, Carlos A Camargo Jr , Kohei Hasegawa , Ville Peltola
Abstract
Objectives: Although the airway microbiota is a highly dynamic ecology, the role of longitudinal changes in airway microbiota during early childhood in asthma development is unclear. We aimed to investigate the association of longitudinal changes in early nasal microbiota with the risk of developing asthma.
Methods: In this prospective, population-based birth cohort study, we followed children from birth to age 7 years. The nasal microbiota was tested by using 16S ribosomal RNA gene sequencing at ages 2, 13, and 24 months. We applied an unsupervised machine learning approach to identify longitudinal nasal microbiota profiles during age 2 to 13 months (the primary exposure) and during age 2 to 24 months (the secondary exposure) and examined the association of these profiles with the risk of physician-diagnosed asthma at age 7 years.
Results: Of the analytic cohort of 704 children, 57 (8%) later developed asthma. We identified 4 distinct longitudinal nasal microbiota profiles during age 2 to 13 months. In the multivariable analysis, compared with the persistent Moraxella dominance profile during age 2 to 13 months, the persistent Moraxella sparsity profile was associated with a significantly higher risk of asthma (adjusted odds ratio, 2.74; 95% confidence interval, 1.20-6.27). Similar associations were observed between the longitudinal changes in nasal microbiota during age 2 to 24 months and risk of asthma.
Conclusions: Children with an altered longitudinal pattern in the nasal microbiota during early childhood had a high risk of developing asthma. Our data guide the development of primary prevention strategies (eg, early identification of children at high risk and modification of microbiota) for childhood asthma. These observations present a new avenue for risk modification for asthma (eg, microbiota modification).
目的：尽管气道微生物群是一个高度动态的生态学，但儿童早期气道微生物群的纵向变化在哮喘发展中的作用尚不清楚。我们的目的是调查早期鼻腔微生物群的纵向变化与哮喘发病风险的关系。
方法：在这项前瞻性，以人群位基础的出生队列研究中，我们随访了从出生到7岁的儿童。通过在2,13和24个月时使用16s核糖体RNA基因测试鼻微生物群。我们应用无监督及其学习方法识别2-13个月（主要暴露）和2-24个月（次要暴露）期间的纵向鼻腔微生物群特征，并检查这些特征与7岁时医生诊断哮喘风险的相关性。
结果：在704名儿童的分析队列中，57名（8%）后来发展为哮喘。我们在2至13个月期间确定了4种不同的纵向鼻微生物群特征。在多变量分析中，与2-13个月的持续性莫拉菌优势特征相比，持续性莫拉菌稀疏特征与哮喘风险显著升高相关（校正比值比，2.74；95%CI，1.2-6.27）。在2至24个月期间鼻微生物群的纵向变化与哮喘风险之间观察到类似的关联。
结论：儿童早期鼻腔微生物群纵向模式改变的儿童患哮喘的风险很高。我们的数据指导儿童哮喘一级预防策略的制定（例如，早期识别风险儿童和改变微生物群）。这些观察结果为哮喘的风险调整（例如，微生物群修改）提高了新的途径。
(中日友好医院呼吸与危重症医学科 张清 摘译 林江涛 审校)
(Pediatrics. 2020 Oct;146(4):e20200421. doi: 10.1542/peds.2020-0421)
(Pediatrics. 2020 Oct;146(4):e20200421. doi: 10.1542/peds.2020-0421)
Longitudinal Changes in Early Nasal Microbiota and the Risk of Childhood Asthma
Laura Toivonen, Sinikka Karppinen , Linnea Schuez-Havupalo , Matti Waris , Qiushui He , Kristi L Hoffman , Joseph F Petrosino, Orianne Dumas, Carlos A Camargo Jr , Kohei Hasegawa , Ville Peltola
Abstract
Objectives: Although the airway microbiota is a highly dynamic ecology, the role of longitudinal changes in airway microbiota during early childhood in asthma development is unclear. We aimed to investigate the association of longitudinal changes in early nasal microbiota with the risk of developing asthma.
Methods: In this prospective, population-based birth cohort study, we followed children from birth to age 7 years. The nasal microbiota was tested by using 16S ribosomal RNA gene sequencing at ages 2, 13, and 24 months. We applied an unsupervised machine learning approach to identify longitudinal nasal microbiota profiles during age 2 to 13 months (the primary exposure) and during age 2 to 24 months (the secondary exposure) and examined the association of these profiles with the risk of physician-diagnosed asthma at age 7 years.
Results: Of the analytic cohort of 704 children, 57 (8%) later developed asthma. We identified 4 distinct longitudinal nasal microbiota profiles during age 2 to 13 months. In the multivariable analysis, compared with the persistent Moraxella dominance profile during age 2 to 13 months, the persistent Moraxella sparsity profile was associated with a significantly higher risk of asthma (adjusted odds ratio, 2.74; 95% confidence interval, 1.20-6.27). Similar associations were observed between the longitudinal changes in nasal microbiota during age 2 to 24 months and risk of asthma.
Conclusions: Children with an altered longitudinal pattern in the nasal microbiota during early childhood had a high risk of developing asthma. Our data guide the development of primary prevention strategies (eg, early identification of children at high risk and modification of microbiota) for childhood asthma. These observations present a new avenue for risk modification for asthma (eg, microbiota modification).
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TL1A/DR3轴在嗜酸性粒细胞性哮喘患者ILC2s活化中的作用
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吸入甘露醇的气道高反应性确定了一组高症状负担的非嗜酸性哮喘患者
