Distinct associations of sputum and oral microbiota with atopic, immunologic, and clinical features in mild asthma

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:146

Article

Durack, Juliana¹  Christian, Laura S.^2,3  Nariya, Snehal⁴  Gonzalez, Jeanmarie^2,3  Bhakta, Nirav R.⁴  Ansel, K. Mark^2,3  Beigelman, Avraham^5,6  Castro, Mario⁷  Dyer, Anne-Marie⁸  Israel, Elliot⁹  Kraft, Monica¹⁰  Martin, Richard J.¹¹  Mauger, David T.⁸  Peters, Stephen P.¹²  Rosenberg, Sharon R.¹³  Sorkness, Christine A.¹⁴  Wechsler, Michael E.¹¹  Wenzel, Sally E.¹⁵  White, Steven R.¹⁶  Lynch, Susan, V¹  Boushey, Homer A.⁴  Huang, Yvonne J.¹⁷ 

[1] Univ Calif San Francisco, Dept Med, Div Gastroenterol, San Francisco, CA 94143 USA

[2] Univ Calif San Francisco, Dept Microbiol & Immunol, San Francisco, CA 94143 USA

[3] Univ Calif San Francisco, Sandler Asthma Basic Res Ctr, San Francisco, CA 94143 USA

[4] Univ Calif San Francisco, Dept Med, Div Pulm Crit Care Med, San Francisco, CA 94143 USA

[5] Washington Univ, Sch Med, Div Pediat Allergy Immunol & Pulm Med, St Louis, MO USA

[6] Tel Aviv Univ, Schneider Childrens Med Ctr Israel, Kipper Inst Allergy & Immunol, Tel Aviv, Israel

[7] Washington Univ, Sch Med, Div Pulm & Crit Care Med, St Louis, MO USA

[8] Penn State Univ, Dept Publ Hlth Sci, Hershey, PA USA

[9] Brigham & Womens Hosp, Dept Med, 75 Francis St, Boston, MA 02115 USA

[10] Univ Arizona, Hlth Sci, Tucson, AZ USA

[11] Natl Jewish Hosp, Dept Med, Denver, CO USA

[12] Wake Forest Sch Med, Winston Salem, NC 27101 USA

[13] Northwestern Univ, Dept Med, Chicago, IL 60611 USA

[14] Univ Wisconsin, Dept Med, Madison, WI USA

[15] Univ Pittsburgh, Asthma Inst UPMC UPSOM, Pittsburgh, PA USA

[16] Univ Chicago, Dept Med, 5841 S Maryland Ave, Chicago, IL 60637 USA

[17] Univ Michigan, Dept Internal Med, Div Pulm Crit Care Med, Ann Arbor, MI 48109 USA

关键词: Microbiome;    cytokines;    sputum;    oral;    asthma;    allergic;    corticosteroids;    type 2 inflammation;   

DOI  :  10.1016/j.jaci.2020.03.028

来源: Elsevier

【 摘 要 】

Background: Whether microbiome characteristics of induced sputum or oral samples demonstrate unique relationships to features of atopy or mild asthma in adults is unknown. Objective: We sought to determine sputum and oral microbiota relationships to clinical or immunologic features in mild atopic asthma and the impact on the microbiota of inhaled corticosteroid (ICS) treatment administered to ICS-naive subjects with asthma. Methods: Bacterial microbiota profiles were analyzed in induced sputum and oral wash samples from 32 subjects with mild atopic asthma before and after inhaled fluticasone treatment, 18 atopic subjects without asthma, and 16 nonatopic healthy subjects in a multicenter study (NCT01537133). Associations with clinical and immunologic features were examined, including markers of atopy, type 2 inflammation, immune cell populations, and cytokines. Results: Sputum bacterial burden inversely associated with bronchial expression of type 2 (T2)-related genes. Differences in specific sputum microbiota also associated with T2-low asthma phenotype, a subgroup of whom displayed elevations in lung inflammatory mediators and reduced sputum bacterial diversity. Differences in specific oral microbiota were more reflective of atopic status. After ICS treatment of patients with asthma, the compositional structure of sputum microbiota showed greater deviation from baseline in ICS nonresponders than in ICS responders. Conclusions: Novel associations of sputum and oral microbiota to immunologic features were observed in this cohort of subjects with or without ICS-naive mild asthma. These findings confirm and extend our previous report of reduced bronchial bacterial burden and compositional complexity in subjects with T2-high asthma, with additional identification of a T2-low subgroup with a distinct microbiota-immunologic relationship.

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