OBJECTIVE: To investigate the alteration of the lower respiratory tract microbiome in severe aspiration pneumonia patients and explore the potential correlation between microbiome components and inflammatory response.
METHODS: Patients in the severe aspiration pneumonia group and control group were enrolled from the intensive care unit of Jinshan Hospital, Fudan University between December 31, 2020 and August 19, 2021. Sputum specimens were collected from all participants and subsequently subjected to 16S rDNA high throughput sequencing technology. The concentration of inflammatory cytokines in serum was measured using enzyme-linked immunosorbent assay (ELISA) kits, and collected data including patients\' demographic information, clinical data, and laboratory examination results were recorded for further analysis.
RESULTS: Alteration in the lower respiratory tract microbiome was observed in severe aspiration pneumonia. Compared to the control group, a significant decrease in the relative abundance of Firmicutes was found at the phylum level (P < 0.01). At the family level, the relative abundance of Corynebacteriaceae, Enterobacteriaceae and Enterococcaceae increased significantly (P < 0.001, P < 0.05, P < 0.01). There were no significant differences in community diversity of the lower respiratory tract between the two groups. Patients in the severe aspiration pneumonia group exhibited significantly higher levels of inflammation compared to those in the control group. Correlation analysis showed that the relative abundance of Corynebacteriaceae was positively correlated with the expression level of IL-1β and IL-18 (P = 0.002, P = 0.02); the relative abundance of Enterobacteriaceae was negatively correlated with IL-4 (P = 0.011); no other significant correlations have been identified between microbiome and inflammatory indicators thus far (P > 0.05).
CONCLUSIONS: Alteration of the lower respiratory tract microbiome is critically involved in inflammation and disease progression in severe cases of aspiration pneumonia. The potential inflammation regulation properties of the microbiome hold promising value for developing novel therapeutic approaches aimed at mitigating the severity of the disease.
目的:了解重症吸入性肺炎患者下呼吸道菌群的变化,探讨菌群成分与炎症反应的潜在相关性。
方法:从金山医院重症监护室收集重症吸入性肺炎组和对照组患者。复旦大学,2020年12月31日至,2021年8月19日。从所有参与者收集痰标本,随后进行16SrDNA高通量测序技术。采用酶联免疫吸附试验(ELISA)试剂盒测定血清中炎性细胞因子的浓度,并收集了包括患者人口统计信息在内的数据,临床资料,并记录实验室检查结果以供进一步分析.
结果:在严重吸入性肺炎中观察到下呼吸道微生物组的改变。与对照组相比,在门水平上发现Firmicutes的相对丰度显着下降(P<0.01)。在家庭层面,棒杆菌科的相对丰度,肠杆菌科和肠球菌科细菌明显增多(P<0.001,P<0.05,P<0.01)。两组下呼吸道群落多样性差异无统计学意义。严重吸入性肺炎组患者的炎症水平明显高于对照组。相关性分析显示,棒状杆菌的相对丰度与IL-1β和IL-18的表达水平呈正相关(P=0.002,P=0.02);肠杆菌的相对丰度与IL-4呈负相关(P=0.011);微生物群与炎症指标之间没有其他显着相关性(P>0.05)。
结论:在严重的吸入性肺炎病例中,下呼吸道微生物组的改变与炎症和疾病进展密切相关。微生物组的潜在炎症调节特性对于开发旨在减轻疾病严重程度的新型治疗方法具有有希望的价值。