目的:慢性疾病中的微生物,包括慢性鼻-鼻窦炎(CRS),最近经历了快速的进步。下一代测序(NGS)技术的引入已经产生了有关这些疾病的细菌学的重要临床见解。我们回顾了使用16SrRNA测序来专门研究CRS患者在各种情况下的微生物区系特征的研究。
方法:使用CINAHL的文献综述,MEDLINE,pubmed,和Cochrane数据库.包括在1995年1月1日至2015年10月31日之间发表的CRS标本上使用16S测序技术的论文。仅限于健康对照的研究被排除。
结果:与已发表的使用非NGS技术的研究一致,通常从CRS患者的鼻窦中确定的主要属包括葡萄球菌,丙酸杆菌,和棒状杆菌。在许多研究中,与对照组相比,CRS患者的微生物组具有较低的细菌多样性。也与非基于NGS的研究一致,葡萄球菌被认为是一个重要的属,高度定植的患者手术结果较差。观察到抗生素对CRS微生物组的影响的相互矛盾的报道。取样方法进行了很好的研究,审查的许多研究未能包括重要的方法细节。
结论:虽然16S测序是一种新颖的微生物实验室方法,目前的研究证实了我们对CRS细菌学的现有理解,但没有提供显著的额外临床见解.用更复杂的NGS方法补充16S研究,同时开发旨在改变被破坏的CRS微生物组的强大临床研究,将为研究提供进一步的临床见解和开发新的治疗靶标的机会。
OBJECTIVE: Microbiomics in chronic diseases, including chronic rhinosinusitis (CRS), have undergone rapid advances in recent times. The introduction of Next Generation Sequencing (NGS) technology has produced significant clinical insights regarding the bacteriology of these conditions. We
review studies that have used 16S rRNA sequencing to specifically investigate the microbiota profiles of patients with CRS in a variety of contexts.
METHODS: Literature
review using the CINAHL, MEDLINE, PUBMED, and the Cochrane databases. Papers utilizing 16S-sequencing technology on CRS specimens published between January 1, 1995, and October 31, 2015, were included. Studies limited to only healthy controls were excluded.
RESULTS: Consistent with published studies using non-NGS techniques, the main genera commonly identified from the sinuses of CRS patients included Staphylococcus, Propionibacterium, and Corynebacterium. The microbiome of CRS patients had lower bacterial diversity compared to controls in a number of studies. Also consistent with non-NGS-based studies, Staphylococcus was implicated as an important genus, with highly colonized patients having worse surgical outcomes. Conflicting reports of antibiotic effects on the CRS microbiome were observed. Sampling methods were well investigated, many of the studies reviewed failed to include important methodological detail.
CONCLUSIONS: While 16S sequencing is a novel microbiological laboratory method, current studies have confirmed our existing understanding of bacteriology of CRS without providing significant additional clinical insight. Complementing 16S studies with more complex NGS methods while developing robust clinical studies aimed at shifting the disrupted CRS microbiome will provide researches with the opportunity to derive further clinical insight and develop new therapeutic targets.