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McCauley K, Durack J, Valladares R, Fadrosh DW, Lin DL, Calatroni A, LeBeau PK, Tran HT, Fujimura KE, LaMere B, Merana G, Lynch K, Cohen RT, Pongracic J, Khurana Hershey GK, Kercsmar CM, Gill M, Liu AH, Kim H, Kattan M, Teach SJ, Togias A, Boushey HA, Gern JE, Jackson DJ, Lynch SV. Distinct nasal airway bacterial microbiotas differentially relate to exacerbation in pediatric patients with asthma. J Allergy Clin Immunol 2019; 144:1187-1197. [PMID: 31201890 PMCID: PMC6842413 DOI: 10.1016/j.jaci.2019.05.035] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 05/21/2019] [Accepted: 05/28/2019] [Indexed: 11/15/2022]
Abstract
BACKGROUND In infants, distinct nasopharyngeal bacterial microbiotas differentially associate with the incidence and severity of acute respiratory tract infection and childhood asthma development. OBJECTIVE We hypothesized that distinct nasal airway microbiota structures also exist in children with asthma and relate to clinical outcomes. METHODS Nasal secretion samples (n = 3122) collected after randomization during the fall season from children with asthma (6-17 years, n = 413) enrolled in a trial of omalizumab (anti-IgE) underwent 16S rRNA profiling. Statistical analyses with exacerbation as the primary outcome and rhinovirus infection and respiratory illnesses as secondary outcomes were performed. Using A549 epithelial cells, we assessed nasal isolates of Moraxella, Staphylococcus, and Corynebacterium species for their capacity to induce epithelial damage and inflammatory responses. RESULTS Six nasal airway microbiota assemblages, each dominated by Moraxella, Staphylococcus, Corynebacterium, Streptococcus, Alloiococcus, or Haemophilus species, were observed. Moraxella and Staphylococcus species-dominated microbiotas were most frequently detected and exhibited temporal stability. Nasal microbiotas dominated by Moraxella species were associated with increased exacerbation risk and eosinophil activation. Staphylococcus or Corynebacterium species-dominated microbiotas were associated with reduced respiratory illness and exacerbation events, whereas Streptococcus species-dominated assemblages increased the risk of rhinovirus infection. Nasal microbiota composition remained relatively stable despite viral infection or exacerbation; only a few taxa belonging to the dominant genera exhibited relative abundance fluctuations during these events. In vitro, Moraxella catarrhalis induced significantly greater epithelial damage and inflammatory cytokine expression (IL-33 and IL-8) compared with other dominant nasal bacterial isolates tested. CONCLUSION Distinct nasal airway microbiotas of children with asthma relate to the likelihood of exacerbation, rhinovirus infection, and respiratory illnesses during the fall season.
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Affiliation(s)
- Kathryn McCauley
- Department of Medicine, University of California, San Francisco, Calif
| | - Juliana Durack
- Department of Medicine, University of California, San Francisco, Calif
| | | | - Douglas W Fadrosh
- Department of Medicine, University of California, San Francisco, Calif
| | - Din L Lin
- Department of Medicine, University of California, San Francisco, Calif
| | | | | | | | - Kei E Fujimura
- Department of Medicine, University of California, San Francisco, Calif
| | - Brandon LaMere
- Department of Medicine, University of California, San Francisco, Calif
| | - Geil Merana
- Department of Medicine, University of California, San Francisco, Calif
| | - Kole Lynch
- Department of Medicine, University of California, San Francisco, Calif
| | | | | | | | - Carolyn M Kercsmar
- Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio
| | - Michelle Gill
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Tex; Department of Immunology, University of Texas Southwestern Medical Center, Dallas, Tex
| | - Andrew H Liu
- Department of Pedatrics and Pulmonology Medicine, National Jewish Health, Denver, Colo; Children's Hospital Colorado and University of Colorado School of Medicine, Aurora, Colo
| | - Haejin Kim
- Department of Internal Medicine, Division of Allergy and Immunology, Henry Ford Health System, Detroit, Mich
| | - Meyer Kattan
- College of Physicians and Surgeons, Columbia University, New York, NY
| | | | - Alkis Togias
- National Institute of Allergy and Infectious Diseases, Bethesda, Md
| | - Homer A Boushey
- Department of Medicine, University of California, San Francisco, Calif
| | - James E Gern
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
| | - Daniel J Jackson
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis.
| | - Susan V Lynch
- Department of Medicine, University of California, San Francisco, Calif.
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Kolbe AR, Castro-Nallar E, Preciado D, Pérez-Losada M. Altered Middle Ear Microbiome in Children With Chronic Otitis Media With Effusion and Respiratory Illnesses. Front Cell Infect Microbiol 2019; 9:339. [PMID: 31637220 PMCID: PMC6787523 DOI: 10.3389/fcimb.2019.00339] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 09/18/2019] [Indexed: 11/25/2022] Open
Abstract
Chronic otitis media with effusion (COME) is a common childhood disease characterized by an accumulation of fluid behind the eardrum. COME often requires surgical intervention and can also lead to significant hearing loss and subsequent learning disabilities. Recent characterization of the middle ear fluid (MEF) microbiome in pediatric patients has led to an improved understanding of the microbiota present in the middle ear during COME. However, it is not currently known how the MEF microbiome might vary due to other conditions, particularly respiratory disorders. Here, we apply an amplicon sequence variant (ASV) pipeline to MEF 16S rRNA high-throughput sequencing data from 50 children with COME (ages 3–176 months) undergoing tube placement. We achieve a more detailed taxonomic resolution than previously reported, including species and genus level resolution. Additionally, we provide the first report of the functional roles of the MEF microbiome and demonstrate that despite high taxonomic diversity, the functional capacity of the MEF microbiome remains uniform between patients. Furthermore, we analyze microbiome differences between children with COME with and without a history of lower airway disease (i.e., asthma or bronchiolitis). The MEF microbiome was less diverse in participants with lower airway disease than in patients without, and phylogenetic β-diversity (weighted UniFrac) was significantly different based on lower airway disease status. Differential abundance between patients with lower airway disease and those without was observed for the genera Haemophilus, Moraxella, Staphylococcus, Alloiococcus, and Turicella. These findings support previous suggestions of a link between COME and respiratory illnesses and emphasize the need for future study of the middle ear and respiratory tract microbiomes in diseases such as asthma and bronchiolitis.
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Affiliation(s)
- Allison R Kolbe
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, Computational Biology Institute, The George Washington University, Washington, DC, United States
| | - Eduardo Castro-Nallar
- Facultad de Ciencias de la Vida, Center for Bioinformatics and Integrative Biology, Universidad Andrés Bello, Santiago, Chile
| | - Diego Preciado
- Division of Pediatric Otolaryngology, Sheikh Zayed Institute, Children's National Health System, Washington, DC, United States
| | - Marcos Pérez-Losada
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, Computational Biology Institute, The George Washington University, Washington, DC, United States.,CIBIO-InBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, Universidade Do Porto, Vairão, Portugal
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Shukla SD, Shastri MD, Chong WC, Dua K, Budden KF, Mahmood MQ, Hansbro NG, Keely S, Eri R, Patel RP, Peterson GM, Hansbro PM. Microbiome-focused asthma management strategies. Curr Opin Pharmacol 2019; 46:143-149. [PMID: 31357048 DOI: 10.1016/j.coph.2019.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 06/24/2019] [Accepted: 06/24/2019] [Indexed: 12/11/2022]
Abstract
Asthma is a common, heterogeneous and serious disease with high prevalence globally. Poorly controlled, steroid-resistant asthma is particularly important as there are no effective therapies and it exerts substantial healthcare and societal burden. The role of microbiomes, particularly in chronic diseases has generated considerable interest in recent times. Existing evidence clearly demonstrates an association between asthma initiation and the microbiome, both respiratory and gastro-intestinal, although its' roles are poorly understood when assessing the asthma progression or heterogeneity (i.e. phenotypes/endotypes) across different geographical locations. Moreover, modulating microbiomes could be preventive and/or therapeutic in patients with asthma warrants urgent attention. Here, we review recent advances in assessing the role of microbiomes in asthma and present the challenges associated with the potential therapeutic utility of modifying microbiomes in management.
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Affiliation(s)
- Shakti D Shukla
- Priority Research Centre for Healthy Lungs, School of Biomedical Sciences and Pharmacy, Hunter Medical Research Institute & University of Newcastle, Callaghan, NSW, Australia
| | - Madhur D Shastri
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Wai Chin Chong
- Department of Molecular and Translational Science, Monash University, Clayton, Australia; Centre for Cancer Research, Hudson Institute of Medical Research, Clayton, Australia
| | - Kamal Dua
- Priority Research Centre for Healthy Lungs, School of Biomedical Sciences and Pharmacy, Hunter Medical Research Institute & University of Newcastle, Callaghan, NSW, Australia; Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Kurtis F Budden
- Priority Research Centre for Healthy Lungs, School of Biomedical Sciences and Pharmacy, Hunter Medical Research Institute & University of Newcastle, Callaghan, NSW, Australia
| | - Malik Quasir Mahmood
- Medicine, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Nicole G Hansbro
- Priority Research Centre for Healthy Lungs, School of Biomedical Sciences and Pharmacy, Hunter Medical Research Institute & University of Newcastle, Callaghan, NSW, Australia; Centre for inflammation, Centenary Institute, Sydney, and School of Life Sciences, University of Technology, Ultimo, NSW, Australia
| | - Simon Keely
- Priority Research Centre for Healthy Lungs, School of Biomedical Sciences and Pharmacy, Hunter Medical Research Institute & University of Newcastle, Callaghan, NSW, Australia
| | - Rajaraman Eri
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Australia
| | - Rahul P Patel
- Pharmacy, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Gregory M Peterson
- Pharmacy, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Philip M Hansbro
- Priority Research Centre for Healthy Lungs, School of Biomedical Sciences and Pharmacy, Hunter Medical Research Institute & University of Newcastle, Callaghan, NSW, Australia; Centre for inflammation, Centenary Institute, Sydney, and School of Life Sciences, University of Technology, Ultimo, NSW, Australia.
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