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Lunjani N, Satitsuksanoa P, Lukasik Z, Sokolowska M, Eiwegger T, O'Mahony L. Recent developments and highlights in mechanisms of allergic diseases: Microbiome. Allergy 2018; 73:2314-2327. [PMID: 30325537 DOI: 10.1111/all.13634] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 09/11/2018] [Accepted: 10/05/2018] [Indexed: 12/13/2022]
Abstract
All body surfaces are exposed to a wide variety of microbes, which significantly influence immune reactivity within the host. This review provides an update on some of the critical novel findings that have been published on the influence of the microbiome on atopic dermatitis, food allergy and asthma. Microbial dysbiosis has consistently been observed in the skin, gut and lungs of patients with atopic dermatitis, food allergy and asthma, respectively, and the role of specific microbes in allergic disorders is being intensively investigated. However, many of these discoveries have yet to be translated into routine clinical practice.
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Affiliation(s)
- Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
- University of Cape Town; Cape Town South Africa
| | | | - Zuzanna Lukasik
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research (SIAF); University of Zurich; Davos Switzerland
| | - Thomas Eiwegger
- Program in Translational Medicine; The Hospital for Sick Children; Toronto Ontario Canada
- Department of Immunology; The University of Toronto; Toronto Ontario Canada
- Division of Immunology and Allergy; Food allergy and Anaphylaxis Program; The Department of Paediatrics; The Hospital for Sick Children; Toronto Ontario Canada
| | - Liam O'Mahony
- Departments of Medicine and Microbiology; APC Microbiome Ireland; National University of Ireland; Cork Ireland
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Early-Life Formation of the Microbial and Immunological Environment of the Human Airways. Cell Host Microbe 2018; 24:857-865.e4. [DOI: 10.1016/j.chom.2018.10.019] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 08/15/2018] [Accepted: 10/29/2018] [Indexed: 12/15/2022]
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Severe bronchiolitis profiles and risk of recurrent wheeze by age 3 years. J Allergy Clin Immunol 2018; 143:1371-1379.e7. [PMID: 30240701 DOI: 10.1016/j.jaci.2018.08.043] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/02/2018] [Accepted: 08/21/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND A better understanding of bronchiolitis heterogeneity might help clarify its relationship with the development of recurrent wheezing and asthma. OBJECTIVES We sought to identify severe bronchiolitis profiles using a clustering approach and to investigate for the first time their association with allergy/inflammatory biomarkers, nasopharyngeal microbiota, and development of recurrent wheezing by age 3 years. METHODS We analyzed data from a prospective, 17-center US cohort study of 921 infants (age <1 year) hospitalized with bronchiolitis (2011-2014 winters) with posthospitalization follow-up. Severe bronchiolitis profiles at baseline (hospitalization) were determined by using latent class analysis based on clinical factors and viral etiology. Blood biomarkers and nasopharyngeal microbiota profiles were determined by using samples collected within 24 hours of hospitalization. Recurrent wheezing by age 3 years was defined based on parental report of breathing problem episodes after discharge. RESULTS Three severe bronchiolitis profiles were identified: profile A (15%), which was characterized by a history of breathing problems/eczema during infancy and non-respiratory syncytial virus (mostly rhinovirus) infection; profile B (49%), which has the largest probability of respiratory syncytial virus infection and resembled classic respiratory syncytial virus-induced bronchiolitis; and profile C (36%), which was composed of the most severely ill group. Profile A infants had higher eosinophil counts, higher cathelicidin levels, and increased proportions of Haemophilus-dominant or Moraxella-dominant microbiota profiles. Compared with profile B, we observed significantly increased risk of recurrent wheezing in children with profile A (hazard ratio, 2.64; 95% CI, 1.90-3.68) and, to a lesser extent, with profile C (hazard ratio, 1.51; 95% CI, 1.14-2.01). CONCLUSION Although longer follow-up is needed, our results might help identify, among children hospitalized for bronchiolitis, subgroups with particularly increased risk of asthma.
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Hahn A, Warnken S, Pérez-Losada M, Freishtat RJ, Crandall KA. Microbial diversity within the airway microbiome in chronic pediatric lung diseases. INFECTION, GENETICS AND EVOLUTION : JOURNAL OF MOLECULAR EPIDEMIOLOGY AND EVOLUTIONARY GENETICS IN INFECTIOUS DISEASES 2018; 63:316-325. [PMID: 29225146 PMCID: PMC5992000 DOI: 10.1016/j.meegid.2017.12.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/22/2017] [Accepted: 12/07/2017] [Indexed: 12/31/2022]
Abstract
The study of the airway microbiome in children is an area of emerging research, especially in relation to the role microbial diversity may play in acute and chronic inflammation. Three such pediatric airway diseases include cystic fibrosis, asthma, and chronic lung disease of prematurity. In cystic fibrosis, the presence of Pseudomonas spp. is associated with decreased microbial diversity. Decreasing microbial diversity is also associated with poor lung function. In asthma, early viral infections appear to drive changes in bacterial diversity which may be associated with asthma risk. Premature infants with Ureaplasma spp. are at higher risk for chronic lung disease due to inflammation. Microbiome changes due to prematurity also appear to affect the inflammatory response to viral infections post-natally. Importantly, microbial diversity can be measured using metataxonomic (e.g., 16S rRNA sequencing) and metagenomic (e.g., shotgun sequencing) approaches. A metagenomics approach may be preferable as it can provide further granularity of the sample composition, identifying the bacterial species or strain, information on additional microbial components, including fungal and viral components, information about functional genomics of the microbiome, and information about antimicrobial resistance mutations. Future studies of pediatric airway diseases incorporating these techniques may provide evidence for new treatment approaches for these vulnerable patient populations.
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Affiliation(s)
- Andrea Hahn
- Division of Infectious Diseases, Children's National Health System (CNHS), Washington, D.C. 20010, USA; Department of Pediatrics, George Washington University (GWU) School of Medicine and Health Sciences (SMHS), Washington, D.C. 20052, USA.
| | - Stephanie Warnken
- Computational Biology Institute, Milken Institute School of Public Health, GWU, Washington, D.C. 20052, USA
| | - Marcos Pérez-Losada
- Computational Biology Institute, Milken Institute School of Public Health, GWU, Washington, D.C. 20052, USA; CIBIO-InBIO, Universidade do Porto, Campus Agrário de Vairão, Vairão 4485-661, Portugal
| | - Robert J Freishtat
- Department of Pediatrics, George Washington University (GWU) School of Medicine and Health Sciences (SMHS), Washington, D.C. 20052, USA; Division of Emergency Medicine, CNHS, Washington, D.C. 20010, USA
| | - Keith A Crandall
- Computational Biology Institute, Milken Institute School of Public Health, GWU, Washington, D.C. 20052, USA
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105
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Ren CL, Muston HN, Yilmaz O, Noah TL. Pediatric Pulmonology year in review 2017: Part 3. Pediatr Pulmonol 2018; 53:1152-1158. [PMID: 29806188 DOI: 10.1002/ppul.24052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 04/24/2018] [Indexed: 11/10/2022]
Abstract
Pediatric Pulmonology publishes original research, reviews, and case reports related to a wide range of children's respiratory disorders. We here summarize the past year's publications in our major topic areas, in the context of selected literature in these areas from other journals relevant to our discipline. This review (Part 3 of a 5-part series) covers selected articles on asthma, physiology/lung function testing, and respiratory infections.
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Affiliation(s)
- Clement L Ren
- Riley Children's Hospital, Indiana University School of Medicine, Department of Pediatrics, Indianapolis, Indiana
| | - Heather N Muston
- Riley Children's Hospital, Indiana University School of Medicine, Department of Pediatrics, Indianapolis, Indiana
| | - Ozge Yilmaz
- Pediatric Allergy and Pulmonology, Celal Bayar University Department of Pediatrics, Manisa, Turkey
| | - Terry L Noah
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Costa AN, Costa FMD, Campos SV, Salles RK, Athanazio RA. The pulmonary microbiome: challenges of a new paradigm. ACTA ACUST UNITED AC 2018; 44:424-432. [PMID: 30066739 PMCID: PMC6467588 DOI: 10.1590/s1806-37562017000000209] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 07/16/2017] [Indexed: 01/06/2023]
Abstract
The study of the human microbiome-and, more recently, that of the respiratory system-by means of sophisticated molecular biology techniques, has revealed the immense diversity of microbial colonization in humans, in human health, and in various diseases. Apparently, contrary to what has been believed, there can be nonpathogenic colonization of the lungs by microorganisms such as bacteria, fungi, and viruses. Although this physiological lung microbiome presents low colony density, it presents high diversity. However, some pathological conditions lead to a loss of that diversity, with increasing concentrations of some bacterial genera, to the detriment of others. Although we possess qualitative knowledge of the bacteria present in the lungs in different states of health or disease, that knowledge has advanced to an understanding of the interaction of this microbiota with the local and systemic immune systems, through which it modulates the immune response. Given this intrinsic relationship between the microbiota and the lungs, studies have put forth new concepts about the pathophysiological mechanisms of homeostasis in the respiratory system and the potential dysbiosis in some diseases, such as cystic fibrosis, COPD, asthma, and interstitial lung disease. This departure from the paradigm regarding knowledge of the lung microbiota has made it imperative to improve understanding of the role of the microbiome, in order to identify possible therapeutic targets and to develop innovative clinical approaches. Through this new leap of knowledge, the results of preliminary studies could translate to benefits for our patients.
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Affiliation(s)
- André Nathan Costa
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Felipe Marques da Costa
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Silvia Vidal Campos
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Roberta Karla Salles
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Rodrigo Abensur Athanazio
- . Divisão de Pneumologia, Instituto do Coração - InCor - Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
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Abstract
The original version of the hygiene hypothesis suggested that infections transmitted early in life by "unhygienic contact" prevented allergies. Examples were endemic fecal-oral infections by viral, bacterial, or protozoic pathogens, such as hepatitis A virus, Helicobacter pylori, or Toxoplasma gondii. Later, this concept also included microorganisms beyond pathogens, such as commensals and symbionts, and the hygiene hypothesis was extended to inflammatory diseases in general. An impressive illustration of the hygiene hypothesis was found in the consistent farm effect on asthma and allergies, which has partly been attributed to immunomodulatory properties of endotoxin as emitted by livestock. Assessment of environmental microorganisms by molecular techniques suggested an additional protective effect of microbial diversity on asthma beyond atopy. Whether microbial diversity stands for a higher probability to encounter protective clusters of microorganisms or whether it is a proxy of a balanced environmental exposure remains elusive. Diversity of the mucosal microbiome of the upper airways probably reflects an undisturbed balance of beneficial microorganisms and pathogens, such as Moraxella catarrhalis, which has been associated with subsequent development of asthma and pneumonia. In addition, specific fermenters of plant fibers, such as the genera Ruminococcus and Bacteroides, have been implied in asthma protection through production of short-chain fatty acids, volatile substances with the capability to reduce T-helper cell type 2-mediated allergic airway inflammation. Evolutionary thinking may offer a key to understanding noncommunicable inflammatory diseases as delayed adaptation to a world of fast and profound environmental changes. Better adaptation may be fostered by growing insight into the interplay between man and microbiome and an adequate choice of the environmental exposure.
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Abstract
The introduction of 16s ribosomal RNA sequencing as a nonculture technique has led to the discovery of the presence of microbiota in the lower airways of healthy individuals. These bacterial communities may originate from the mouth and nasopharynx or from the environment by inhalation. The microbial composition of the lower airways may be modulated by dietary factors, antibiotic therapy, and microbial infections, particularly in early life. In addition, circulatory products from gut microbiota may influence the lung microbiota to maintain mucosal immunity. Recent studies have revealed that, in asthma, the lower airway microbiota show reduced diversity and community composition that is linked to severity and inflammatory phenotype. There is also a greater prevalence of proteobacteria, including Haemophilus, in symptomatic asthma. Microbial dysbiosis may contribute to both the inception and progression of asthma in infants and children, and to corticosteroid resistance in asthma. A better understanding of the regulation of the lung and gut microbiota in asthma may pave the way for targeting microbiota to prevent and treat asthma.
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Haspeslagh E, Heyndrickx I, Hammad H, Lambrecht BN. The hygiene hypothesis: immunological mechanisms of airway tolerance. Curr Opin Immunol 2018; 54:102-108. [PMID: 29986301 PMCID: PMC6202673 DOI: 10.1016/j.coi.2018.06.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 06/14/2018] [Indexed: 02/06/2023]
Abstract
Microbial and environmental signals set tonic activation status of barrier tissues. Signaling from barrier tissues licenses dendritic cells to induce T helper 2 cells. Pulmonary immune system in early-life prone to asthma development. Mechanistic understanding needed to translate epidemiological findings in therapies.
The hygiene hypothesis was initially proposed as an explanation for the alarming rise in allergy prevalence in the last century. The immunological idea behind this hypothesis was a lack of infections associated with a Western lifestyle and a consequential reduction in type 1 immune responses. It is now understood that the development of tolerance to allergens depends on microbial colonization and immunostimulatory environmental signals during early-life or passed on by the mother. These environmental cues are sensed and integrated by barrier epithelial cells of the lungs and possibly skin, which in turn instruct dendritic cells to regulate or impede adaptive T cell responses. Recent reports also implicate immunoregulatory macrophages as powerful suppressors of allergy by the microbiome. We propose that loss of adequate microbial stimulation due to a Western lifestyle may result in hypersensitive barrier tissues and the observed rise in type 2 allergic disease.
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Affiliation(s)
- Eline Haspeslagh
- Laboratory of Immunoregulation and Mucosal Immunology, VIB Center for Inflammation Research, Technologiepark 927, B-9052 Ghent (Zwijnaarde), Belgium; Department of Biomedical Molecular Biology, Ghent University, Technologiepark 927, B-9052 Ghent (Zwijnaarde), Belgium; Department of Internal Medicine, Ghent University, De Pintelaan 185 K12, B-9000 Ghent, Belgium
| | - Ines Heyndrickx
- Laboratory of Immunoregulation and Mucosal Immunology, VIB Center for Inflammation Research, Technologiepark 927, B-9052 Ghent (Zwijnaarde), Belgium; Department of Internal Medicine, Ghent University, De Pintelaan 185 K12, B-9000 Ghent, Belgium
| | - Hamida Hammad
- Laboratory of Immunoregulation and Mucosal Immunology, VIB Center for Inflammation Research, Technologiepark 927, B-9052 Ghent (Zwijnaarde), Belgium; Department of Internal Medicine, Ghent University, De Pintelaan 185 K12, B-9000 Ghent, Belgium.
| | - Bart N Lambrecht
- Laboratory of Immunoregulation and Mucosal Immunology, VIB Center for Inflammation Research, Technologiepark 927, B-9052 Ghent (Zwijnaarde), Belgium; Department of Internal Medicine, Ghent University, De Pintelaan 185 K12, B-9000 Ghent, Belgium; Department of Pulmonary Medicine, ErasmusMC, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
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Sitarik A, Havstad S, Levin A, Lynch SV, Fujimura K, Ownby D, Johnson C, Wegienka G. Dog introduction alters the home dust microbiota. INDOOR AIR 2018; 28:539-547. [PMID: 29468742 PMCID: PMC6003855 DOI: 10.1111/ina.12456] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 02/13/2018] [Indexed: 05/13/2023]
Abstract
Research has largely reported that dog exposure is associated with reduced allergic disease risk. Responsible mechanism(s) are not understood. The goal was to investigate whether introducing a dog into the home changes the home dust microbiota. Families without dogs or cats planning to adopt a dog and those who were not were recruited. Dust samples were collected from the homes at recruitment and 12 months later. Microbiota composition and taxa (V4 region of the 16S rRNA gene) were compared between homes that did and did not adopt a dog. A total of 91 dust samples from 54 families (27 each, dog and no dog; 17 dog and 20 no dog homes with paired samples) were analyzed. A significant dog effect was seen across time in both unweighted UniFrac and Canberra metrics (both P = .008), indicating dog introduction may result in rapid establishment of rarer and phylogenetically related taxa. A significant dog-time interaction was seen in both weighted UniFrac (P < .001) and Bray-Curtis (P = .002) metrics, suggesting that while there may not initially be large relative abundance shifts following dog introduction, differences can be seen within a year. Therefore, dog introduction into the home has both immediate effects and effects that emerge over time.
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Affiliation(s)
- Alexandra Sitarik
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
- The in-FLAME Global Network, an affiliate of the World Universities Network (WUN), West New York, NJ 07093 USA
| | - Suzanne Havstad
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
- The in-FLAME Global Network, an affiliate of the World Universities Network (WUN), West New York, NJ 07093 USA
| | - Albert Levin
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
| | - Susan V. Lynch
- Division of Gastroenterology, University of California, San Francisco, California
| | - Kei Fujimura
- Division of Gastroenterology, University of California, San Francisco, California
| | - Dennis Ownby
- Department of Pediatrics, Medical College of Georgia at Augusta University, Augusta, Georgia
| | - Christine Johnson
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
- The in-FLAME Global Network, an affiliate of the World Universities Network (WUN), West New York, NJ 07093 USA
| | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI
- The in-FLAME Global Network, an affiliate of the World Universities Network (WUN), West New York, NJ 07093 USA
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111
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Durack J, Huang YJ, Nariya S, Christian LS, Ansel KM, Beigelman A, Castro M, Dyer AM, Israel E, Kraft M, Martin RJ, Mauger DT, Rosenberg SR, King TS, White SR, Denlinger LC, Holguin F, Lazarus SC, Lugogo N, Peters SP, Smith LJ, Wechsler ME, Lynch SV, Boushey HA. Bacterial biogeography of adult airways in atopic asthma. MICROBIOME 2018; 6:104. [PMID: 29885665 PMCID: PMC5994066 DOI: 10.1186/s40168-018-0487-3] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 05/25/2018] [Indexed: 05/24/2023]
Abstract
BACKGROUND Perturbations to the composition and function of bronchial bacterial communities appear to contribute to the pathophysiology of asthma. Unraveling the nature and mechanisms of these complex associations will require large longitudinal studies, for which bronchoscopy is poorly suited. Studies of samples obtained by sputum induction and nasopharyngeal brushing or lavage have also reported asthma-associated microbiota characteristics. It remains unknown, however, whether the microbiota detected in these less-invasive sample types reflect the composition of bronchial microbiota in asthma. RESULTS Bacterial microbiota in paired protected bronchial brushings (BB; n = 45), induced sputum (IS; n = 45), oral wash (OW; n = 45), and nasal brushings (NB; n = 27) from adults with mild atopic asthma (AA), atopy without asthma (ANA), and healthy controls (HC) were profiled using 16S rRNA gene sequencing. Though microbiota composition varied with sample type (p < 0.001), compositional similarity was greatest for BB-IS, particularly in AAs and ANAs. The abundance of genera detected in BB correlated with those detected in IS and OW (r median [IQR] 0.869 [0.748-0.942] and 0.822 [0.687-0.909] respectively), but not with those in NB (r = 0.004 [- 0.003-0.011]). The number of taxa shared between IS-BB and NB-BB was greater in AAs than in HCs (p < 0.05) and included taxa previously associated with asthma. Of the genera abundant in NB, only Moraxella correlated positively with abundance in BB; specific members of this genus were shared between the two compartments only in AAs. Relative abundance of Moraxella in NB of AAs correlated negatively with that of Corynebacterium but positively with markers of eosinophilic inflammation in the blood and BAL fluid. The genus, Corynebacterium, trended to dominate all NB samples of HCs but only half of AAs (p = 0.07), in whom abundance of this genus was negatively associated with markers of eosinophilic inflammation. CONCLUSIONS Induced sputum is superior to nasal brush or oral wash for assessing bronchial microbiota composition in asthmatic adults. Although compositionally similar to the bronchial microbiota, the microbiota in induced sputum are distinct, reflecting enrichment of oral bacteria. Specific bacterial genera are shared between the nasal and the bronchial mucosa which are associated with markers of systemic and bronchial inflammation.
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Affiliation(s)
- Juliana Durack
- Department of Medicine, Division of Gastroenterology, University of California San Francisco, San Francisco, CA, USA
| | - Yvonne J Huang
- Department of Internal Medicine, Division of Pulmonary/Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Snehal Nariya
- Department of Medicine, Division of Pulmonary/Critical Care Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Laura S Christian
- Department Microbiology/Immunology and Sandler Asthma Basic Research Center, University of California San Francisco, San Francisco, CA, USA
| | - K Mark Ansel
- Department Microbiology/Immunology and Sandler Asthma Basic Research Center, University of California San Francisco, San Francisco, CA, USA
| | - Avraham Beigelman
- Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Mario Castro
- Division of Pediatric Allergy, Immunology and Pulmonary Medicine, Washington University School of Medicine, St Louis, MO, USA
- Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO, USA
| | - Anne-Marie Dyer
- Department of Public Health Sciences, Penn State University, Hershey, PA, USA
| | - Elliot Israel
- Department of Medicine, Brigham & Women's Hospital, Boston, MA, USA
| | - Monica Kraft
- University of Arizona, Health Sciences, Tucson, AZ, USA
| | - Richard J Martin
- Department of Medicine, National Jewish Hospital, Denver, CO, USA
| | - David T Mauger
- Department of Public Health Sciences, Penn State University, Hershey, PA, USA
| | | | - Tonya S King
- Department of Public Health Sciences, Penn State University, Hershey, PA, USA
| | - Steven R White
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Loren C Denlinger
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Fernando Holguin
- The University of Pittsburgh Asthma Institute at UPMC/UPSOM, Pittsburgh, PA, USA
| | - Stephen C Lazarus
- Department of Medicine, Division of Pulmonary/Critical Care Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Njira Lugogo
- Duke Asthma, Allergy & Airway Center, Duke University School of Medicine, Durham, NC, USA
| | | | - Lewis J Smith
- Department of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Susan V Lynch
- Department of Medicine, Division of Gastroenterology, University of California San Francisco, San Francisco, CA, USA
| | - Homer A Boushey
- Department of Medicine, Division of Pulmonary/Critical Care Medicine, University of California San Francisco, San Francisco, CA, USA.
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Lu D, Yao X, Abulimiti A, Cai L, Zhou L, Hong J, Li N. Profiling of lung microbiota in the patients with obstructive sleep apnea. Medicine (Baltimore) 2018; 97:e11175. [PMID: 29952967 PMCID: PMC6039595 DOI: 10.1097/md.0000000000011175] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Lung microbiota may affect innate immunity and treatment consequence in the obstructive sleep apnea (OSA) patients. Bronchoalveolar lavage fluid (BALF) was obtained from 11 OSA patients and 8 patients with other lung diseases as control, and used for lung microbiota profiling by PCR amplification and sequencing of the microbial samples. It was demonstrated that phyla of Firmicutes, Fusobacteria, and Bacteriodetes were relatively abundant in the lung microbiota. Alpha-diversity comparison between OSA and control group revealed that Proteobacteria and Fusobacteria were significantly higher in OSA patients (0.3863 ± 0.0631 and 0.0682 ± 0.0159, respectively) than that in control group (0.119 ± 0.074 and 0.0006 ± 0.0187, respectively, P < .05 for both phyla). In contrast, Firmicutes was significantly less in OSA patients (0.1371 ± 0.0394) compared with that in the control group (0.384 ± 0.046, P < .05). Comparison within a group (ß-diversity) indicated that the top 5 phyla in the OSA lung were Proteobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and Acidobacteria, while the top 5 phyla in the control group were Firmicutes, Bacteroidetes, Proteobacteria, Actinobacteria, and Acidobacteria. These findings indicated that lung microbiota in OSA is distinct from that of non-OSA patients. Manipulation of the microbiota may be an alternative strategy to augment airway immunity and to reduce susceptibility to airway infection.
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Affiliation(s)
- Dongmei Lu
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang
- Pulmonary and Critical Care Medicine Department, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Xiaoguang Yao
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang
| | - Ayinigeer Abulimiti
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang
| | - Li Cai
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang
| | - Ling Zhou
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang
| | - Jing Hong
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang
| | - Nanfang Li
- The Center of Hypertension of the People's Hospital of Xinjiang Uygur Autonomous Region, The Center of Diagnosis, Treatment and Research of Hypertension in Xinjiang
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Benjamino J, Lincoln S, Srivastava R, Graf J. Low-abundant bacteria drive compositional changes in the gut microbiota after dietary alteration. MICROBIOME 2018; 6:86. [PMID: 29747692 PMCID: PMC5944116 DOI: 10.1186/s40168-018-0469-5] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 04/26/2018] [Indexed: 05/24/2023]
Abstract
BACKGROUND As the importance of beneficial bacteria is better recognized, understanding the dynamics of symbioses becomes increasingly crucial. In many gut symbioses, it is essential to understand whether changes in host diet play a role in the persistence of the bacterial gut community. In this study, termites were fed six dietary sources and the microbial community was monitored over a 49-day period using 16S rRNA gene sequencing. A deep backpropagation artificial neural network (ANN) was used to learn how the six different lignocellulose food sources affected the temporal composition of the hindgut microbiota of the termite as well as taxon-taxon and taxon-substrate interactions. RESULTS Shifts in the termite gut microbiota after diet change in each colony were observed using 16S rRNA gene sequencing and beta diversity analyses. The artificial neural network accurately predicted the relative abundances of taxa at random points in the temporal study and showed that low-abundant taxa maintain community driving correlations in the hindgut. CONCLUSIONS This combinatorial approach utilizing 16S rRNA gene sequencing and deep learning revealed that low-abundant bacteria that often do not belong to the core community are drivers of the termite hindgut bacterial community composition.
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Affiliation(s)
- Jacquelynn Benjamino
- Department of Molecular and Cell Biology, University of Connecticut, 91 N. Eagleville Road, U-3125, Storrs, CT, 06269, USA
| | - Stephen Lincoln
- Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, CT, USA
| | - Ranjan Srivastava
- Department of Chemical and Biomolecular Engineering, University of Connecticut, Storrs, CT, USA
| | - Joerg Graf
- Department of Molecular and Cell Biology, University of Connecticut, 91 N. Eagleville Road, U-3125, Storrs, CT, 06269, USA.
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114
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Müller-Rompa SEK, Markevych I, Hose AJ, Loss G, Wouters IM, Genuneit J, Braun-Fahrländer C, Horak E, Boznanski A, Heederik D, von Mutius E, Heinrich J, Ege MJ. An approach to the asthma-protective farm effect by geocoding: Good farms and better farms. Pediatr Allergy Immunol 2018; 29:275-282. [PMID: 29314275 DOI: 10.1111/pai.12861] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND The highly consistent association of growing up on a farm with a reduced asthma risk has so far been attributed to direct farm exposure. In contrast, geographic determinants of the larger environment have never been assessed. In this study, the effects of proximity to farms and environmental variables in relation to the residential address on asthma and atopy were assessed. METHODS Addresses of 2265 children of the Bavarian arm of the GABRIELA study were converted into geocodes. Proximity to the nearest cow farm was calculated, and environmental characteristics were derived from satellite data or terrestrial monitoring. Bacterial diversity in mattress dust samples was assessed in 501 children by sequencing of the 16S rRNA amplicons. Logistic regression models were used to calculate associations between outcomes and exposure variables. RESULTS Asthma and atopy were inversely associated with the presence of a farm within a radius of maximum 100 m. The environmental variables greenness, tree cover, soil sealing, altitude, air pollution differed not only between farm and non-farm children but also between farm children with and without another farm nearby. The latter distinction revealed strong associations with characteristics of traditional farms including a broader diversity of microbial exposure, which mainly contributed to the protective effect on asthma. In non-farm children, the protective effect of a farm nearby was completely explained by consumption of farm milk. CONCLUSIONS Clustering of farms within a neighborhood of 100 m is strongly associated with the protective effect on asthma and may represent a more traditional style of farming with broader microbial exposure.
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Affiliation(s)
| | - I Markevych
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany.,Institute for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - A J Hose
- Dr von Hauner Children's Hospital, LMU Munich, Munich, Germany
| | - G Loss
- Dr von Hauner Children's Hospital, LMU Munich, Munich, Germany.,Departments of Pediatrics and Computer Science & Engineering, University of California at San Diego, San Diego, CA, USA
| | - I M Wouters
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - J Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - C Braun-Fahrländer
- Swiss Tropical and Public Health Institute Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - E Horak
- Innsbruck Medical University, Innsbruck, Austria
| | | | - D Heederik
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - E von Mutius
- Dr von Hauner Children's Hospital, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany.,Institute for Asthma and Allergy Prevention, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - J Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - M J Ege
- Dr von Hauner Children's Hospital, LMU Munich, Munich, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Munich, Germany
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115
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Beigelman A, Rosas-Salazar C, Hartert TV. Childhood Asthma: Is It All About Bacteria and Not About Viruses? A Pro/Con Debate. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2018; 6:719-725. [PMID: 29339131 PMCID: PMC5948130 DOI: 10.1016/j.jaip.2017.11.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/14/2017] [Accepted: 11/18/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Avraham Beigelman
- Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine, St Louis, Mo.
| | - Christian Rosas-Salazar
- Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tenn
| | - Tina V Hartert
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tenn.
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116
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Mariani J, Favero C, Spinazzè A, Cavallo DM, Carugno M, Motta V, Bonzini M, Cattaneo A, Pesatori AC, Bollati V. Short-term particulate matter exposure influences nasal microbiota in a population of healthy subjects. ENVIRONMENTAL RESEARCH 2018; 162:119-126. [PMID: 29291434 DOI: 10.1016/j.envres.2017.12.016] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 11/13/2017] [Accepted: 12/17/2017] [Indexed: 05/06/2023]
Abstract
BACKGROUND Exposure to air pollutants, such as particulate matter (PM), represents a growing health problem. The aim of our study was to investigate whether PM could induce a dysbiosis in the nasal microbiota in terms of α-diversity and taxonomic composition. METHODS We investigated structure and characteristics of the microbiota of 40 healthy subjects through metabarcoding analysis of the V3-V4 regions of the 16s rRNA gene. Exposure to PM10 and PM2.5 was assessed with a personal sampler worn for 24h before sample collection (Day -1) and with measurements from monitoring stations (from Day -2 to Day -7). RESULTS We found an inverse association between PM10 and PM2.5 levels of the 3rd day preceding sampling (Day -3) and α-diversity indices (Chao1, Shannon and PD_whole_tree). Day -3 PM was inversely associated also with the majority of analyzed taxa, except for Moraxella, which showed a positive association. In addition, subjects showed different structural profiles identifying two groups: one characterized by an even community and another widely dominated by the Moraxella genus. CONCLUSIONS Our findings support the role of PM exposure in influencing microbiota and altering the normal homeostasis within the bacterial community. Whether these alterations could have a role in disease development and/or exacerbation needs further research.
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Affiliation(s)
- Jacopo Mariani
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
| | - Chiara Favero
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Andrea Spinazzè
- Department of Science and High Technology, University of Insubria, Como, Italy
| | | | - Michele Carugno
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Valeria Motta
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Matteo Bonzini
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Andrea Cattaneo
- Department of Science and High Technology, University of Insubria, Como, Italy
| | - Angela Cecilia Pesatori
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Bollati
- EPIGET LAB, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy; Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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117
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Abstract
BACKGROUND Nasal microbiota may influence asthma pathobiology. OBJECTIVE We sought to characterize the nasal microbiome of subjects with exacerbated asthma, nonexacerbated asthma, and healthy controls to identify nasal microbiota associated with asthma activity. METHODS We performed 16S ribosomal RNA sequencing on nasal swabs obtained from 72 primarily adult subjects with exacerbated asthma (n = 20), nonexacerbated asthma (n = 31), and healthy controls (n = 21). Analyses were performed using Quantitative Insights into Microbial (QIIME); linear discriminant analysis effect size (LEfSe); Phylogenetic Investigation of Communities by Reconstruction of Unobserved States; and Statistical Analysis of Metagenomic Profiles (PICRUSt); and Statistical Analysis of Metagenomic Profiles (STAMP). Species found to be associated with asthma activity were validated using quantitative PCR. Metabolic pathways associated with differentially abundant nasal taxa were inferred through metagenomic functional prediction. RESULTS Nasal bacterial composition significantly differed among subjects with exacerbated asthma, nonexacerbated asthma, and healthy controls (permutational multivariate ANOVA, P = 2.2 × 10-2). Relative to controls, the nasal microbiota of subjects with asthma were enriched with taxa from Bacteroidetes (Wilcoxon-Mann-Whitney, r = 0.33, P = 5.1 × 10-3) and Proteobacteria (r = 0.29, P = 1.4 × 10-2). Four species were differentially abundant based on asthma status after correction for multiple comparisons: Prevotella buccalis, Padj = 1.0 × 10-2; Dialister invisus, Padj = 9.1 × 10-3; Gardnerella vaginalis, Padj = 2.8 × 10-3; Alkanindiges hongkongensis, Padj = 2.6 × 10-3. These phyla and species were also differentially abundant based on asthma activity (exacerbated asthma vs nonexacerbated asthma vs controls). Quantitative PCR confirmed species overrepresentation in asthma relative to controls for Prevotella buccalis (fold change = 130, P = 2.1 × 10-4) and Gardnerella vaginalis (fold change = 160, P = 6.8 × 10-4). Metagenomic inference revealed differential glycerolipid metabolism (Kruskal-Wallis, P = 1.9 × 10-4) based on asthma activity. CONCLUSIONS Nasal microbiome composition differs in subjects with exacerbated asthma, nonexacerbated asthma, and healthy controls. The identified nasal taxa could be further investigated for potential mechanistic roles in asthma and as possible biomarkers of asthma activity.
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118
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Kim BS, Lee E, Lee MJ, Kang MJ, Yoon J, Cho HJ, Park J, Won S, Lee SY, Hong SJ. Different functional genes of upper airway microbiome associated with natural course of childhood asthma. Allergy 2018; 73:644-652. [PMID: 29052232 DOI: 10.1111/all.13331] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND Microbial colonization of the airway plays a role in the pathogenesis of asthma; however, the effect of the upper airway microbiome on childhood asthma is not fully understood. We analyzed the metagenome of airway microbiome to understand the associated role of upper airway microbiome with the natural course of childhood asthma. METHODS Nasopharyngeal swabs were collected from children with asthma, those in asthma remission, and control groups. High-throughput sequencing was used to examine the structure and functional dynamics of the airway microbiome with respect to asthma phenotypes. RESULTS The composition of microbiota differed among healthy control, asthma, and remission groups. The relative abundance of Streptococcus was negatively associated with FEV1% predicted (P = .023) and that of Staphylococcus was negatively associated with methacholine PC20 (P = .013). Genes related to arachidonic acid metabolites, lysine residues, and glycosaminoglycans in the microbiome could be associated with airway inflammation. In particular, genes related to synthesis of anti-inflammatory prostaglandin E2 (PGE2 ) were not detected from the airway microbiome in the asthma group. CONCLUSIONS These data suggest that alterations in the composition and function of the upper airway microbiome could be related with the natural course of asthma in children.
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Affiliation(s)
- B.-S. Kim
- Department of Life Science; Multidisciplinary Genome Institute; Hallym University; Chuncheon Korea
| | - E. Lee
- Department of Pediatrics; Chonnam National University Hospital; Gwangju Korea
| | - M.-J. Lee
- Department of Life Science; Multidisciplinary Genome Institute; Hallym University; Chuncheon Korea
| | - M.-J. Kang
- Asan Institute for Life Science; University of Ulsan College of Medicine; Seoul Korea
| | - J. Yoon
- Department of Pediatrics; Childhood Asthma Atopy Center; Environmental Health Center; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - H.-J. Cho
- Department of Pediatrics; Childhood Asthma Atopy Center; Environmental Health Center; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - J. Park
- Interdisciplinary Program of Bioinformatics; Seoul National University; Seoul Korea
| | - S. Won
- Interdisciplinary Program of Bioinformatics; Seoul National University; Seoul Korea
- Department of Public Health Science; Seoul National University; Seoul Korea
- Institute of Health and Environment; Seoul National University; Seoul Korea
| | - S. Y. Lee
- Department of Pediatrics; Childhood Asthma Atopy Center; Environmental Health Center; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
| | - S. J. Hong
- Department of Pediatrics; Childhood Asthma Atopy Center; Environmental Health Center; Asan Medical Center; University of Ulsan College of Medicine; Seoul Korea
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119
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Perdijk O, van Splunter M, Savelkoul HFJ, Brugman S, van Neerven RJJ. Cow's Milk and Immune Function in the Respiratory Tract: Potential Mechanisms. Front Immunol 2018; 9:143. [PMID: 29483908 PMCID: PMC5816034 DOI: 10.3389/fimmu.2018.00143] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Accepted: 01/17/2018] [Indexed: 12/12/2022] Open
Abstract
During the last decades, the world has witnessed a dramatic increase in allergy prevalence. Epidemiological evidence shows that growing up on a farm is a protective factor, which is partly explained by the consumption of raw cow’s milk. Indeed, recent studies show inverse associations between raw cow’s milk consumption in early life and asthma, hay fever, and rhinitis. A similar association of raw cow’s milk consumption with respiratory tract infections is recently found. In line with these findings, controlled studies in infants with milk components such as lactoferrin, milk fat globule membrane, and colostrum IgG have shown to reduce respiratory infections. However, for ethical reasons, it is not possible to conduct controlled studies with raw cow’s milk in infants, so formal proof is lacking to date. Because viral respiratory tract infections and aeroallergen exposure in children may be causally linked to the development of asthma, it is of interest to investigate whether cow’s milk components can modulate human immune function in the respiratory tract and via which mechanisms. Inhaled allergens and viruses trigger local immune responses in the upper airways in both nasal and oral lymphoid tissue. The components present in raw cow’s milk are able to promote a local microenvironment in which mucosal immune responses are modified and the epithelial barrier is enforced. In addition, such responses may also be triggered in the gut after exposure to allergens and viruses in the nasal cavity that become available in the GI tract after swallowing. However, these immune cells that come into contact with cow’s milk components in the gut must recirculate into the blood and home to the (upper and lower) respiratory tract to regulate immune responses locally. Expression of the tissue homing-associated markers α4β7 and CCR9 or CCR10 on lymphocytes can be influenced by vitamin A and vitamin D3, respectively. Since both vitamins are present in milk, we speculate that raw milk may influence homing of lymphocytes to the upper respiratory tract. This review focuses on potential mechanisms via which cow’s milk or its components can influence immune function in the intestine and the upper respiratory tract. Unraveling these complex mechanisms may contribute to the development of novel dietary approaches in allergy and asthma prevention.
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Affiliation(s)
- Olaf Perdijk
- Cell Biology and Immunology Group, Wageningen University & Research, Wageningen, Netherlands
| | - Marloes van Splunter
- Cell Biology and Immunology Group, Wageningen University & Research, Wageningen, Netherlands
| | - Huub F J Savelkoul
- Cell Biology and Immunology Group, Wageningen University & Research, Wageningen, Netherlands
| | - Sylvia Brugman
- Cell Biology and Immunology Group, Wageningen University & Research, Wageningen, Netherlands
| | - R J Joost van Neerven
- Cell Biology and Immunology Group, Wageningen University & Research, Wageningen, Netherlands.,FrieslandCampina, Amersfoort, Netherlands
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120
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Sokolowska M, Frei R, Lunjani N, Akdis CA, O'Mahony L. Microbiome and asthma. Asthma Res Pract 2018; 4:1. [PMID: 29318023 PMCID: PMC5755449 DOI: 10.1186/s40733-017-0037-y] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/18/2017] [Indexed: 12/14/2022] Open
Abstract
The mucosal immune system is in constant communication with the vast diversity of microbes present on body surfaces. The discovery of novel molecular mechanisms, which mediate host-microbe communication, have highlighted the important roles played by microbes in influencing mucosal immune responses. Dendritic cells, epithelial cells, ILCs, T regulatory cells, effector lymphocytes, NKT cells and B cells can all be influenced by the microbiome. Many of the mechanisms being described are bacterial strain- or metabolite-specific. Microbial dysbiosis in the gut and the lung is increasingly being associated with the incidence and severity of asthma. More accurate endotyping of patients with asthma may be assisted by further analysis of the composition and metabolic activity of an individual’s microbiome. In addition, the efficacy of specific therapeutics may be influenced by the microbiome and novel bacterial-based therapeutics should be considered in future clinical studies.
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Affiliation(s)
- Milena Sokolowska
- Swiss Institute of Allergy and Asthma Research, University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Remo Frei
- Swiss Institute of Allergy and Asthma Research, University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Nonhlanhla Lunjani
- Swiss Institute of Allergy and Asthma Research, University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland.,University of Cape Town, Cape Town, South Africa
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland.,Christine Kühne - Center for Allergy Research and Education (CK-CARE), Davos, Switzerland
| | - Liam O'Mahony
- Swiss Institute of Allergy and Asthma Research, University of Zürich, Obere Strasse 22, 7270 Davos, Switzerland
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Luna PN, Hasegawa K, Ajami NJ, Espinola JA, Henke DM, Petrosino JF, Piedra PA, Sullivan AF, Camargo CA, Shaw CA, Mansbach JM. The association between anterior nares and nasopharyngeal microbiota in infants hospitalized for bronchiolitis. MICROBIOME 2018; 6:2. [PMID: 29298732 PMCID: PMC5751828 DOI: 10.1186/s40168-017-0385-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 12/14/2017] [Indexed: 05/09/2023]
Abstract
BACKGROUND The airway microbiome is a subject of great interest for the study of respiratory disease. Anterior nare samples are more accessible than samples from deeper within the nasopharynx. However, the correlation between the microbiota found in the anterior nares and the microbiota found within the nasopharynx is unknown. We assessed the anterior nares and nasopharyngeal microbiota to determine (1) the relation of the microbiota from these two upper airway sites and (2) if associations were maintained between the microbiota from these two sites and two bronchiolitis severity outcomes. RESULTS Among 815 infants hospitalized at 17 US centers for bronchiolitis with optimal 16S rRNA gene sequence reads from both nasal swab and nasopharyngeal aspirate samples, there were strong intra-individual correlations in the microbial communities between the two sample types, especially relating to Haemophilus and Moraxella genera. By contrast, we found a high abundance of Staphylococcus genus in the nasal swabs-a pattern not found in the nasopharyngeal samples and not informative when predicting the dominant nasopharyngeal genera. While these disparities may have been due to sample processing differences (i.e., nasal swabs were mailed at ambient temperature to emulate processing of future parent collected swabs while nasopharyngeal aspirates were mailed on dry ice), a previously reported association between Haemophilus-dominant nasopharyngeal microbiota and the increased severity of bronchiolitis was replicated utilizing the nasal swab microbiota and the same outcome measures: intensive care use (adjusted OR 6.43; 95% CI 2.25-20.51; P < 0.001) and hospital length-of-stay (adjusted OR 4.31; 95% CI, 1.73-11.11; P = 0.002). Additionally, Moraxella-dominant nasopharyngeal microbiota was previously identified as protective against intensive care use, a result that was replicated when analyzing the nasal swab microbiota (adjusted OR 0.30; 95% CI, 0.11-0.64; P = 0.01). CONCLUSIONS While the microbiota of the anterior nares and the nasopharynx are distinct, there is considerable overlap between the bacterial community compositions from these two anatomic sites. Despite processing differences between the samples, these results indicate that microbiota severity associations from the nasopharynx are recapitulated in the anterior nares, suggesting that nasal swab samples not only are effective sample types, but also can be used to detect microbial risk markers.
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Affiliation(s)
- Pamela N Luna
- Department of Statistics, Rice University, Houston, TX, USA
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nadim J Ajami
- Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Janice A Espinola
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David M Henke
- Department of Molecular and Human Genetics MS 225, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Joseph F Petrosino
- Alkek Center for Metagenomics and Microbiome Research, Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX, USA
| | - Pedro A Piedra
- Department of Molecular Virology and Microbiology and Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Ashley F Sullivan
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Chad A Shaw
- Department of Statistics, Rice University, Houston, TX, USA.
- Department of Molecular and Human Genetics MS 225, Baylor College of Medicine, Houston, TX, 77030, USA.
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Comparison of Oropharyngeal Microbiota from Children with Asthma and Cystic Fibrosis. Mediators Inflamm 2017; 2017:5047403. [PMID: 29445257 PMCID: PMC5763206 DOI: 10.1155/2017/5047403] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/24/2017] [Accepted: 10/22/2017] [Indexed: 12/16/2022] Open
Abstract
A genuine microbiota resides in the lungs which emanates from the colonization by the oropharyngeal microbiota. Changes in the oropharyngeal microbiota might be the source of dysbiosis observed in the lower airways in patients suffering from asthma or cystic fibrosis (CF). To examine this hypothesis, we compared the throat microbiota from healthy children (n = 62) and that from children with asthma (n = 27) and CF (n = 57) aged 6 to 12 years using 16S rRNA amplicon sequencing. Our results show high levels of similarities between healthy controls and children with asthma and CF revealing the existence of a core microbiome represented by Prevotella, Streptococcus, Neisseria, Veillonella, and Haemophilus. However, in CF, the global diversity, the bacterial load, and abundances of 53 OTUs were significantly reduced, whereas abundances of 6 OTUs representing opportunistic pathogens such as Pseudomonas, Staphylococcus, and Streptococcus were increased compared to those in healthy controls controls and asthmatics. Our data reveal a core microbiome in the throat of healthy children that persists in asthma and CF indicating shared host regulation favoring growth of commensals. Furthermore, we provide evidence for dysbiosis with a decrease in diversity and biomass associated with the presence of known pathogens consistent with impaired host defense in children with CF.
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123
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Disordered oropharyngeal microbial communities in H7N9 patients with or without secondary bacterial lung infection. Emerg Microbes Infect 2017; 6:e112. [PMID: 29259328 PMCID: PMC5750457 DOI: 10.1038/emi.2017.101] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 11/02/2017] [Accepted: 11/07/2017] [Indexed: 02/06/2023]
Abstract
Secondary bacterial lung infection (SBLI) is a serious complication in patients with H7N9 virus infection, and increases disease severity. The oropharyngeal (OP) microbiome helps prevent colonisation of respiratory pathogens. We aimed to investigate the OP microbiome of H7N9 patients with/without secondary bacterial pneumonia using 16S rRNA gene sequencing. OP swab samples were collected from 51 H7N9 patients (21 with SBLI and 30 without) and 30 matched healthy controls (HCs) and used for comparative composition, diversity and richness analyses of microbial communities. Principal coordinates analysis successfully distinguished between the OP microbiomes of H7N9 patients and healthy subjects, and the OP microbiome diversity of patients with SBLI was significantly increased. There was significant dysbiosis of the OP microbiome in H7N9 patients, with an abundance of Leptotrichia, Oribacterium, Streptococcus, Atopobium, Eubacterium, Solobacterium and Rothia species in patients with SBLI, and Filifactor, Megasphaera and Leptotrichia species in patients without SBLI, when compared with HCs. Importantly, Haemophilus and Bacteroides species were enriched in HCs. These findings revealed dysbiosis of the OP microbiota in H7N9 patients, and identified OP microbial risk indicators of SBLI, suggesting that the OP microbiome could provide novel and non-invasive diagnostic biomarkers for early microbiota-targeted prophylactic therapies for SBLI prevention.
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124
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Spierenburg EAJ, Smit LAM, Krop EJM, Heederik D, Hylkema MN, Wouters IM. Occupational endotoxin exposure in association with atopic sensitization and respiratory health in adults: Results of a 5-year follow-up. PLoS One 2017; 12:e0189097. [PMID: 29211772 PMCID: PMC5718503 DOI: 10.1371/journal.pone.0189097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 11/18/2017] [Indexed: 11/18/2022] Open
Abstract
The objective of the present longitudinal study was to investigate the effects of occupational endotoxin exposure on respiratory health and atopic sensitization in adults. Health outcomes and personal endotoxin exposure estimates were determined for 234 farmers and agricultural workers both at baseline and 5 years later. A questionnaire was used to assess respiratory symptoms, spirometry tests were performed and total and specific IgE levels were measured in serum. A twofold increase in personal endotoxin exposure was associated with less hay fever (OR 0.68, 95%CI 0.54-0.87) and grass IgE positivity (OR 0.81, 95%CI 0.68-0.97) at both time points ("persistent" versus "never"). Although not statistically significant, a consistent protective pattern was observed for an increased loss of hay fever symptoms (OR 2.19, 95%CI 0.96-4.99) and grass IgE positivity (OR 1.24, 95%CI 0.76-2.02), and for less new-onset of hay fever (OR 0.87, 95%CI 0.65-1.17), grass IgE positivity (OR 0.83, 95%CI 0.61-1.12) and atopic sensitization (OR 0.75, 95%CI 0.55-1.02). Endotoxin exposure was not associated with changes in lung function. We showed that occupational endotoxin exposure is associated with a long-term protective effect on hay fever and grass IgE positivity. Results on longitudinal changes in hay fever, atopy and grass IgE positivity in adulthood were consistent with a protective effect of endotoxin exposure, but results need to be confirmed in larger cohorts. An effect of endotoxin exposure on lung function decline was not found.
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Affiliation(s)
- Elisabeth A. J. Spierenburg
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Lidwien A. M. Smit
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Esmeralda J. M. Krop
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Dick Heederik
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Machteld N. Hylkema
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- GRIAC- Groningen Research Institute for Asthma and COPD, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Inge M. Wouters
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
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125
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The nasopharyngeal microbiome. Emerg Top Life Sci 2017; 1:297-312. [PMID: 33525776 DOI: 10.1042/etls20170041] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 10/19/2017] [Accepted: 10/20/2017] [Indexed: 02/07/2023]
Abstract
Human microbiomes have received increasing attention over the last 10 years, leading to a pervasiveness of hypotheses relating dysbiosis to health and disease. The respiratory tract has received much less attention in this respect than that of, for example, the human gut. Nevertheless, progress has been made in elucidating the immunological, ecological and environmental drivers that govern these microbial consortia and the potential consequences of aberrant microbiomes. In this review, we consider the microbiome of the nasopharynx, a specific niche of the upper respiratory tract. The nasopharynx is an important site, anatomically with respect to its gateway position between upper and lower airways, and for pathogenic bacterial colonisation. The dynamics of the latter are important for long-term respiratory morbidity, acute infections of both invasive and non-invasive disease and associations with chronic airway disease exacerbations. Here, we review the development of the nasopharyngeal (NP) microbiome over the life course, examining it from the early establishment of resilient profiles in neonates through to perturbations associated with pneumonia risk in the elderly. We focus specifically on the commensal, opportunistically pathogenic members of the NP microbiome that includes Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae and Moraxella catarrhalis. In addition, we consider the role of relatively harmless genera such as Dolosigranulum and Corynebacterium. Understanding that the NP microbiome plays such a key, beneficial role in maintaining equilibrium of commensal species, prevention of pathogen outgrowth and host immunity enables future research to be directed appropriately.
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126
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Nicola I, Cerutti F, Grego E, Bertone I, Gianella P, D'Angelo A, Peletto S, Bellino C. Characterization of the upper and lower respiratory tract microbiota in Piedmontese calves. MICROBIOME 2017; 5:152. [PMID: 29157308 PMCID: PMC5697440 DOI: 10.1186/s40168-017-0372-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 11/09/2017] [Indexed: 05/13/2023]
Abstract
BACKGROUND The microbiota of the bovine upper respiratory tract has been recently characterized, but no data for the lower respiratory tract are available. A major health problem in bovine medicine is infectious bronchopneumonia, the most common respiratory syndrome affecting cattle. With this study, we used 16S rRNA gene sequencing to characterize and compare the microbial community composition of the upper and lower respiratory tracts in calves. RESULTS The microbiota of the upper (nasal swab [NS]) and the lower (trans-tracheal aspiration [TTA]) respiratory tracts of 19 post-weaned Piedmontese calves with (8/19) and without (11/19) clinical signs of respiratory disease, coming from six different farms, was characterized by 16S rRNA gene metabarcoding. A total of 29 phyla (29 in NS, 21 in TTA) and 305 genera (289 in NS, 182 in TTA) were identified. Mycoplasma (60.8%) was the most abundant genus identified in both the NS (27.3%) and TTA (76.7%) samples, followed by Moraxella (16.6%) in the NS and Pasteurella (7.3%) in the TTA samples. Pasteurella multocida (7.3% of total operational taxonomic units [OTUs]) was the most abundant species in the TTA and Psychrobacter sanguinis (1.1% of total OTUs) in the NS samples. Statistically significant differences between the NS and the TTA samples were found for both alpha (Shannon index, observed species, Chao1 index, and Simpson index; P = 0.001) and beta (Adonis; P = 0.001) diversity. Comparison of the NS and TTA samples by farm origin and clinical signs revealed no statistical difference (P > 0.05), except for farm origin for the NS samples when compared by the unweighted UniFrac metric (P = 0.05). CONCLUSIONS Using 16S rRNA gene sequencing, we characterized the microbiota of the upper and lower respiratory tracts of calves, both healthy individuals and those with clinical signs of respiratory disease. Our results suggest that environmental factors may influence the composition of the upper airway microbiota in cattle. While the two microbial communities (upper and lower airways) differed in microbial composition, they shared several OTUs, suggesting that the lung microbiota may be a self-sustaining, more homogeneous ecosystem, influenced by the upper respiratory tract microbiota.
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Affiliation(s)
- Isabella Nicola
- Department of Veterinary Sciences, Clinical section, University of Turin, Largo Paolo Braccini 2, 10095, Grugliasco, TO, Italy
| | - Francesco Cerutti
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Via Bologna 148, 10154, Turin, TO, Italy
| | - Elena Grego
- Department of Veterinary Sciences, Clinical section, University of Turin, Largo Paolo Braccini 2, 10095, Grugliasco, TO, Italy
| | - Iride Bertone
- Department of Veterinary Sciences, Clinical section, University of Turin, Largo Paolo Braccini 2, 10095, Grugliasco, TO, Italy
| | - Paola Gianella
- Department of Veterinary Sciences, Clinical section, University of Turin, Largo Paolo Braccini 2, 10095, Grugliasco, TO, Italy
| | - Antonio D'Angelo
- Department of Veterinary Sciences, Clinical section, University of Turin, Largo Paolo Braccini 2, 10095, Grugliasco, TO, Italy
| | - Simone Peletto
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d'Aosta, Via Bologna 148, 10154, Turin, TO, Italy
| | - Claudio Bellino
- Department of Veterinary Sciences, Clinical section, University of Turin, Largo Paolo Braccini 2, 10095, Grugliasco, TO, Italy.
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Grosse-Kock S, Kolodkina V, Schwalbe EC, Blom J, Burkovski A, Hoskisson PA, Brisse S, Smith D, Sutcliffe IC, Titov L, Sangal V. Genomic analysis of endemic clones of toxigenic and non-toxigenic Corynebacterium diphtheriae in Belarus during and after the major epidemic in 1990s. BMC Genomics 2017; 18:873. [PMID: 29132312 PMCID: PMC5683216 DOI: 10.1186/s12864-017-4276-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/03/2017] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Diphtheria remains a major public health concern with multiple recent outbreaks around the world. Moreover, invasive non-toxigenic strains have emerged globally causing severe infections. A diphtheria epidemic in the former Soviet Union in the 1990s resulted in ~5000 deaths. In this study, we analysed the genome sequences of a collection of 93 C. diphtheriae strains collected during and after this outbreak (1996 - 2014) in a former Soviet State, Belarus to understand the evolutionary dynamics and virulence capacities of these strains. RESULTS C. diphtheriae strains from Belarus belong to ten sequence types (STs). Two major clones, non-toxigenic ST5 and toxigenic ST8, encompassed 76% of the isolates that are associated with sore throat and diphtheria in patients, respectively. Core genomic diversity is limited within outbreak-associated ST8 with relatively higher mutation rates (8.9 × 10-7 substitutions per strain per year) than ST5 (5.6 × 10-7 substitutions per strain per year) where most of the diversity was introduced by recombination. A variation in the virulence gene repertoire including the presence of tox gene is likely responsible for pathogenic differences between different strains. However, strains with similar virulence potential can cause disease in some individuals and remain asymptomatic in others. Eight synonymous single nucleotide polymorphisms were observed between the tox genes of the vaccine strain PW8 and other toxigenic strains of ST8, ST25, ST28, ST41 and non-toxigenic tox gene-bearing (NTTB) ST40 strains. A single nucleotide deletion at position 52 in the tox gene resulted in the frameshift in ST40 isolates, converting them into NTTB strains. CONCLUSIONS Non-toxigenic C. diphtheriae ST5 and toxigenic ST8 strains have been endemic in Belarus both during and after the epidemic in 1990s. A high vaccine coverage has effectively controlled diphtheria in Belarus; however, non-toxigenic strains continue to circulate in the population. Recombination is an important evolutionary force in shaping the genomic diversity in C. diphtheriae. However, the relative role of recombination and mutations in diversification varies between different clones.
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Affiliation(s)
- Steffen Grosse-Kock
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Valentina Kolodkina
- Republican Research and Practical Centre for Epidemiology and Microbiology, Minsk, Republic of Belarus
| | - Edward C. Schwalbe
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | | | - Andreas Burkovski
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Paul A. Hoskisson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Sylvain Brisse
- Institut Pasteur, Biodiversity and Epidemiology of Bacterial Pathogens, Paris, France
| | - Darren Smith
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Iain C. Sutcliffe
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Leonid Titov
- Republican Research and Practical Centre for Epidemiology and Microbiology, Minsk, Republic of Belarus
| | - Vartul Sangal
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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128
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The immunology of the allergy epidemic and the hygiene hypothesis. Nat Immunol 2017; 18:1076-1083. [PMID: 28926539 DOI: 10.1038/ni.3829] [Citation(s) in RCA: 227] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/04/2017] [Indexed: 12/18/2022]
Abstract
The immunology of the hygiene hypothesis of allergy is complex and involves the loss of cellular and humoral immunoregulatory pathways as a result of the adoption of a Western lifestyle and the disappearance of chronic infectious diseases. The influence of diet and reduced microbiome diversity now forms the foundation of scientific thinking on how the allergy epidemic occurred, although clear mechanistic insights into the process in humans are still lacking. Here we propose that barrier epithelial cells are heavily influenced by environmental factors and by microbiome-derived danger signals and metabolites, and thus act as important rheostats for immunoregulation, particularly during early postnatal development. Preventive strategies based on this new knowledge could exploit the diversity of the microbial world and the way humans react to it, and possibly restore old symbiotic relationships that have been lost in recent times, without causing disease or requiring a return to an unhygienic life style.
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129
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The effect of obesity, weight gain, and weight loss on asthma inception and control. Curr Opin Allergy Clin Immunol 2017; 17:123-130. [PMID: 28030376 DOI: 10.1097/aci.0000000000000339] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW There is ample and growing evidence that obesity increases the risk of asthma and morbidity from asthma. Here, we review recent clinical evidence supporting a causal link between obesity and asthma, and the mechanisms that may lead to 'obese asthma'. RECENT FINDINGS Although in some children obesity and asthma simply co-occur, those with 'obese asthma' have increased asthma severity, lower quality of life, and reduced medication response. Underlying mechanistic pathways may include anatomical changes of the airways such as obstruction and dysanapsis, systemic inflammation, production of adipokines, impaired glucose-insulin metabolism, altered nutrient levels, genetic and epigenetic changes, and alterations in the airway and/or gut microbiome. A few small studies have shown that weight loss interventions may lead to improvements in asthma outcomes, but thus far research on therapeutic interventions for these children has been limited. SUMMARY Obesity increases the risk of asthma - and worsens asthma severity or control - via multiple mechanisms. 'Obese asthma' is a complex, multifactorial phenotype in children. Obesity and its complications must be managed as part of the treatment of asthma in obese children.
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130
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Microbes, allergic sensitization, and the natural history of asthma. Curr Opin Allergy Clin Immunol 2017; 17:116-122. [PMID: 28030377 DOI: 10.1097/aci.0000000000000338] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Understanding factors that lead to asthma development in early life is essential to developing strategies aimed at primary or secondary prevention. RECENT FINDINGS This article will review current evidence addressing the development of early life allergic sensitization in relation to microbes and the gut and airway microbiome. Wheezing illnesses, particularly viral, remain a significant risk factor for asthma inception; however, bacterial pathogens have recently emerged as an additional important contributor to asthma risk, either alone or as cofactors with viral infections. The combined influence and interaction of early life viral wheezing and aeroallergen sensitization is important, with allergic sensitization preceding the onset of viral wheeze. Lastly, we review recent data from longitudinal studies regarding the development of irreversible airway obstruction and its impact on the natural history of asthma. SUMMARY The development of asthma remains complex and incompletely understood. There is interplay between genetic predisposition and environmental exposures, including allergens and microbes. Interventions aimed at these risk factors during the preschool years may prevent the longitudinal course of asthma progression to irreversible airway obstruction.
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131
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Ober C, Sperling AI, von Mutius E, Vercelli D. Immune development and environment: lessons from Amish and Hutterite children. Curr Opin Immunol 2017; 48:51-60. [PMID: 28843541 DOI: 10.1016/j.coi.2017.08.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/06/2017] [Accepted: 08/08/2017] [Indexed: 12/20/2022]
Abstract
Children who grow up in traditional farm environments are protected from developing asthma and allergy. This 'farm effect' can be largely explained by the child's early life contact with farm animals, in particular cows, and their microbes. Our studies in Amish and Hutterite school children living on farms in the U.S. have further demonstrated that this protection is mediated through innate immune pathways. Although very similar with respect to ancestry and many lifestyle factors that are associated with asthma risk, Amish and Hutterites follow farming practices that are associated with profound differences in the levels of house dust endotoxin, in the prevalence of asthma and atopy among school children, and in the proportions, phenotypes, and functions of immune cells from these children. In this review, we will consider our studies in Amish and Hutterites children in the context of the many previous studies in European farm children and discuss how these studies have advanced our understanding of the asthma-protective 'farm effect'.
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Affiliation(s)
- Carole Ober
- Department of Human Genetics, University of Chicago, Chicago, IL 60637, USA.
| | - Anne I Sperling
- Section of Pulmonary and Critical Care Medicine, Department of Medicine and the Committee on Immunology, University of Chicago, Chicago, IL 60637, USA
| | - Erika von Mutius
- Dr. von Hauner Children's Hospital, Ludwig Maximilians University Munich, Germany; Comprehensive Pneumology Center, Munich, Germany; German Center for Lung Research, Germany
| | - Donata Vercelli
- Department of Cellular and Molecular Medicine, Asthma and Airway Disease Research Center, and Bio5 Institute, The University of Arizona, Tucson, AZ 85724, USA
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132
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Agarwal D, Dhotre D, Patil R, Shouche Y, Juvekar S, Salvi S. Potential of Health and Demographic Surveillance System in Asthma and Chronic Obstructive Pulmonary Disease Microbiome Research. Front Public Health 2017; 5:196. [PMID: 28824902 PMCID: PMC5543077 DOI: 10.3389/fpubh.2017.00196] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/20/2017] [Indexed: 12/11/2022] Open
Abstract
Health and demographic surveillance system (HDSS) is a population-based health and vital event registration system that monitors demographic and health events in a geographically defined population at regular intervals. Human microbiome research in the past decade has been the field of increasingly intense research much due to its demonstrated impact upon various health conditions including human chronic airway diseases such as asthma and chronic obstructive pulmonary disease (COPD). Many confounding factors have been revealed to play a role in shaping the microbiome in chronic airway diseases. Asthma and COPD follows a typical pattern of disease progression, which includes stable and exacerbation state in which the microbiota is known to vary. However, many such studies lack extensive and longitudinal sampling with inadequate metadata, which has resulted in the inconsistencies in the observations. HDSS provides such a platform, which can offer a deeper understanding of the role of the microbiome in human health. In this review, we highlight opportunities and limitations in microbiome research with the help of studies conducted on chronic airway diseases like asthma and COPD. In addition, we also emphasize on the benefits of HDSS and future directions in lung microbiome research.
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Affiliation(s)
- Dhiraj Agarwal
- Chest Research Foundation, Pune, India.,Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Dhiraj Dhotre
- Microbial Culture Collection, National Centre for Cell Science, Pune, India
| | - Rutuja Patil
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Yogesh Shouche
- Microbial Culture Collection, National Centre for Cell Science, Pune, India
| | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India.,INDEPTH Network, Accra, Ghana
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133
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Danielewicz H. Hits and defeats of genome-wide association studies of atopy and asthma. J Appl Biomed 2017. [DOI: 10.1016/j.jab.2017.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
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134
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Estrada RD, Ownby DR. Rural Asthma: Current Understanding of Prevalence, Patterns, and Interventions for Children and Adolescents. Curr Allergy Asthma Rep 2017; 17:37. [PMID: 28484946 PMCID: PMC6533905 DOI: 10.1007/s11882-017-0704-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
PURPOSE OF REVIEW Asthma is the most common chronic illness of children and adolescents in the USA. While asthma has been understood to disproportionately affect urban dwellers, recent investigations have revealed rural pediatric asthma prevalence to be very similar to urban and to be more closely correlated with socioeconomic and environmental factors than geographic location or population density. RECENT FINDINGS Rural children experience factors unique to location that impact asthma development and outcomes, including housing quality, cigarette smoke exposure, and small/large-scale farming. Additionally, there are challenging barriers to appropriate asthma care that frequently are more severe for those living in rural areas, including insurance status, lack of primary care providers and pulmonary specialists, knowledge deficits (both patient and provider), and a lack of culturally tailored asthma interventions. Interventions designed to address rural pediatric asthma disparities are more likely to be successful when targeted to specific challenges, such as the use of school-based services or telemedicine to mitigate asthma care access issues. Continued research on understanding the complex interaction of specific rural environmental factors with host factors can inform future interventions designed to mitigate asthma disparities.
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Affiliation(s)
| | - Dennis R Ownby
- Allergy & Immunology, Augusta University, Augusta, GA, USA
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135
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136
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Umweltmikrobiom. Monatsschr Kinderheilkd 2017. [DOI: 10.1007/s00112-017-0271-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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137
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Hong SW, Kim KS, Surh CD. Beyond Hygiene: Commensal Microbiota and Allergic Diseases. Immune Netw 2017; 17:48-59. [PMID: 28261020 PMCID: PMC5334122 DOI: 10.4110/in.2017.17.1.48] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Revised: 01/23/2017] [Accepted: 01/31/2017] [Indexed: 12/12/2022] Open
Abstract
Complex communities of microorganisms, termed commensal microbiota, inhabit mucosal surfaces and profoundly influence host physiology as well as occurrence of allergic diseases. Perturbing factors such as the mode of delivery, dietary fibers and antibiotics can influence allergic diseases by altering commensal microbiota in affected tissues as well as in intestine. Here, we review current findings on the relationship between commensal microbiota and allergic diseases, and discuss the underlying mechanisms that contribute to the regulation of allergic responses by commensal microbiota.
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Affiliation(s)
- Sung-Wook Hong
- Academy of Immunology and Microbiology, Institute for Basic Science, Pohang University of Science and Technology, Pohang 37673, Korea
| | - Kwang Soon Kim
- Academy of Immunology and Microbiology, Institute for Basic Science, Pohang University of Science and Technology, Pohang 37673, Korea
| | - Charles D Surh
- Academy of Immunology and Microbiology, Institute for Basic Science, Pohang University of Science and Technology, Pohang 37673, Korea.; Department of Integrative Biosciences and Biotechnology. Pohang University of Science and Technology, Pohang 37673, Korea
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138
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Lynch JP, Sikder MAA, Curren BF, Werder RB, Simpson J, Cuív PÓ, Dennis PG, Everard ML, Phipps S. The Influence of the Microbiome on Early-Life Severe Viral Lower Respiratory Infections and Asthma-Food for Thought? Front Immunol 2017; 8:156. [PMID: 28261214 PMCID: PMC5311067 DOI: 10.3389/fimmu.2017.00156] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 01/30/2017] [Indexed: 12/24/2022] Open
Abstract
Severe viral lower respiratory infections are a major cause of infant morbidity. In developing countries, respiratory syncytial virus (RSV)-bronchiolitis induces significant mortality, whereas in developed nations the disease represents a major risk factor for subsequent asthma. Susceptibility to severe RSV-bronchiolitis is governed by gene-environmental interactions that affect the host response to RSV infection. Emerging evidence suggests that the excessive inflammatory response and ensuing immunopathology, typically as a consequence of insufficient immunoregulation, leads to long-term changes in immune cells and structural cells that render the host susceptible to subsequent environmental incursions. Thus, the initial host response to RSV may represent a tipping point in the balance between long-term respiratory health or chronic disease (e.g., asthma). The composition and diversity of the microbiota, which in humans stabilizes in the first year of life, critically affects the development and function of the immune system. Hence, perturbations to the maternal and/or infant microbiota are likely to have a profound impact on the host response to RSV and susceptibility to childhood asthma. Here, we review recent insights describing the effects of the microbiota on immune system homeostasis and respiratory disease and discuss the environmental factors that promote microbial dysbiosis in infancy. Ultimately, this knowledge will be harnessed for the prevention and treatment of severe viral bronchiolitis as a strategy to prevent the onset and development of asthma.
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Affiliation(s)
- Jason P. Lynch
- Laboratory of Respiratory Mucosal Immunity, School of Biomedical Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Md. Al Amin Sikder
- Laboratory of Respiratory Mucosal Immunity, School of Biomedical Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Bodie F. Curren
- Laboratory of Respiratory Mucosal Immunity, School of Biomedical Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Rhiannon B. Werder
- Laboratory of Respiratory Mucosal Immunity, School of Biomedical Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Jennifer Simpson
- Laboratory of Respiratory Mucosal Immunity, School of Biomedical Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Páraic Ó Cuív
- Translational Research Institute, The University of Queensland Diamantina Institute, The University of Queensland, St. Lucia, QLD, Australia
| | - Paul G. Dennis
- The School of Agriculture and Food Sciences, The University of Queensland, St. Lucia, QLD, Australia
| | - Mark L. Everard
- School of Paediatrics and Child Health, University of Western Australia, Perth, WA, Australia
| | - Simon Phipps
- Laboratory of Respiratory Mucosal Immunity, School of Biomedical Sciences, The University of Queensland, St. Lucia, QLD, Australia
- Australian Infectious Diseases Research Centre, The University of Queensland, St. Lucia, QLD, Australia
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139
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Licari A, Castagnoli R, Denicolò CF, Rossini L, Marseglia A, Marseglia GL. The Nose and the Lung: United Airway Disease? Front Pediatr 2017; 5:44. [PMID: 28316969 PMCID: PMC5334318 DOI: 10.3389/fped.2017.00044] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 02/16/2017] [Indexed: 12/31/2022] Open
Abstract
Epidemiologic, pathophysiologic, and clinical evidences recently revealed the link between upper and lower airways, changing the global pathogenic view of respiratory allergy. The aim of this review is to highlight the strong interaction between the upper and lower respiratory tract diseases, in particular allergic rhinitis and asthma.
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Affiliation(s)
- Amelia Licari
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
| | - Riccardo Castagnoli
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
| | - Chiara Francesca Denicolò
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
| | - Linda Rossini
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
| | - Alessia Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
| | - Gian Luigi Marseglia
- Department of Pediatrics, Fondazione IRCCS Policlinico San Matteo, University of Pavia , Pavia , Italy
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