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Aspirated bile: a major host trigger modulating respiratory pathogen colonisation in cystic fibrosis patients

F J Reen1, D F Woods, M J Mooij

  • 1BIOMERIT Research Centre, School of Microbiology, University College Cork-National University of Ireland, Cork, Ireland.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|May 13, 2014
PubMed

Insights

Bile aspiration from acid reflux significantly reduces lung microbiome diversity in cystic fibrosis patients. This shift promotes chronic infections by promoting harmful bacteria, impacting disease progression.

Area of Science:

  • Microbiology
  • Pulmonology
  • Gastroenterology

Background:

  • Chronic respiratory infections are a major cause of illness and death globally.
  • The triggers for persistent, untreatable respiratory infections are poorly understood.
  • Bile aspiration due to gastro-oesophageal reflux (GOR) is increasingly linked to respiratory diseases, especially cystic fibrosis (CF).

Purpose of the Study:

  • To investigate the impact of bile aspiration on the lung microbiome in pediatric CF patients.
  • To determine if bile influences the microbial community structure in the lungs.

Main Methods:

  • Sputum samples from 25 pediatric CF patients were analyzed for bile acids using liquid chromatography-mass spectrometry (LC-MS).
  • DNA from 10 patients (5 bile aspirating, 5 non-bile aspirating) was analyzed using pyrosequencing and denaturing gradient gel electrophoresis (DGGE).

Main Results:

  • Bile aspirating patients showed significantly reduced lung microbiome biodiversity and richness compared to non-aspirating patients.
  • The lungs of bile aspirating patients were dominated by CF-associated bacteria, while non-aspirating patients had more healthy lung-associated bacteria.
  • Bile acids were detected in the sputum of bile aspirating patients.

Conclusions:

  • Bile aspiration, linked to GOR, acts as a significant host trigger for chronic bacterial infections in the lungs.
  • Reduced lung biodiversity and increased colonization by CF-associated pathogens in bile aspirating patients suggest bile plays a key role in CF disease progression.
  • These findings highlight bile aspiration as a critical factor in the development and progression of respiratory diseases like CF.

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