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Published on: August 3, 2021
Differences in the lower airway microbiota of infants with and without cystic fibrosis
Katherine B Frayman1, Kristine M Wylie2, David S Armstrong3
1Department of Respiratory and Sleep Medicine, Royal Children's Hospital, Victoria, Australia; Respiratory Diseases Group, Murdoch Childrens Research Institute, Victoria, Australia; Department of Paediatrics, University of Melbourne, Victoria, Australia; Allergy, Immunology and Cystic Fibrosis, Alfred Health, Victoria, Australia; Department of Respiratory Medicine, Monash Children's Hospital, Victoria, Australia.
Insights
The lower airway microbiota of infants with cystic fibrosis (CF) differs significantly from healthy infants by six months of age. These early microbial changes are linked to increased inflammation in CF lung disease.
Area of Science:
- Microbiology
- Pediatric Pulmonology
- Inflammation Research
Background:
- Cystic fibrosis (CF) lung disease begins in infancy.
- Understanding the role of the lower airway microbiota in CF pathogenesis is critical.
- This study investigated the relationship between infant microbiota and airway inflammation in early life.
Purpose of the Study:
- To compare the lower airway microbiota of infants with and without CF.
- To examine the association between microbiota and airway inflammation in early CF lung disease.
- To identify early microbial differences in infants with CF.
Main Methods:
- Recruited infants newly-diagnosed with CF and healthy controls.
- Collected bronchoalveolar lavage samples for microbiological and inflammatory analysis.
- Utilized 16S ribosomal RNA gene sequencing to analyze microbial communities.
Main Results:
- Bacterial biomass positively correlated with inflammation.
- Reduced alpha diversity was observed in infants with CF.
- Microbiota differences were driven by increased Staphylococcus and decreased Fusobacterium, particularly in symptomatic infants.
Conclusions:
- Lower airway microbial communities are distinct in infants with CF by six months of age.
- Early-life microbial composition and structure are altered in CF.
- These early microbial shifts may contribute to airway inflammation in CF lung disease.
Background:
Cystic fibrosis (CF) lung disease commences in infancy, and understanding the role of the microbiota in disease pathogenesis is critical. This study examined and compared the lower airway microbiota of infants with and without CF and its relationship to airway inflammation in the first months of life.
Methods:
Infants newly-diagnosed with CF were recruited into a single-centre study in Melbourne, Australia from 1992 to 2001. Bronchoalveolar lavage was performed at study entry. Healthy infants undergoing bronchoscopy to investigate chronic stridor acted as controls. Quantitative microbiological culture was performed and inflammatory markers were measured contemporaneously. 16S ribosomal RNA gene analysis was performed on stored samples.
Results:
Thirteen bronchoalveolar samples from infants with CF and nine from control infants, collected at median ages of 1.8-months (25th-75th percentile 1.5 to 3.1-months) and 5-months (25th-75th percentile 2.9 to 8.2-months) respectively, provided 16S rRNA gene data. Bacterial biomass was positively associated with inflammation. Alpha diversity was reduced in infants with CF and between-group compositional differences were apparent. These differences were driven by increased Staphylococcus and decreased Fusobacterium and were most apparent in symptomatic infants with CF.
Conclusion:
In CF lung disease, differences in lower airway microbial community composition and structure are established by age 6-months.
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