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Published on: August 7, 2017
Nasopharyngeal microbiota in children is associated with severe asthma exacerbations
Gina J van Beveren1, Wouter A A de Steenhuijsen Piters2, Shelley A Boeschoten3
1Department of Paediatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, The Netherlands; Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands; Department of Paediatrics, Spaarne Hospital, Haarlem, The Netherlands.
Insights
Children with severe asthma exacerbations have distinct nasopharyngeal microbiomes, with increased Staphylococcus and oral bacteria, and decreased beneficial microbes. These changes may link to environmental exposures.
Area of Science:
- Microbiology
- Pulmonology
- Environmental Health
Background:
- The respiratory microbiome plays a role in asthma development and progression.
- Understanding the nasopharyngeal microbiota in pediatric asthma exacerbations is crucial.
Purpose of the Study:
- To investigate the nasopharyngeal microbiota composition in children experiencing severe asthma exacerbations.
- To explore associations between the microbiota and medication use, air quality, and viral infections.
Main Methods:
- A cross-sectional study involving children aged 2-18 years admitted for asthma exacerbation (n=162).
- Case-control analysis matched children with asthma exacerbation to healthy controls (n=87 vs n=182).
- Nasopharyngeal microbiota characterized using 16S-rRNA gene sequencing.
Main Results:
- Children with asthma exacerbations exhibited higher microbial diversity and distinct community composition compared to controls.
- Increased abundance of Staphylococcus and "oral" taxa (Neisseria, Veillonella, Streptococcus) and decreased abundance of Dolosigranulum pigrum, Corynebacterium, and Moraxella were observed in cases.
- Neisseria abundance correlated with disease severity and fine particulate matter exposure; Haemophilus and Streptococcus correlated with inhaled corticosteroid use. No viral infection correlations were found.
Conclusions:
- Pediatric asthma exacerbations are associated with an overgrowth of Staphylococcus and "oral" microbes, and an underrepresentation of beneficial commensals.
- Environmental and medical exposures may influence these microbial alterations, but causal relationships require further investigation.
Background:
The respiratory microbiome has been associated with the etiology and disease course of asthma.
Objective:
We sought to assess the nasopharyngeal microbiota in children with a severe asthma exacerbation and their associations with medication, air quality, and viral infection.
Methods:
A cross-sectional study was performed among children aged 2 to 18 years admitted to the medium care unit (MCU; n = 84) or intensive care unit (ICU; n = 78) with an asthma exacerbation. For case-control analyses, we matched all cases aged 2 to 6 years (n = 87) to controls in a 1:2 ratio. Controls were participants of either a prospective case-control study or a longitudinal birth cohort (n = 182). The nasopharyngeal microbiota was characterized by 16S-rRNA-gene sequencing.
Results:
Cases showed higher Shannon diversity index (ICU and MCU combined; P = .002) and a distinct microbial community composition when compared with controls (permutational multivariate ANOVA R2 = 1.9%; P < .001). We observed significantly higher abundance of Staphylococcus and "oral" taxa, including Neisseria, Veillonella, and Streptococcus spp. and a lower abundance of Dolosigranulum pigrum, Corynebacterium, and Moraxella spp. (MaAsLin2; q < 0.25) in cases versus controls. Furthermore, Neisseria abundance was associated with more severe disease (ICU vs MCU MaAslin2, P = .03; q = 0.30). Neisseria spp. abundance was also related with fine particulate matter exposure, whereas Haemophilus and Streptococcus abundances were related with recent inhaled corticosteroid use. We observed no correlations with viral infection.
Conclusions:
Our results demonstrate that children admitted with asthma exacerbations harbor a microbiome characterized by overgrowth of Staphylococcus and "oral" microbes and an underrepresentation of beneficial niche-appropriate commensals. Several of these associations may be explained by (environmental or medical) exposures, although cause-consequence relationships remain unclear and require further investigations.
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