Pneumocystis Pneumonia Severity Is Associated with Taxonomic Shifts in the Respiratory Microbiota
Valentina Del Prete1, Antonia Piazzesi2, Matteo Scanu2
1Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
Abstract:
Pneumonia caused by Pneumocystis jirovecii infection (PCP) is a potentially life-threatening illness, particularly affecting the immunocompromised. The past two decades have shown an increase in PCP incidence; however, the underlying factors that promote disease severity and fatality have yet to be fully elucidated. Recent evidence suggests that the microbiota of the respiratory tract may play a role in stimulating or repressing pulmonary inflammation, as well as the progression of both bacterial and viral pneumonia. Here, we employed 16S rRNA metataxonomic sequencing to profile the respiratory microbiota of patients with mild-moderate and severe PCP. Our results show that the upper and lower airways of PCP patients have bacterial profiles which have been associated with a pro-inflammatory response. Furthermore, we find that severe PCP is associated with lower bacterial diversity and an increase in Prevotella and a decrease in Neisseria. Functionally, severe PCP was associated with a decrease in metabolic pathways of molecules with anti-inflammatory and antimicrobial properties. To our knowledge, this is the first study showing an association of PCP severity with shifts in the respiratory microbiome and may provide some insight into which patients are more susceptible to the more severe manifestations of the disease.
Insights
Pneumocystis pneumonia (PCP) severity is linked to respiratory tract bacteria. Severe PCP shows lower diversity, increased Prevotella, and decreased Neisseria, impacting inflammation and antimicrobial pathways.
Area of Science:
- Microbiology
- Immunology
- Pulmonology
Background:
- Pneumocystis pneumonia (PCP) is a severe infection, especially in immunocompromised individuals.
- Increasing PCP incidence necessitates understanding factors driving disease severity.
- The respiratory tract microbiota's role in pulmonary inflammation and pneumonia progression is increasingly recognized.
Purpose of the Study:
- To investigate the association between respiratory microbiota composition and PCP severity.
- To identify specific microbial shifts correlating with mild-moderate versus severe PCP cases.
Main Methods:
- 16S rRNA metataxonomic sequencing was used to profile the respiratory microbiota.
- Samples were collected from the upper and lower airways of patients with varying PCP severity.
- Bioinformatic analysis was performed to compare microbial profiles and associated functions.
Main Results:
- PCP patients exhibited pro-inflammatory bacterial profiles in their airways.
- Severe PCP was characterized by reduced bacterial diversity.
- Significant shifts included an increase in Prevotella and a decrease in Neisseria in severe cases.
- Metabolic pathways related to anti-inflammatory and antimicrobial molecules were decreased in severe PCP.
Conclusions:
- This study is the first to link respiratory microbiome alterations with PCP severity.
- Specific microbial signatures may indicate susceptibility to severe PCP manifestations.
- Understanding these microbiome shifts could inform future therapeutic strategies for PCP.
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