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Published on: April 28, 2014
Prospective association between the gut microbiota and incident pneumonia: a cohort study of 6419 individuals
Irina Wikki1,2, Joonatan Palmu3, Anni Kauko3,4
1Department of Internal Medicine, University of Turku, P.O. Box 52, Turku, FI-20521, Finland. irina.wikki@varha.fi.
Background:
Previous animal studies have identified the protective capacity of the gut microbiota against respiratory infections. Nevertheless, the prospective association between human gut microbiota and pneumonia risk remains unknown.
Objectives:
To evaluate the links between gut microbiota and incident pneumonia in a representative population sample.
Methods:
We performed shotgun metagenome sequencing on stool samples from 6419 FINRISK 2002 participants. Participants were followed up for incident pneumonia using nationwide health register data. We employed multivariable-adjusted Cox regression models and permutational multivariate analysis of variance (PERMANOVA) to assess the association of gut microbiome alpha diversity, compositional variation (beta diversity), and taxonomic composition with pneumonia risk.
Results:
Altogether, 685 patients (10.7%) developed pneumonia during a mean follow-up of 17.8 years. Alpha diversity was not associated with incident pneumonia (hazard ratio [HR] 1.00; 95% confidence interval [CI] 0.93 - 1.08), whereas community composition was (PERMANOVA R2 = 0.03%; P = 0.02). We observed an inverse association between the relative abundance of butyrate-producing bacteria and incident pneumonia (HR per 1-SD increase 0.91; 95% CI 0.85-0.98). The relative abundance of Bacteroides_F pectinophilus, Eubacterium_G ventriosum, Agathobaculum butyriciproducens, Butyribacter intestini, Eubacterium_I ramulus, CAG-1427 sp000435675, and CAG-603 sp900066105 were inversely associated with pneumonia risk. The relative abundance of Clostridium_AQ innocuum was positively correlated with pneumonia risk.
Conclusions:
The gut microbiota composition, and especially the relative abundance of butyrate-producing bacteria, was associated with lower pneumonia risk in the population. These findings warrant further studies to investigate whether microbiome modulation to increase short chain fatty acid production through diet, prebiotics, or probiotics could reduce pneumonia risk.
Insights
The composition of gut bacteria, particularly butyrate-producing species, is linked to a reduced risk of pneumonia. Further research into microbiome modulation could offer new prevention strategies for this common infection.
Area of Science:
- Microbiome research
- Infectious disease epidemiology
- Gut-lung axis
Background:
- Animal studies suggest gut microbiota protects against respiratory infections.
- The association between human gut microbiota and pneumonia risk is not well understood.
Purpose of the Study:
- To investigate the relationship between gut microbiota composition and the incidence of pneumonia in a large population sample.
- To identify specific microbial taxa or functional pathways associated with pneumonia risk.
Main Methods:
- Shotgun metagenome sequencing of stool samples from 6419 participants.
- Longitudinal follow-up for pneumonia incidence using nationwide health registers.
- Statistical analysis using Cox regression and PERMANOVA to assess microbiome-disease associations.
Main Results:
- Microbiome composition, not alpha diversity, was associated with pneumonia risk.
- Higher abundance of butyrate-producing bacteria correlated with lower pneumonia incidence (HR 0.91; 95% CI 0.85-0.98).
- Specific bacteria like Bacteroides pectinophilus and Clostridium innocuum showed inverse and positive associations with pneumonia risk, respectively.
Conclusions:
- Gut microbiota composition, particularly butyrate-producing bacteria, is associated with reduced pneumonia risk.
- Findings suggest potential for microbiome-targeted interventions (diet, prebiotics, probiotics) to lower pneumonia incidence.
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