婴儿支气管炎的鼻菌亚型和疾病严重性风险
Ryohei Shibata1, Zhaozhong Zhu1, Michihito Kyo1
1Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
EBioMedicine
|August 3, 2023
概括
婴儿支气管炎的真菌和病毒共同感染定义了不同的真菌类型. 某些真菌类型,如具有RSV/RV的M.globosa真菌,与减少呼吸支持需求和独特的免疫路径改变有关.
科学领域:
- 儿童传染病 儿童传染病
- 呼吸道病毒学 呼吸道病毒学
- 菌类学 菌类学是指菌类学.
- 微生物组研究 微生物组研究
背景情况:
- 支气管炎是婴儿住院的主要原因,已知与病毒和细菌有关.
- 菌类在支气管炎的严重程度和病原发生中的作用仍然在很大程度上未被探索.
- 了解真菌,病毒和细菌的相互作用对于破译疾病异质性至关重要.
研究的目的:
- 在患有支气管炎的住院婴儿中识别明显的真菌-病毒联合感染模式 (型).
- 调查这些真菌类型与支气管炎严重程度的关联,包括需要正压通风 (PPV) 的需要.
- 探索与不同真菌类型相关的生物特征和宿主免疫反应.
主要方法:
- 一项多中心前性队列研究,涉及398名因支气管炎住院的一岁以下的婴儿.
- 用RNA测序来检测真菌和病毒 (RSV,RV) 存在的鼻样本进行分析.
- 集群方法集成的真菌和病毒数据来定义菌类;通过PPV使用评估严重程度;通过metatranscriptome和转录组数据分析的生物特征.
主要成果:
- 确定了四种不同的真菌类型:真菌M.restricta/病毒RSV/RV,真菌M.restricta/病毒RSV,真菌M.globosa/病毒RSV/RV,以及真菌阴性/病毒RSV/RV.
- 与最大组 (菌M.restricta/病毒RSV/RV) 相比,M.globosa/病毒RSV/RV菌型的婴儿需要PPV的风险明显较低.
- 菌型C (真菌M.globosa/病毒RSV/RV) 呈现出相似的细菌组成,但免疫通路失调,包括Fc γ受体介导的细胞分裂和化学激素信号传递.
结论:
- 在婴儿支气管炎中可以识别出真菌病毒共感染模式 (型).
- 这些独特的真菌类型与需要呼吸支持的严重疾病的差异性风险有关.
- 特定的真菌类型与独特的宿主免疫路径失调有关,提供了对支气管炎病原学的见解.
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