早期鼻腔微生物群的动态影响局部粘膜的免疫应答和儿童呼吸道疾病的易感性。本病例对照研究的目的是监测、评估和比较鼻炎和喘息婴儿与健康对照组婴儿在出生后18个月的鼻微生物群的构成情况。在新加坡成长的122名研究对象中，在出生后的18个月里，纵向收集了超过7个时间点的前鼻拭子。采用16S rRNA双端测序法对3个临床组的鼻微生物群特征进行分析:(1)仅鼻炎患者28例，(2)伴有喘息的鼻炎患者34例，(3)健康对照组60例与对照组相比，两组婴儿鼻部微生物组的成熟模式均有明显差异。对照组婴儿在18个月的生命周期内细菌多样性增加，而鼻炎患儿的细菌多样性呈下降趋势(P < .05)。草酸杆菌科(proteobacteraceae门)和航空球菌科(Aerococcaceae门)的丰度的增加与鼻炎和伴随喘息有关(校正P < 0.01)，而棒状杆菌科(Actinobacteria门)和葡萄球菌科(Firmicutes门)的早期定殖（3周至9个月）与对照组相关(调整后P < .05)。鼻炎组与对照组的唯一差异是棒状杆菌科的丰度降低(调整后P < .05)。鼻微生物群落演替的决定因素包括性别、分娩方式、兄弟姐妹的出现以及婴儿的护理情况。我们的研究结果支持了鼻部微生物组与婴儿早期鼻炎和喘息发展有关的假设。
Establishment of the nasal microbiota in the first 18 months of life: Correlation with early-onset rhinitis and wheezing
DOI: 10.1016/j jaci.2018.01.032
Dynamic establishment of the nasal microbiota in early life influences local mucosal immune responses and susceptibility to childhood respiratory disorders.
The aim of this case-control study was to monitor, evaluate, and compare development of the nasal microbiota of infants with rhinitis and wheeze in the first 18 months of life with those of healthy control subjects.
Anterior nasal swabs of 122 subjects belonging to the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) birth cohort were collected longitudinally over 7 time points in the first 18 months of life. Nasal microbiota signatures were analyzed by using 16S rRNA multiplexed pair-end sequencing from 3 clinical groups: (1) patients with rhinitis alone (n = 28), (2) patients with rhinitis with concomitant wheeze (n = 34), and (3) healthy control subjects (n = 60).
Maturation of the nasal microbiome followed distinctive patterns in infants from both rhinitis groups compared with control subjects. Bacterial diversity increased over the period of 18 months of life in control infants, whereas infants with rhinitis showed a decreasing trend (P < .05). An increase in abundance of the Oxalobacteraceae family (Proteobacteria phylum) and Aerococcaceae family (Firmicutes phylum) was associated with rhinitis and concomitant wheeze (adjusted P < .01), whereas the Corynebacteriaceae family (Actinobacteria phylum) and early colonization with the Staphylococcaceae family (Firmicutes phylum; 3 weeks until 9 months) were associated with control subjects (adjusted P < .05). The only difference between the rhinitis and control groups was a reduced abundance of the Corynebacteriaceae family (adjusted P < .05). Determinants of nasal microbiota succession included sex, mode of delivery, presence of siblings, and infant care attendance.
Our results support the hypothesis that the nasal microbiome is involved in development of early-onset rhinitis and wheeze in infants.
Le Duc Huy Tax
Bee Wah Lee