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Lung microbiota predict invasive pulmonary aspergillosis and its outcome in immunocompromised patients

RATIONALE: Recent studies have revealed that the lung microbiota of critically ill patients is altered and predicts clinical outcomes. The incidence of invasive fungal infections, namely, invasive pulmonary aspergillosis (IPA), in immunocompromised patients is increasing, but the clinical significan...

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Autores principales: Hérivaux, Anaïs, Willis, Jesse R, Mercier, Toine, Lagrou, Katrien, Gonçalves, Samuel M, Gonçales, Relber A, Maertens, Johan, Carvalho, Agostinho, Gabaldón, Toni, Cunha, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8867272/
https://www.ncbi.nlm.nih.gov/pubmed/34172558
http://dx.doi.org/10.1136/thoraxjnl-2020-216179
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author Hérivaux, Anaïs
Willis, Jesse R
Mercier, Toine
Lagrou, Katrien
Gonçalves, Samuel M
Gonçales, Relber A
Maertens, Johan
Carvalho, Agostinho
Gabaldón, Toni
Cunha, Cristina
author_facet Hérivaux, Anaïs
Willis, Jesse R
Mercier, Toine
Lagrou, Katrien
Gonçalves, Samuel M
Gonçales, Relber A
Maertens, Johan
Carvalho, Agostinho
Gabaldón, Toni
Cunha, Cristina
author_sort Hérivaux, Anaïs
collection PubMed
description RATIONALE: Recent studies have revealed that the lung microbiota of critically ill patients is altered and predicts clinical outcomes. The incidence of invasive fungal infections, namely, invasive pulmonary aspergillosis (IPA), in immunocompromised patients is increasing, but the clinical significance of variations in lung bacterial communities is unknown. OBJECTIVES: To define the contribution of the lung microbiota to the development and course of IPA. METHODS AND MEASUREMENTS: We performed an observational cohort study to characterise the lung microbiota in 104 immunocompromised patients using bacterial 16S ribosomal RNA gene sequencing on bronchoalveolar lavage samples sampled on clinical suspicion of infection. Associations between lung dysbiosis in IPA and pulmonary immunity were evaluated by quantifying alveolar cytokines and chemokines and immune cells. The contribution of microbial signatures to patient outcome was assessed by estimating overall survival. MAIN RESULTS: Patients diagnosed with IPA displayed a decreased alpha diversity, driven by a markedly increased abundance of the Staphylococcus, Escherichia, Paraclostridium and Finegoldia genera and a decreased proportion of the Prevotella and Veillonella genera. The overall composition of the lung microbiome was influenced by the neutrophil counts and associated with differential levels of alveolar cytokines. Importantly, the degree of bacterial diversity at the onset of IPA predicted the survival of infected patients. CONCLUSIONS: Our results reveal the lung microbiota as an understudied source of clinical variation in patients at risk of IPA and highlight its potential as a diagnostic and therapeutic target in the context of respiratory fungal diseases.
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spelling pubmed-88672722022-03-15 Lung microbiota predict invasive pulmonary aspergillosis and its outcome in immunocompromised patients Hérivaux, Anaïs Willis, Jesse R Mercier, Toine Lagrou, Katrien Gonçalves, Samuel M Gonçales, Relber A Maertens, Johan Carvalho, Agostinho Gabaldón, Toni Cunha, Cristina Thorax Respiratory Infection RATIONALE: Recent studies have revealed that the lung microbiota of critically ill patients is altered and predicts clinical outcomes. The incidence of invasive fungal infections, namely, invasive pulmonary aspergillosis (IPA), in immunocompromised patients is increasing, but the clinical significance of variations in lung bacterial communities is unknown. OBJECTIVES: To define the contribution of the lung microbiota to the development and course of IPA. METHODS AND MEASUREMENTS: We performed an observational cohort study to characterise the lung microbiota in 104 immunocompromised patients using bacterial 16S ribosomal RNA gene sequencing on bronchoalveolar lavage samples sampled on clinical suspicion of infection. Associations between lung dysbiosis in IPA and pulmonary immunity were evaluated by quantifying alveolar cytokines and chemokines and immune cells. The contribution of microbial signatures to patient outcome was assessed by estimating overall survival. MAIN RESULTS: Patients diagnosed with IPA displayed a decreased alpha diversity, driven by a markedly increased abundance of the Staphylococcus, Escherichia, Paraclostridium and Finegoldia genera and a decreased proportion of the Prevotella and Veillonella genera. The overall composition of the lung microbiome was influenced by the neutrophil counts and associated with differential levels of alveolar cytokines. Importantly, the degree of bacterial diversity at the onset of IPA predicted the survival of infected patients. CONCLUSIONS: Our results reveal the lung microbiota as an understudied source of clinical variation in patients at risk of IPA and highlight its potential as a diagnostic and therapeutic target in the context of respiratory fungal diseases. BMJ Publishing Group 2022-03 2021-06-25 /pmc/articles/PMC8867272/ /pubmed/34172558 http://dx.doi.org/10.1136/thoraxjnl-2020-216179 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Respiratory Infection
Hérivaux, Anaïs
Willis, Jesse R
Mercier, Toine
Lagrou, Katrien
Gonçalves, Samuel M
Gonçales, Relber A
Maertens, Johan
Carvalho, Agostinho
Gabaldón, Toni
Cunha, Cristina
Lung microbiota predict invasive pulmonary aspergillosis and its outcome in immunocompromised patients
title Lung microbiota predict invasive pulmonary aspergillosis and its outcome in immunocompromised patients
title_full Lung microbiota predict invasive pulmonary aspergillosis and its outcome in immunocompromised patients
title_fullStr Lung microbiota predict invasive pulmonary aspergillosis and its outcome in immunocompromised patients
title_full_unstemmed Lung microbiota predict invasive pulmonary aspergillosis and its outcome in immunocompromised patients
title_short Lung microbiota predict invasive pulmonary aspergillosis and its outcome in immunocompromised patients
title_sort lung microbiota predict invasive pulmonary aspergillosis and its outcome in immunocompromised patients
topic Respiratory Infection
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8867272/
https://www.ncbi.nlm.nih.gov/pubmed/34172558
http://dx.doi.org/10.1136/thoraxjnl-2020-216179
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