Follow-up study of airway microbiota in children with persistent wheezing

Lei Wu,Lingling Yan,Xuefeng Xu,Chencong Shen,Chengcheng Hang,Xiaofei Luo,Xin Yang,Yuanling Chen

doi:10.1186/s12931-021-01806-9

Abstract

BackgroundIncreasing evidence revealed that airway microbial dysbiosis was associated with increased risk of asthma, or persistent wheezing (PW). However, the role of lung microbiota in PW or wheezing recurrence remains poorly understood.MethodsIn this prospective observational study, we performed a longitudinal 16S rRNA-based microbiome survey on bronchoalveolar lavage (BAL) samples collected from 35 infants with PW and 28 age-matched infants (control group). A 2-year follow-up study on these PW patients was conducted. The compositions of lower airway microbiota were analyzed at the phylum and genus levels.ResultsOur study showed a clear difference in lower airway microbiota between PW children and the control group. Children with PW had a higher abundance of Elizabethkingia and Rothia, and lower abundance of Fusobacterium compared with the control group. At the end of the 2-year follow-up, 20 children with PW (57.1%) experienced at least one episode of wheezing, and 15 (42.9%) did not suffer from wheezing episodes. Furthermore, PW children with recurrence also had increased abundances of Elizabethkingia and Rothia relative to those who had no recurrence. Additionally, wheezing history, different gender, and caesarean section demonstrated a greater impact in airway microbiota compositions.ConclusionThis study suggests that the alterations of lower airway microbiota could be strongly associated with the development of wheezing, and early airway microbial changes could also be associated with wheezing recurrence later in life.

Highlights

Pediatric asthma is a common chronic disease of childhood and a major public health problem
Antibiotics administration had the impact on the airway microbiota, there were no significant differences observed in β-lactam and macrolides uses before hospitalization between the two groups
We found that children with persistent wheezing (PW) had higher abundances of Elizabethkingia and Rothia, and a lower abundance of Fusobacterium

Summary

Introduction

Pediatric asthma is a common chronic disease of childhood and a major public health problem. Some infants will develop persistent or recurrent wheezing, which is often severe [1]. There is evidence that infantile wheezing or persistent wheezing (PW) is strongly associated with the development of asthma later in life [2]. The underlying mechanisms between them are still poorly understood. A number of biologically plausible mechanisms have suggested the effect of environmental changes early in life on the subsequent development of asthma, including cytokine response, developmental origins of adult disease, and microbial exposure [3,4,5,6]. Increasing evidence revealed that airway microbial dysbiosis was associated with increased risk of asthma, or persistent wheezing (PW). The role of lung microbiota in PW or wheezing recurrence remains poorly understood

Methods

Results

Discussion

Conclusion