Abstract
Perturbation of the microbiome has numerous associations with the phenotypes and progression in chronic airways disease. However, the differences in the nasal microbiome in asthma and allergic rhinitis (AR) have not been defined. We examined whether the nasal microbiome would vary among different comorbidities in asthma and AR and that those differences may be associated with the severity of asthma. Nasal lavage fluid was collected from 110 participants, including 20 healthy controls, 30 subjects with AR, 30 subjects with asthma and 30 subjects with combined asthma + AR. The Asthma Control Questionnaire (ACQ-7) was used to evaluate asthma control status. Using 16S rRNA bacterial gene sequencing, we analyzed nasal microbiome in patients with asthma, AR, combined asthma + AR, and healthy controls. Bacterial diversity was analyzed in corresponding with α diversity indices (Chao and Shannon index). Compared with healthy controls, the Chao index tended to be lower in subjects with AR (P = 0.001), asthma (P = 0.001), and combined asthma + AR (P = 0.001) when compared with healthy controls. Furthermore, the Shannon index was significantly lower in subjects with asthma (P = 0.013) and comorbid asthma with AR (P = 0.004) than the control subjects. Disparity in the structure and composition of nasal bacteria were also observed among the four groups. Furthermore, patients with combined asthma + AR and isolated asthma were divided into two groups according to the level of disease control: partially or well-controlled and uncontrolled asthma. The mean relative abundance observed in the groups mentioned the genera of Pseudoflavonifractor were dominated in patients with well and partially controlled disease, in both isolated asthma and combined asthma + AR. In subjects with uncontrolled asthma and combined asthma + AR, a lower evenness and richness (Shannon index, P = 0.040) was observed in nasal microbiome composition. Importantly, lower evenness and richness in the nasal microbiome may be associated with poor disease control in combined asthma + AR. This study showed the upper airway microbiome is associated with airway inflammation disorders and the level of asthma control.
Highlights
Perturbation of the microbiome has numerous associations with the phenotypes and progression in chronic airways disease (Fazlollahi et al, 2018; Mac Aogáin et al, 2020)
Considering that microbiota population and composition host-microbe interactions play an important role in inflammation, we conducted this study to investigate the nasal microbiome of patients with asthma and allergic rhinitis (AR)
The findings from this study show significant disparities in the structure and composition of nasal bacteria composition between healthy controls and patients with asthma patients with or without comorbid AR
Summary
Perturbation of the microbiome has numerous associations with the phenotypes and progression in chronic airways disease (Fazlollahi et al, 2018; Mac Aogáin et al, 2020). Asthma and allergic rhinitis (AR) are among the commonest chronic inflammatory respiratory diseases. Increasing data suggest that the composition and structure of the bronchial microbiome differ between those with allergic respiratory disease and healthy subjects (Huang et al, 2015; Durack et al, 2020). One study indicated that 103 taxa including the genus of Prevotella, Haemophilus, and Fusobacterium enrichments differed significantly between asthma with or without atopy; these two groups shared 26% and 29% bronchial bacteria compared to healthy controls (Durack et al, 2017). The airway microbiome of chronic inflammatory respiratory disease conducted by endoscope has been well studied, it is an invasive investigation for patients, not without risks (Durack et al, 2018)
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