Abstract

The intestinal microbiota generates many different metabolites which are critical for the regulation of host signaling pathways. In fact, a wide-range of diseases are associated with increased levels of local or systemic microbe-derived metabolites. In contrast, certain bacterial metabolites, such as tryptophan metabolites, are known to contribute to both local and systemic homeostasis. Chronic alcohol consumption is accompanied by alterations to intestinal microbial communities, and their functional capacities. However, little is known about the role of alcohol-associated dysbiosis on host defense against bacterial pneumonia. Our previous work using fecal transplantation demonstrated that alcohol-associated intestinal dysbiosis, independent of ethanol consumption, increased susceptibility to Klebsiella pneumonia. Here, we demonstrate that intestinal microbiota treatments mitigate the increased risk of alcohol-associated pneumonia. Treatment with the microbial metabolite indole or with probiotics reduced pulmonary and extrapulmonary bacterial burden, restored immune responses, and improved cellular trafficking required for host defense. Protective effects were, in part, mediated by aryl hydrocarbon receptors (AhR), as inhibition of AhR diminished the protective effects. Thus, alcohol appears to impair the production/processing of tryptophan catabolites resulting in immune dysregulation and impaired cellular trafficking. These data support microbiota therapeutics as novel strategies to mitigate the increased risk for alcohol-associated bacterial pneumonia.

Highlights

  • The intestinal microbiota generates many different metabolites which are critical for the regulation of host signaling pathways

  • Klebsiella pneumoniae infections are overrepresented in pneumonia patients with AUD3,4, and Alcohol use disorder (AUD) patients admitted to the hospital with community-acquired Klebsiella pneumonia experience almost double the mortality of AUD patients infected with other pathogens[4]

  • A plethora of data has emerged demonstrating the importance of the intestinal microbiota for optimal host defense against bacterial and viral respiratory infections[29,30,31,39,40,41,42,43]

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Summary

Introduction

The intestinal microbiota generates many different metabolites which are critical for the regulation of host signaling pathways. Alcohol appears to impair the production/processing of tryptophan catabolites resulting in immune dysregulation and impaired cellular trafficking These data support microbiota therapeutics as novel strategies to mitigate the increased risk for alcohol-associated bacterial pneumonia. There are several potential mechanisms by which AUD increase the risk of pneumonia These include aspiration of microbes from the upper alimentary tract, decreased mucusfacilitated clearance of bacterial pathogens from the upper airway, and impaired pulmonary host defenses[5]. Chronic ethanol feeding reduces; amino acid metabolism, levels of short-chain, and saturated longchain fatty acids[17,18,19], and bile acid metabolism in the gut[20] Together, these data demonstrate that chronic alcohol use is associated with impairments in mechanisms that maintain intestinal microbiota homeostasis. This study sought to investigated, whether targeting the intestinal microbiota could mitigate the increased risk of alcohol-associated pneumonia via alterations to the composition of the microbiota and cellular trafficking

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