Aerodigestive dysbiosis in children with chronic cough

Kazachkov, Mikhail; Kapoor, Bianca; Malecha, Patrick; Wu, Benjamin; Li, Yonghua; Levine, Jeremiah; Erkman, Jessica; Fitzgerald, Kathryn C.; Moy, Libia

doi:10.1002/ppul.24115

Cited by 7 publications

(10 citation statements)

References 37 publications

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“…41,42 Investigations of the aerodigestive microbial composition in children with chronic cough revealed that the lower airway microbiota was enriched with Prevotella in the bacterial bronchitis group. 43 Airway microbiome studies have also found a high relative abundance of oral microbes, suggesting that recurrent microaspirations might influence the lower airway microbiota. 36,43 Especially in EA/TEF patients with a high number of possible aspirations associated with esophageal dysmotility and gastroesophageal reflux, the oral microbiota could have a major impact on the composition of the airway microbiome.…”

Section: Airway Microbiomementioning

confidence: 99%

“…43 Airway microbiome studies have also found a high relative abundance of oral microbes, suggesting that recurrent microaspirations might influence the lower airway microbiota. 36,43 Especially in EA/TEF patients with a high number of possible aspirations associated with esophageal dysmotility and gastroesophageal reflux, the oral microbiota could have a major impact on the composition of the airway microbiome. For instance, Veillonella, another oral commensal, was found significantly enriched in the lower airway microbiome of orally fed, neurologically impaired children who frequently suffer from aspiration of food, oral secretions, and common reflux of gastrointestinal contents into the airways.…”

Section: Airway Microbiomementioning

confidence: 99%

“…For instance, Veillonella, another oral commensal, was found significantly enriched in the lower airway microbiome of orally fed, neurologically impaired children who frequently suffer from aspiration of food, oral secretions, and common reflux of gastrointestinal contents into the airways. 43 However, only little is known about the microbial functionality and the kinetics of microbiome changes. 44 The microbiota composition can be influenced by exogenous forces, including diets, environmental biodiversity, infection, and antibiotics.…”

Section: Airway Microbiomementioning

confidence: 99%

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Cardiorespiratory performance capacity and airway microbiome in patients following primary repair of esophageal atresia

et al. 2020

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BACKGROUND: Patients following repair of an esophageal atresia (EA) or tracheoesophageal fistula (TEF) carry an increased risk of long-term cardiopulmonary malaise. The role of the airway microbiome in EA/TEF patients remains unclear. METHODS: All EA/TEF patients treated between 1980 and 2010 were invited to a prospective clinical examination, spirometry, and spiroergometry. The airway microbiome was determined from deep induced sputum by 16 S rRNA gene sequencing. The results were compared to a healthy age-and sex-matched control group. RESULTS: Nineteen EA/TEF patients with a mean age of 24.7 ± 7 years and 19 age-and sex-matched controls were included. EA/TEF patients showed a significantly lower muscle mass, lower maximum vital capacity (VC max), and higher rates of restrictive ventilation disorders. Spiroergometry revealed a significantly lower relative performance capacity and lower peak VO 2 in EA/TEF patients. Alphaand beta-diversity of the airway microbiome did not differ significantly between the two groups. Linear discriminant effect size analysis revealed significantly enriched species of Prevotella_uncultured, Streptococcus_anginosus, Prevotella_7_Prevotella_enoeca, and Mogibacterium_timidum. CONCLUSION: EA/TEF patients frequently suffer from restrictive ventilation disorders and impaired cardiopulmonary function associated with minor alterations of the airway microbiome. Long-term examinations of EA/TEF patients seem to be necessary in order to detect impaired cardiopulmonary function.

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Section: Airway Microbiomementioning

confidence: 99%

Section: Airway Microbiomementioning

confidence: 99%

Section: Airway Microbiomementioning

confidence: 99%

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Cardiorespiratory performance capacity and airway microbiome in patients following primary repair of esophageal atresia

et al. 2020

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“…Work from our group and others has extensively characterised the fungal component of the bronchiectasis microbiome (the Mycobiome) and highlights a high frequency of fungal sensitisation associated with worsening disease severity, lung function and exacerbations [35]. In chronic cough, microbiome analysis has been applied to paediatric patients which has illustrated an increased abundance of commensal taxa in the lower airway and the potential association of specific microbiome signatures with particular patients including asthma, bacterial bronchitis or neurologically impaired orally fed subjects [36]. These observations highlight the potential for characterising cough endotypes based on microbiome analysis, however, the specific influence of the microbiome in bronchiectasis-associated cough remains to be defined.…”

Section: The Inter-relationship Between Cough and Bronchiectasismentioning

confidence: 99%

Bronchiectasis and cough: An old relationship in need of renewed attention

Aogáin

Chotirmall

2019

Pulmonary Pharmacology & Therapeutics

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A B S T R A C TBronchiectasis is an increasingly recognised respiratory condition with limited therapeutic options and a complex spectrum of clinical manifestations that invariably includes chronic cough. As the primary presentation of bronchiectasis in most cases, chronic cough and its mechanistic underpinnings are of central importance but remain poorly understood in this setting. Bronchiectasis is also increasingly identified as an underlying cause of chronic cough highlighting the interrelationship between the two conditions that share overlapping clinical features. Several therapeutic approaches have illustrated positive effects on bronchiectasis-associated cough, however, more focused treatment of heterogeneous cough subtypes may yield better outcomes for patients. A current challenge is the identification of bronchiectasis and cough endophenotypes that may allow improved patient stratification and more targeted therapeutic matching of the right treatment to the right patient. Here we discuss the complex disease phenotypes of bronchiectasis and their interrelationship with cough while considering current and emerging treatment options. We discuss some key cough promoters in bronchiectasis including infection, allergy and immune dysfunction.

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“…This includes antibiotic perturbations which can decrease the abundance of presumed beneficial commensal bacteria and increase the risk of respiratory infections following a course of antibiotics 7 . Research has shown that upper airway and gastric microbiota can be found in lower airway lavage samples in children with chronic cough and impaired swallow, supporting a degree of microaspiration which may or may not have been clinically suspected 8,9 . Duvallet et al 9 showed there was a greater overlap between oropharyngeal‐lung microbiota than gastric‐lung microbiota highlighting that the care of children with concern for aspiration may benefit from increased focus on oropharyngeal dysphagia instead of antireflux surgeries such as the Nissen fundoplication or medications targeting gastroesophageal reflux.…”

Section: Introductionmentioning

confidence: 99%

Metagenomic sequencing and evaluation of the host response in the pediatric aerodigestive population

Gatcliffe

Rao

Brigger

et al. 2020

Pediatric Pulmonology

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Objectives: To assess the diagnostic utility of metagenomic sequencing in pediatric aerodigestive clinic patients being evaluated for chronic aspiration. We hypothesize that using a metagenomics platform will aid in the identification of microbes not found on standard culture. Study Design and Methods: Twenty-four children referred to an aerodigestive clinic were enrolled in a prospective, single-site, cross-sectional cohort study. At the time of clinical evaluation under anesthesia, two samples were obtained: an upper airway sample and a sample from bronchoalveolar lavage (BAL). Samples were sent for routine culture and analyzed using Explify® Respiratory, a CLIA Laboratory Developed Test which identifies respiratory commensals and pathogens through RNA and DNA sequencing. Since RNA was sequenced in the course of the metagenomic analysis to identify organisms (RNA viruses and bacteria), the sequencing approach also captured host derived messenger RNA during sample analysis. This incidentally obtained host transcriptomic data were analyzed to evaluate the host immune response. The results of these studies were correlated with the clinical presentation of the research subjects. Results: In 10 patients, organisms primarily associated with oral flora were identified in the BAL. Standard culture was negative in three patients where clinical metagenomics led to a result with potential clinical significance. Transcriptomic data correlated with the presence or absence of dysphagia as identified on prior videofluoroscopic evaluation of swallowing. Conclusions: Clinical metagenomics allows for simultaneous analysis of the microbiota and the host immune response from BAL samples. As the technologies in this field continue to advance, such testing may improve the diagnostic evaluation of patients with suspected chronic aspiration.

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Aerodigestive dysbiosis in children with chronic cough

Abstract: Distinct dysbiotic signatures can be identified in the lower airway microbiota of pediatric subjects with chronic cough that relates to the degree and type of inflammation.

Cited by 7 publications

References 37 publications

Cardiorespiratory performance capacity and airway microbiome in patients following primary repair of esophageal atresia

Cardiorespiratory performance capacity and airway microbiome in patients following primary repair of esophageal atresia

Bronchiectasis and cough: An old relationship in need of renewed attention

Metagenomic sequencing and evaluation of the host response in the pediatric aerodigestive population

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