儿童支气管哮喘患者鼻咽微生态特征分析

Nasopharyngeal microecological characteristics in children with bronchial asthma

目的探讨儿童支气管哮喘(以下简称“哮喘”)患者鼻咽微生态与疾病的关系。方法将2020年11月—2023年3月在海南省中医院接受治疗的41例哮喘儿童回顾性纳入研究,同时选择同期行腺样体检查的26例健康儿童作为对照组。从下鼻甲的前内侧采集鼻黏膜样本,通过聚合酶链反应分析DEFB2、IL17A、TSLP、IL13、IL5、T1R3基因表达。从研究人群中收集鼻拭子,使用基于16S核糖体RNA基因测序对细菌组成进行分析。结果与对照组相比,哮喘组特应症患儿比例增加(53.7%vs.19.2%,P<0.05)。在门的水平上,与对照组相比,哮喘组儿童中绿弯菌门、髌骨细菌门、软壁菌门和硝化螺旋菌门检出数量增加(P<0.05),迷踪菌门检出数量降低(P<0.05)。在属的水平上,与对照组相比,哮喘组儿童中芽孢杆菌属(厚壁菌门)、瘤胃球菌属(厚壁菌门)、红球菌属(放线菌门)、不动杆菌属(变形菌门)、莫拉菌属(变形菌门)和亚细亚菌属(变形菌门)的成员明显增加(P<0.05),肠球菌属(厚壁菌门)、需烷烃型菌属(变形菌门)、立克次体属(变形菌门)、根瘤杆菌属(变形菌门)的成员减少(P<0.05)。与对照组相比,哮喘组的Shannon指数降低(2.63±1.45 vs.3.90±1.44;t=2.708,P=0.010)。根据受试者操作特征曲线分析确定的Shannon指数最佳分界点值为3.10。在所有研究人群中,与Shannon指数高于分界点儿童相比,Shannon指数低于分界点的儿童鼻腔炎症的特征是IL17A、T1R3表达增加(P<0.05),TSLP表达降低(P<0.05)。结论哮喘儿童和健康对照儿童的鼻咽微生态组成和丰度明显不同。

Objective To explore the relationship between nasopharyngeal microecology and diseases in children with bronchial asthma.Methods A total of 41 children with asthma who were treated in Hainan Provincial Hospital of Traditional Chinese Medicine between November 2020 and March 2023 were retrospectively included in the study,and 26 healthy children undergoing adenoid examination in the same period were selected as the control group.Samples of nasal mucosa were collected from the anterior and medial side of inferior turbinate,and the expression of DEFB2,IL17A,TSLP,IL13,IL5 and T1R3 genes was analyzed by polymerase chain reaction.Nasal swabs were collected from the children,and the bacterial composition was analyzed by 16S ribosomal RNA gene sequencing.Results Compared with the control group,the rate of atopy cases in the asthma group increased significantly(53.7%vs.19.2%,P<0.05).At the phylum level,compared with the control group,the phylum Chloroflexi,the phylum Patescibacteria,the phylum Tenericutes and the phylum Nitrospirae in the asthma group increased significantly(P<0.05),and the phylum Elusimicrobia decreased significantly(P<0.05).At the genus level,compared with the control group,the members of Bacillus(Fimnicutes),Ruminococcus(Fimnicutes),Rhodococcus(Actinobacteria),Acinetobacter(Proteobacteria),Moraxella(Proteobacteria)and Asaia(Proteobacteria)in the asthma group increased significantly(P<0.05),and the members of Enterococcus(Fimnicutes),Alkanindiges(Proteobacteria),Rickettsia(Proteobacteria),and Rhizobium(Proteobacteria)in the asthma group decreased significantly(P<0.05).Compared with the control group,the Shannon index of the asthma group decreased significantly(2.63±1.45 vs.3.90±1.44;t=2.708,P=0.010).According to receiver operating characteristic curve analysis,the optimal cut-off point of Shannon index was 3.10.In all study populations,compared with children whose Shannon index was higher than the cut-off point,children whose Shannon index was lower than the cut-off point were characterized by increased expression of IL17A and T1R3(P<0.05)and decreased expression of TSLP(P<0.05).Conclusion The composition and abundance of nasopharyngeal microbiota are significantly different between children with asthma and healthy control children.