Muc5b is the major polymeric mucin in mucus from thoroughbred horses with and without airway mucus accumulation

Mucus accumulation is a feature of inflammatory airway disease in the horse and has been associated with reduced performance in racehorses. In this study, we have analysed the two major airways gel-forming mucins Muc5b and Muc5ac in respect of their site of synthesis, their biochemical properties, and their amounts in mucus from healthy horses and from horses with signs of airway mucus accumulation. Polyclonal antisera directed against equine Muc5b and Muc5ac were raised and characterised. Immunohistochemical staining of normal equine trachea showed that Muc5ac and Muc5b are produced by cells in the submucosal glands, as well as surface epithelial goblet cells. Western blotting after agarose gel electrophoresis of airway mucus from healthy horses, and horses with mucus accumulation, was used to determine the amounts of these two mucins in tracheal wash samples. The results showed that in healthy horses Muc5b was the predominant mucin with small amounts of Muc5ac. The amounts of Muc5b and Muc5ac were both dramatically increased in samples collected from horses with high mucus scores as determined visually at the time of endoscopy and that this increase also correlated with increase number of bacteria present in the sample. The change in amount of Muc5b and Muc5ac indicates that Muc5b remains the most abundant mucin in mucus. In summary, we have developed mucin specific polyclonal antibodies, which have allowed us to show that there is a significant increase in Muc5b and Muc5ac in mucus accumulated in equine airways and these increases correlated with the numbers of bacteria.     

Effects of dexamethasone on Muc5ac mucin production by primary airway goblet cells

Mucus hypersecretion associated with airway inflammation is reduced by glucocorticoids. Two mechanisms of glucocorticoid-mediated inhibition of mucus production have been proposed, direct inhibition of mucus production by airway epithelial cells and indirectly through inhibition of proinflammatory mediators that stimulate mucus production. In this study, we examined the effect of dexamethasone (DEX) on mRNA expression and synthesis of MUC5AC by A549 human lung adenocarcinoma cells as well as Muc5ac and total high-molecular-weight (HMW) mucins by primary rat tracheal surface epithelial (RTSE) cells. Our results showed that in primary RTSE cells, DEX 1) dose dependently suppressed Muc5ac mRNA levels, but the levels of cellular Muc5ac protein and HMW mucins were unaffected; 2) did not affect constitutive or UTP-stimulated mucin secretion; 3) enhanced the translation of Muc5ac; and 4) increased the stability of intracellular Muc5ac protein by a mechanism other than the inhibition of the proteasomal degradation. In A549 cells, however, DEX suppressed both MUC5AC mRNA levels and MUC5AC protein secretion in a dose-dependent manner. We conclude that whereas DEX inhibits the levels of Muc5ac mRNA in primary RTSE cells, the levels of Muc5ac protein remain unchanged as a consequence of increases in both translation and protein stability. Interestingly, some of the effects of DEX were opposite in a cell line.     

Muc1 mucins on the cell surface are adhesion sites for Pseudomonas aeruginosa

Recently, we cloned and characterized a full-length cDNA of the hamster Muc1 gene, the expression of which appears to be associated with secretory cell differentiation (Park HR, Hyun SW, and Kim KC. Am J Respir Cell Mol Biol 15: 237-244, 1996). The role of Muc1 mucins in the airway, however, is unknown. In this study, we investigated whether cell surface mucins are adhesion sites for Pseudomonas aeruginosa. Chinese hamster ovary (CHO) cells not normally expressing Muc1 mucin were stably transfected with the hamster Muc1 cDNA, and binding to P. aeruginosa was examined. Our results showed that 1) stably transfected CHO cells expressed both Muc1 mRNA and Muc1 mucins based on Northern and Western blot analyses, 2) Muc1 mucins present on the cell surface were degraded by neutrophil elastase, and 3) expression of Muc1 mucins on the cell surface resulted in a significant increase in adhesion of P. aeruginosa that was completely abolished by either proteolytic cleavage with neutrophil elastase or deletion of the extracellular domain by mutation. We conclude that Muc1 mucins expressed on the surface of CHO cells serve as adhesion sites for P. aeruginosa, suggesting a possible role for these glycoproteins in the early stage of airway infection and providing a model system for studying epithelial cell responses to bacterial adhesion that leads to airway inflammation in general and cystic fibrosis in particular.     

团头鲂黏蛋白基因Muc5b克隆及表达分析

摘要：黏液（mucus）在鱼体防御外界病原侵袭、信息传递、调节渗透压等方面具有重要作用。黏蛋白（mucin）作为黏液的基础骨架组分,与其相关的研究正受到广泛的关注。在本研究中,作者克隆获得团头鲂（Megalobrama amblycephala）Muc5b mRNA 的部分序列3895 bp,并通过qRT-PCR分析了Muc5b在团头鲂不同组织的表达分布及其在捕捞应激后在鳃和表皮中的表达变化。序列分析结果显示,团头鲂Muc5b与鲤等脊椎动物的Muc5b有较高的同源性,其N端含有黏液蛋白特异性结构域：三个VWD区域,三个C8区域,二个TIL区。组织表达分析结果表明,Muc5b在鳃和表皮表达量相对较高,在脑、脾、肾中表达水平较低,在肝、肠道几乎不表达。捕捞应激后1 h时鳃中Muc5b显著降低（P < 0.05）,24 h时恢复初始水平;表皮中4 h时Muc5b显著上升（P < 0.05）,24 h时恢复到初始水平。     

COPD大鼠肺组织中Muc5ac和IL-13的相关性研究

目的:研究慢性阻塞性肺病(COPD)大鼠气道粘蛋白Muc5ac和白介素13(IL-13)的表达及其相关性.方法:20只wistar雄性大鼠随机分为对照组和COPD组.正常组8只,COPD组12只,分别用免疫组化法测定肺组织Muc5ac和IL-13的表达.结果:Muc5ac和IL-13蛋白表达主要位于气道上皮细胞,细胞胞浆呈棕黄色.COPD组大鼠肺组织IL-13和Muc5ac的表达均高于正常组(P均＜0.05).结论:IL-13是引起粘液分泌的重要因子,它可能上调Muc5ac的表达.     

Abnormal expression of Muc5b in Cftr-null mice and in mammary tumors of MMTV-ras mice

Gel-forming mucins are large, high molecular weight, and heavily O-glycosylated proteins that are responsible for the rheological properties of mucus gel. Among them, the mucin MUC5B has been implicated in breast cancer and cystic fibrosis. We obtained a new polyclonal serum, named CP1, which was isolated from a rabbit immunized with a mouse Muc5b peptide. The immunoprofile of Muc5b was determined on paraffin-embedded and frozen mouse tissue sections and showed a similar expression pattern in mouse to that in the human. The “nonmammary” mucin Muc5b was detected in all mammary tumors analyzed from MMTV-ras mice, suggesting that the CP1 antibody is a valuable tool for investigating the involvement of this mucin in mammary cancer. We also found that uninfected Cftr ^−/− mice harbored more Clara cells, which were Muc5b-positive, than did their wild-type control littermates. The number of Muc5b-positive cells increased in Cftr ^−/− mice infected experimentally with Pseudomonas aeruginosa, and the mice developed mucus plugs in their bronchi and bronchioles with a high frequency of Muc5b content (87%, Cohen’s kappa = 0.82; p < 0.0001). These findings suggest that mice genetically deficient in the Cftr gene are predisposed to develop mucus plugs and that MUC5B may provide a valuable target for decreasing mucus viscosity in cystic fibrosis.     

Variation in glycogen and mucins in the equine uterus related to physiologic and pathologic conditions

Histochemical stains were applied to six equine uterine biopsies representative of the physiologic breeding season, Spring and Fall transition, and Winter anestrus periods. These were compared with uterine biopsies from six mares with intrauterine urine pooling, eight mares used to study the uterine response to indwelling catheterization, and necropsy specimens from four pregnant mares at approximately 60 or 100 d of gestation. Alcian blue staining at pH 2.5 or 1.0 was used to identify the presence of carboxylated and sulfated acid mucins or only suflated acid mucins, respectively. Periodic acid-Schiff staining was used to identify neutral mucosubstances or glycogen, with or without prior diastase digestion. The uterine glands contained glycogen, which was most abundant during the physiologic breeding season. The luminal epithelial cells during the physiologic breeding season and Spring and Fall transition contained predominately carboxylated acid mucins. Carboxylated acid mucin secretion also was stimulated by indwelling catheterization and intrauterine urine pooling. It is hypothesized that secretion of carboxylated acid mucins by the endometrial epithelium may be elicited by hormonal or irritative/inflammatory stimuli, and it may be a protective response.     

Increased levels of mucins in the cystic fibrosis mouse small intestine, and modulator effects of the Muc1 mucin expression

The mouse model (Cftr(tm1UNC)/Cftr(tm1UNC)) for cystic fibrosis (CF) shows mucus accumulation and increased Muc1 mucin mRNA levels due to altered splicing (Hinojosa-Kurtzberg AM, Johansson MEV, Madsen CS, Hansson GC, and Gendler SJ. Am J Physiol Gastrointest Liver Physiol 284: G853-G862, 2003). However, it is not known whether Muc1 is a major mucin contributing to the increased mucus and why CF/Muc1-/- mice show lower mucus accumulation. To address this, we have purified mucins from the small intestine of CF mice using guanidinium chloride extraction, ultracentrifugation, and gel filtration and analyzed them by slot blot, gel electrophoresis, proteomics, and immunoblotting. Normal and CF mice with wild-type (WT) Muc1 or Muc1-/- or that are transgenic for human MUC1 (MUC1.Tg, on a Muc1-/- background) were analyzed. The total amount of mucins, both soluble and insoluble in guanidinium chloride, increased up to 10-fold in the CF mice compared with non-CF animals, whereas the CF mice lacking Muc1 showed intermediate levels between the CF and non-CF mice. However, the levels of Muc3 (orthologue of human MUC17) were increased in the CF/Muc1-/- mice compared with the CF/MUC1.Tg animals. The amount of MUC1 mucin was increased several magnitudes in the CF mice, but MUC1 did still not appear to be a major mucin. The amount of insoluble mucus of the large intestine was also increased in the CF mice, an effect that was partially restored in the CF/Muc1-/- mice. The thickness of the firmly adherent mucus layer of colon in the Muc1-/- mice was significantly lower than that of WT mice. The results suggest that MUC1 is not a major component in the accumulated mucus of CF mice and that MUC1 can influence the amount of other mucins in a still unknown way.     

Localization of amylase and mucins in the major salivary glands of the mouse

Summary Antibodies against murine submandibular and sublingual mucins have been raised in rabbits. Both antisera appeared to be specific. Using these antibodies, the mucins were localized in the acinar cells of the submandibular and sublingual glands respectively.The dyed amylopectin method was used to estimate the activity of amylase in the salivary glands. The enzyme was localized either by a starch-substrate film method or with antibodies against purified parotid amylase. The activity of amylase in parotid homogenates is about 1000-fold higher than that in homogenates of either submandibular or sublingual glands, in which the activity was comparable. Amylase was localized in the acinar cells of the parotid gland with both localization techniques. In the sublingual gland, amylase was found predominantly in the stroma around the acini, and there was some evidence that amylase was present in the demilune cells as well. In the submandibular gland, contradictory results were obtained with both techniques. With the starch-substrate film method, amylase activity was found in the granular convoluted tubular cells, whereas immuno-reactive amylase could only be demonstrated in the acinar cells of this gland. It is concluded that in the submandibular gland amylase and mucin are present in the same cell type.     

miRNA-34b/c regulates mucus secretion in RSV-infected airway epithelial cells by targeting FGFR1

Respiratory syncytial virus (RSV) infection in airway epithelial cells is the main cause of bronchiolitis in children. Excessive mucus secretion is one of the primary symbols in RSV related lower respiratory tract infections (RSV-related LRTI). However, the pathological processes of mucus hypersecretion in RSV-infected airway epithelial cells remains unclear. The current study explores the involvement of miR-34b/miR-34c in mucus hypersecretion in RSV-infected airway epithelial cells by targeting FGFR1. First, miR-34b/miR-34c and FGFR1 mRNA were quantified by qPCR in throat swab samples and cell lines, respectively. Then, the luciferase reporters’ assay was designed to verify the direct binding between FGFR1 and miR-34b/miR-34c. Finally, the involvement of AP-1 signalling was assessed by western blot. This study identified that miR-34b/miR-34c was involved in c-Jun-regulated MUC5AC production by targeting FGFR1 in RSV-infected airway epithelial cells. These results provide some useful insights into the molecular mechanisms of mucus hypersecretion which may also bring new potential strategies to improve mucus hypersecretion in RSV disease.     

Aerosol deposition in the airway model with excessive mucus secretions

Aerosol deposition in the airways with excessive mucus secretions was investigated utilizing an in vitro airway model lined with various mucus simulants of differing rheological properties. The airway model was made with a straight glass tube (1.0 cm ID and 20 cm in length) and positioned vertically. The mucus simulants were supplied into the tube at a constant rate and made to move upward through the tube as a thin layer (0.6-1.7 mm) undergoing a random wave motion by means of upward airflow. Aerosols (3.0 and 5.0-micron diam) were passed through the mucus-lined tube at flow rates of 0.33-1.17 l/s, and the deposition of the aerosols in the tube was determined by sampling the aerosols at the inlet and the outlet of the tube on filters. During the sampling, pressure drop across the tube model was also measured. Deposition efficiency in the 20-cm-long mucus-lined tube ranged from 13 to 92% with 3.0-micron-diam particles and from 66 to 98% with 5.0-micron-diam particles. This deposition was 25-300 times higher than that in the dry tube. The deposition was higher with increasing viscosity of mucus but was lower with increasing elasticity of mucus. Pressure drop across the mucus-lined tube was much higher than that in the dry tube, and the increase was more prominent with mucous layers with higher viscosity but lower elasticity values. Therefore, aerosol deposition showed a good positive relationship with pressure drop. However, percent increase of aerosol deposition in the mucus-lined tube was 2-5 times higher than that of pressure drop.(ABSTRACT TRUNCATED AT 250 WORDS)     

ITGB4 deficiency induces mucus hypersecretion by upregulating MUC5AC in RSV-infected airway epithelial cells

Respiratory syncytial virus (RSV) infection is the main cause of bronchiolitis in children. Excessive mucus secretion is one of the primary symbols in RSV related lower respiratory tract infections (RSV-related LRTI), which is closely associated with the occurrence and development of asthma in later life. Integrin β4 (ITGB4) is down-regulated in the airway epithelial cells (AECs) of asthma patients which plays a critical role in the pathogenesis of asthma. However, whether ITGB4 is involved in the pathological processes of RSV infection remains unclear. In this study, we found that decreased expression of ITGB4 was negatively correlated with the level of MUC5AC in childhood AECs following RSV infection. Moreover, ITGB4 deficiency led to mucus hypersecretion and MUC5AC overexpression in the small airway of RSV-infected mice. MUC5AC expression was upregulated by ITGB4 in HBE cells through EGFR, ERK and c-Jun pathways. EGFR inhibitors treatment inhibited mucus hypersecretion and MUC5AC overexpression in ITGB4-deficient mice after RSV infection. Together, these results demonstrated that epithelial ITGB4 deficiency induces mucus hypersecretion by upregulating the expression of MUC5AC through EGFR/ERK/c-Jun pathway, which further associated with RSV-related LRTI.     

CD4(+) T cell-dependent airway mucus production occurs in response to IL-5 expression in lung

The potential role of airway interleukin-5 (IL-5) expression in eliciting mucus production was demonstrated in a pulmonary IL-5 transgenic mouse model (NJ.1726) in which naive transgenic mice display comparable levels of airway mucus relative to allergen-sensitized and -challenged wild-type mice. The intrinsic mucus accumulation of NJ.1726 was abolished in compound transgenic-gene knockout mice deficient of either CD4(+) cells [NJ.1726/CD4(-/-)] or alphabeta T cell receptor-positive (TCR(+)) cells [NJ.1726/alphabeta TCR(-/-)]. In addition, mucus production in naive NJ.1726 was inhibited by >90% after administration of the soluble anti-IL-4 receptor alpha-subunit antagonist. The loss of mucus production in NJ.1726/CD4(-/-), NJ.1726/alphabeta TCR(-/-), and anti-IL-4 receptor alpha-subunit antagonist-treated mice occurred notwithstanding the significant pulmonary eosinophilia and expansion of airway B cells induced by ectopic IL-5 expression. Furthermore, the loss of mucus accumulation occurred in these mice despite elevated levels of airway and peripheral IL-5, indicating that IL-5 does not directly induce goblet cell metaplasia and mucus production. Thus pulmonary expression of IL-5 alone is capable of inducing CD4(+) T cell-dependent goblet cell metaplasia, apparently mediated by IL-4 receptor alpha-subunit-ligand interactions, and represents a previously unrecognized novel pathway for augmenting allergen-induced mucus production.     

Protease-activated receptor 2 mediates mucus secretion in the airway submucosal gland

Protease-activated receptor 2 (PAR2), a G protein-coupled receptor expressed in airway epithelia and smooth muscle, plays an important role in airway inflammation. In this study, we demonstrated that activation of PAR2 induces mucus secretion from the human airway gland and examined the underlying mechanism using the porcine and murine airway glands. The mucosa with underlying submucosal glands were dissected from the cartilage of tissues, pinned with the mucosal side up at the gas/bath solution interface of a physiological chamber, and covered with oil so that secretions from individual glands could be visualized as spherical bubbles in the oil. Secretion rates were determined by optical monitoring of the bubble diameter. The Ca(2+)-sensitive dye Fura2-AM was used to determine intracellular Ca(2+) concentration ([Ca(2+)](i)) by means of spectrofluorometry. Stimulation of human tracheal mucosa with PAR2-activating peptide (PAR2-AP) elevated intracellular Ca(2+) and induced glandular secretion equal to approximately 30% of the carbachol response in the human airway. Porcine gland tissue was more sensitive to PAR2-AP, and this response was dependent on Ca(2+) and anion secretion. When the mouse trachea were exposed to PAR2-AP, large amounts of secretion were observed in both wild type and ΔF508 cystic fibrosis transmembrane conductance regulator mutant mice but there is no secretion from PAR-2 knock out mice. In conclusion, PAR2-AP is an agonist for mucus secretion from the airway gland that is Ca(2+)-dependent and cystic fibrosis transmembrane conductance regulator-independent.     

Large scale identification of proteins, mucins, and their O-glycosylation in the endocervical mucus during the menstrual cycle

The mucus filling the human cervical opening blocks the entry to the uterus, but this has to be relative and allow for the sperm to penetrate at ovulation. We studied this mucus, its content of proteins and mucins, and the mucin O-glycosylation in cervical secretions before, during, and after ovulation. Cervical mucosal secretions from 12 subjects were collected, reduced-alkylated, separated with polyacrylamide or agarose/polyacrylamide gel electrophoresis, and stained with silver, Alcian blue, or Coomassie Blue stain. Protein and mucin bands from before and during ovulation were digested and subsequently analyzed by nano-LC-FT-ICR MS and MS/MS. We identified 194 proteins after searches against the NCBI non-redundant protein database and an in-house mucin database. Three gel-forming (MUC5B, MUC5AC, and MUC6) and two transmembrane mucins (MUC16 and MUC1) were identified. For the analysis of mucin O-glycosylation, separated mucins from six individuals were blotted to PVDF membranes, and the O-glycans were released by reductive beta-elimination and analyzed with capillary HPLC-MS and -MS/MS. At least 50 neutral, sialic acid-, and sulfate-containing oligosaccharides were found. An increase of GlcNAc-6GalNAcol Core 2 structures and a relative decrease of NeuAc residues are typical for ovulation, and NeuAc-6GalNAcol and NeuAc-3Gal- epitopes are typical for the non-ovulatory phases. The cervical mucus at ovulation is thus characterized by a relative increase in neutral fucosylated oligosaccharides. This comprehensive characterization of the mucus during the menstrual cycle suggests mucin glycosylation as the major alteration at ovulation, but the relation to the altered physicochemical properties and sperm penetrability is still not understood.     

Electrolyte and other chemical concentrations in tracheal airway surface liquid and mucus

With the ferret in vitro tracheal preparation, we measured the electrolyte and chemical composition of airway surface liquid (ASL) under control conditions and when drugs were added to promote submucosal gland secretion and to change epithelial ion transport. Control ASL was hyperosmolar (342 +/- 2.8 mosmol/kg) compared with ferret plasma and surrounding buffer. Higher values were also found for sodium (167 +/- 1.7 mmol/l), potassium (9.0 +/- 0.05 mmol/l), total calcium (3.46 +/- 0.11 mmol/l), and ionized calcium (2.55 +/- 0.18 mmol/l). pH was lower (7.12 +/- 0.03) than in plasma or buffer. Addition of methacholine to the surrounding buffer increased flow of ASL and potential difference across the mucosa and lowered pH, calcium, sodium, and chloride concentrations. Potassium concentration was increased. Phenylephrine increased flow and decreased calcium concentrations. Salbutamol (albuterol) had no effect on flow but decreased pH and increased calcium and potassium concentrations. Histamine increased flow and calcium concentrations and decreased pH. These changes are presumably due to changes in gland secretion and epithelial transport. Methacholine and phenylephrine increased the sugar content of the secretions, the changes with phenylephrine being larger. Thus resting ASL is hyperosmolar and relatively acid, with high cation contents, and administration of drugs changes its composition by actions on submucosal glands and epithelium.     

Pseudomonas aeruginosa stimulates phosphorylation of the airway epithelial membrane glycoprotein Muc1 and activates MAP kinase

We reported previously that Muc1 on the surface of epithelial cells was a receptor for Pseudomonas aeruginosa (Lillehoj EP, Kim BT, and Kim KC. Am J Physiol Lung Cell Mol Physiol 282: L751-L756, 2002). Other studies showed that the Muc1 cytoplasmic tail (CT) contains multiple phosphorylation sites, some of which are phosphorylated constitutively and associated with signaling proteins. However, the relationship between extracellular P. aeruginosa binding and intracellular signaling is unknown. To investigate the signaling mechanism of Muc1, this study examined phosphorylation of its CT and activation of the extracellular signal-regulated kinase (ERK) in response to stimulation by P. aeruginosa or purified flagellin. Our results showed 1) the Muc1 CT was phosphorylated constitutively on serine and tyrosine, 2) serine phosphorylation was stimulated by bacterial cells or flagellin, and 3) binding of P. aeruginosa or flagellin to Muc1 induced phosphorylation of ERK. These results are the first to demonstrate Muc1 CT phosphorylation and ERK activation in response to a clinically important airway pathogen.     

Reduced three-dimensional motility in dehydrated airway mucus prevents neutrophil capture and killing bacteria on airway epithelial surfaces

Cystic fibrosis (CF) lung disease is characterized by persistent lung infection. Thickened (concentrated) mucus in the CF lung impairs airway mucus clearance, which initiates bacterial infection. However, airways have other mechanisms to prevent bacterial infection, including neutrophil-mediated killing. Therefore, we examined whether neutrophil motility and bacterial capture and killing functions are impaired in thickened mucus. Mucus of three concentrations, representative of the range of normal (1.5 and 2.5% dry weight) and CF-like thickened (6.5%) mucus, was obtained from well-differentiated human bronchial epithelial cultures and prepared for three-dimensional studies of neutrophil migration. Neutrophil chemotaxis in the direction of gravity was optimal in 1.5% mucus, whereas 2.5% mucus best supported neutrophil chemotaxis against gravity. Lateral chemokinetic movement was fastest on airway epithelial surfaces covered with 1.5% mucus. In contrast, neutrophils exhibited little motility in any direction in thickened (6.5%) mucus. In in vivo models of airway mucus plugs, neutrophil migration was inhibited by thickened mucus (CF model) but not by normal concentrations of mucus ("normal" model). Paralleling the decreased neutrophil motility in thickened mucus, bacterial capture and killing capacity were decreased in CF-like thickened mucus. Similar results with each mucus concentration were obtained with mucus from CF cultures, indicating that inhibition of neutrophil functions was mucus concentration dependent not CF source dependent. We conclude that concentrated ("thick") mucus inhibits neutrophil migration and killing and is a key component in the failure of defense against chronic airways infection in CF.     

小儿支原体肺炎合并气道黏液栓形成的气道微生物菌群变化

研究支原体肺炎（MPP）合并气道黏液栓的患儿气道微生物菌群的变化。

选取2018年1月至2020年1月在我院诊治的116例MPP患儿为研究对象。根据支气管镜检查结果,将56例合并气道黏液栓的MMP患儿纳入MPP合并黏液栓组,60例无气道黏液栓的MPP患儿纳入单纯MPP组。用16S rRNA测序技术分析各组患儿支气管灌洗液中气道菌群的组成,比较各组气道微生物菌群分布差异,采用Pearson相关性分析探讨MPP合并黏液栓组菌属与临床参数的相关性。

单纯MPP组和MPP合并黏液栓组的优势菌门是软壁菌门、拟杆菌门、厚壁菌门。MPP合并黏液栓组软壁菌门和变形菌门相对丰度显著高于单纯MPP组（P = 0.012、0.001）,两组的拟杆菌门、厚壁菌门、放线菌门和梭杆菌门相对丰度间差异无统计学意义（P＞0.05）。单纯MPP组和MPP合并黏液栓组的优势菌属包括支原体属、放线菌属、鞘氨醇单胞菌属、苯杆菌属、伊丽莎白菌属、普氏菌属、链球菌属和韦荣球菌属。相比于单纯MPP组,MPP 组合并黏液栓组支原体属、放线菌属的相对丰度较高（P＜0.001）,鞘氨醇单胞菌属和伊丽莎白菌属相对丰度较低（P＜0.001）。单纯MPP组和MPP合并黏液栓组的苯杆菌属、普氏菌属、链球菌属和韦荣球菌属的相对丰度差异无统计学意义（P＞0.05）。相比于单纯MPP组,MPP合并黏液栓组菌群多样性及相对丰度差异不具有统计学意义（P＞0.05）。MPP合并黏液栓组链球菌属的相对丰度与患儿年龄呈显著负相关（r = −0.524,P = 0.014）,和发热时间呈显著正相关性（r = 0.684,P = 0.002）。

MPP合并气道黏液栓患儿气道菌群的变化可能是气道黏液栓形成的重要因素,MPP合并气道黏液栓患儿链球菌属的相对丰度与患儿年龄呈负相关,与发热时间呈正相关,值得临床深入研究。