基于高通量测序分析哮喘小鼠呼吸道菌群的变化

通过高通量测序分析哮喘模型小鼠呼吸道菌群的变化情况。

将12只SPF级BALB/c雄性小鼠随机分为对照组和模型组, 每组6只。采用卵清蛋白致敏方法建立哮喘小鼠模型后, 进行支气管组织切片病理学观察, ELISA法检测血清IgE水平, 测定肺指数, 采集咽拭子后提取DNA行高通量测序分析。

与对照组比较, 模型组小鼠血清IgE水平明显升高(P < 0.05), 肺指数明显上升(P < 0.05), 可见支气管上皮粘膜有水肿, 少量淋巴细胞浸润, 平滑肌增生。模型组小鼠呼吸道菌群与对照组比较, 菌种丰度升高, 厚壁菌门较对照组减少(P < 0.05), 放线菌门和变形菌门增多(P < 0.05), 菌群结构有明显差异。

哮喘小鼠存在呼吸道微生态菌群失衡。

     

儿童呼吸道菌群的调查

目的了解儿童呼吸道菌群的分布特征。方法对重庆医科大学附属儿童医院的呼吸内科住院部500例小儿下呼吸道负压吸引法痰标本做分离培养;105例门诊未使用抗生素有咽部体征的上呼吸道患儿咽拭子标本做分离培养;同时对150例健康儿童上呼吸道咽拭子标本做分离培养,对他们的生长菌群进行分类鉴定和药敏试验,并对结果作对比分析讨论。结果草绿色链球菌、表皮葡萄球菌、金黄色葡萄球菌、溶血葡萄球菌、流感嗜血杆菌检出率差异无显著性（P〉0.05）;而儿童下呼吸道痰标本结果和105例门诊上呼吸道患儿咽拭子标本结果比较大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、肺炎链球菌、副流感嗜血杆菌、卡他莫拉菌、真菌差异无显著性（P〉0.05）,与150例健康儿童上呼吸道咽拭子标本结果比较差异有显著性（P〈0.05）。革兰阴性杆菌对亚胺硫霉素（IMP）耐药率最低,对哌拉西林/他唑巴坦（TZP）、阿米卡星（AK）、环丙沙星（CIP）耐药率〈30%;革兰阳性球菌未发现耐万古霉素（VA）菌株,对利福平（RD）、哌拉西林/他唑巴坦（TZP）耐药率相对较低;流感嗜血杆菌、副流感嗜血杆菌、卡他莫拉菌对CIP、IMP耐药率〈10%;肺炎链球菌无VA耐药菌株,对氧氟沙星（OFX）、RD耐药率〈10%;草绿色链球菌也无耐VA菌株;对RD、复方磺胺（SXT）、四环素（TE）耐药率〈30%。结论儿童正常菌群的分布特征以草绿色链球菌为主。从病原菌来看,下呼吸道住院患儿痰标本分离的致病菌大于门诊上呼吸道感染患儿咽拭子分离的致病菌大于健康儿童咽拭子标本携带的致病菌。     

呼吸道病毒和呼吸道、肠道菌群的相互作用

随着新技术的应用,人们对人体不同部位的微生态系统有了进一步的认识,其中的微生物部分不仅指细菌还包括病毒。病毒的存在可以影响呼吸道和肠道菌群变化,同样呼吸道和肠道菌群状态也影响着病毒对人体的入侵程度。本研究就呼吸道和肠道菌群与呼吸道病毒相互作用关系的研究进展作一综述。     

抗生素诱导的呼吸道菌群缺失对小鼠RSV感染的影响

目的 探究抗生素雾化暴露引起的呼吸道菌群缺失对小鼠呼吸道合胞病毒(RSV)感染的影响,为临床合理使用抗生素提供指导意见。 方法 32只BALB/c小鼠分为2组:雾化ddH2O对照组和雾化ABX组合抗生素组,处理6 d后,进行细菌16S rRNA基因PCR检测,构建呼吸道菌群缺失小鼠模型。上述2组组内再随机分为2小组,即PBS对照组(ddH2O+PBS,ABX+PBS)和RSV感染组(ddH2O+RSV,ABX+RSV),饲养至第14天。检测和分析各组小鼠支气管肺泡灌洗液(BALF)中的炎症细胞和相关细胞因子(TNFα、IL8、IL10及MCP1)的数量和水平,观察肺组织病理学状况及检测病毒载量。 结果 BALF中细菌DNA提取和16S rRNA基因PCR检测显示,雾化ABX组合抗生素处理能够有效地剔除呼吸道菌群。BALF中炎症细胞和相关细胞因子检测显示,ABX+RSV组炎症细胞总数明显增多(P2O+RSV组和ABX+RSV组小鼠肺部损伤明显加重(均P≤0.01),与ddH2O+RSV组相比较,ABX+RSV组的病毒载量明显升高(t=2.716 0,P=0.021 7)。 结论 雾化ABX组合抗生素不仅能够有效地剔除呼吸道菌群,而且明显增加了小鼠感染RSV的风险,导致呼吸道炎症加重,以及病毒载量升高。     

抑郁症患者肠道菌群研究

目的研究抑郁症患者肠道微生物群落分布情况。方法选择2017年1月-2018年1月在本院临床心理科就诊的确诊为抑郁症的患者79例,以及同时期在本院体检的健康者80例。收集患者新鲜粪便,利用16SrRNA基因测序技术分析患者肠道菌群。结果对159例粪便标本进行16SrRNA基因测序,共获得1 276 841条有效16SrRNA基因序列,抑郁组Shannon指数明显高于对照组。在门水平,共发现20个细菌门,抑郁患者肠道菌群丰度前3位的分别是厚壁菌门、拟杆菌门、梭杆菌门;在科水平,前3位主要为拟杆菌科、普雷沃氏菌科和瘤胃菌科;在属水平,前3位分别是多形杆菌属、普氏菌属、另枝菌属。对照组肠道菌群丰度前3位的分别是厚壁菌门、拟杆菌门、梭杆菌门;在科水平,前3位主要是拟杆菌科,普雷沃氏菌科和瘤胃菌科;在属水平,前3位分别是多形拟杆菌属、普氏菌属、另枝菌属。抑郁组多形杆菌属、普氏菌属、另枝菌属、栖粪杆菌属、考拉杆菌属丰度明显低于对照组,抑郁组毛螺菌属、副杆菌属、布劳特氏菌属、巨单胞菌属丰度明显高于对照组。抑郁组拟杆菌属和栖粪杆菌属丰度与SDS评分成负相关,毛螺菌属丰度与SDS评分成正相关。结论抑郁症患者病情严重程度与抗炎性细菌拟杆菌属和栖粪杆菌属丰度成反比,与毛螺菌属丰度成正比。     

SPF和正常鼠下呼吸道菌群多样性研究

目的 探讨SPF和正常鼠下呼吸道菌群多样性区别,为研究洁净环境下呼吸道菌群对免疫耐受形成的影响提供简便的动物模型.方法 采用飞行质谱和DGGE的方法检测正常和SPF BALB/c小鼠及Wistar大鼠呼吸道支气管肺泡灌洗液中菌群多样性的区别.结果 SPF BALB/c小鼠下呼吸道菌群丰度小于普通小鼠,下呼吸道菌群丰度小于消化道.SPF Wistar大鼠下呼吸道菌群丰度小于普通大鼠.结论 SPF环境造成鼠下呼吸道菌群丰度减小.     

支原体性阴道炎患者阴道菌群变化的研究

对正常人及支原体性阴道炎患者的阴道菌群进行定量测定,结果表明支原体性阴道炎分泌物中,乳杆菌的分离率和数量均较正常对照组低,而其他条件致病菌的分离率和数量均较正常对照组高。说明支原体性阴道炎患者阴道的正常菌群失调较为明显,因此,在临床治疗中除抗支原体外,尚需调整阴道菌群失调。     

肠道和呼吸道菌群与肺部疾病的研究新进展

宿主微生物群落对机体局部以及系统免疫的影响已逐渐引起人们的关注,目前发现局部的微生物群落能够对机体远端部位的免疫能力造成影响。肠道和呼吸道菌群稳态对机体免疫系统发育以及抗病原微生物感染至关重要,肠道和呼吸道菌群失衡与炎症性疾病、代谢性疾病以及过敏性疾病密切相关。肠道和呼吸道菌群失衡会通过"肠—肺轴"的相互作用,引起免疫系统改变与急性、慢性肺部疾病的发生。在这篇综述中,我们对肠道微生物和呼吸道微生物在肠-肺轴中发挥作用的研究进展作一总结,并对从微生物角度进行疾病治疗干预的可能性进行分析。     

急性脑卒中患者肠道菌群研究

通过粪便标本检测急性脑卒中患者肠道菌群变化情况, 探讨急性脑卒中患者肠道菌群结构。

通过高通量二代测序技术对10例健康者(对照组)及10例急性脑卒中患者(疾病组)粪便样本进行菌群结构测序分析。

与对照组比较, 急性脑卒中患者粪便样本中物种OTU信息量显著增加(P < 0.01), 菌群多样性指数(Shannon)和物种均一度指数(Evenness)也有所增加但差异无统计学意义(均P > 0.05)。门水平上, 疾病组患者肠道Bacteroidetes数量较对照组显著增加, Firmicutes数量显著减少(均P < 0.05)。属水平上, 疾病组患者肠道Bacteroides、Bilophila、Butyricimonas比例较对照组显著升高, 而Collinsella、Coprococcus、Clostridium等比例较对照组显著降低(均P < 0.05)。

急性脑卒中患者肠道菌群结构与健康人存在显著差异。

     

肺部菌群与呼吸道疾病的相互关系

由于呼吸道黏膜免疫系统具有很好的防御保护作用和强大的清除病原体的能力,过去学术界曾经一度认为健康机体的肺是无菌的。随着不依赖于体外培养的第二代测序技术的发展,关于肺部共生微生物的结构组成及其免疫调节功能的研究越来越受重视。肺部菌群的结构组成与出生方式、饮食结构、生活环境和抗生素使用等多种因素有关,生命早期的肺部菌群的形成和发育会影响全生命周期的呼吸道疾病的发生和发展。肺部菌群通过与宿主免疫系统相互作用调节肺部免疫稳态,还可以与肠道菌群、呼吸道病毒相互作用影响呼吸道感染。因此,干预生命早期肺部菌群的结构组成可以成为预防和控制呼吸道疾病的有效策略和新靶点。     

Metabolomic profiling of regulatory lipid mediators in sputum from adult cystic fibrosis patients

Retained respiratory tract (RT) secretions, infection, and exuberant inflammatory responses are core abnormalities in cystic fibrosis (CF) lung disease. Factors contributing to the destructive CF airway inflammatory processes remain incompletely characterized. The pro-oxidative inflammatory CF RT milieu is known to contain enzymatically and nonenzymatically produced regulatory lipid mediators, a panel of structurally defined oxidized metabolites of polyunsaturated fatty acids known to play a role in pathology related to inflammation. Using an extraction protocol that maximizes recoveries of sputum-spiked deuterated standards, coupled with an LC/MS/MS detection system, this study presents a metabolomic method to assess a broad spectrum of regulatory lipid mediators in freshly obtained sputum from CF patients. A broad range of both proinflammatory and anti-inflammatory lipid mediators was detected, including PGE2, PGD2, TXB2, LTB4, 6-trans-LTB4, 20-OH-LTB4, 20-COOH-LTB4, 20-HETE, 15-HETE, 11-HETE, 12-HETE, 8-HETE, 9-HETE, 5-HETE, EpETrEs, diols, resolvin E1, 15-deoxy-PGJ2, and LXA4. The vast majority of these oxylipins have not been reported previously in CF RT secretions. Whereas direct associations of individual proinflammatory lipid mediators with compromised lung function (FEV-1) were observed, the relationships were not robust. However, multiple statistical analyses revealed that the regulatory lipid mediators profile taken in aggregate proved to have a stronger association with lung function in relatively stable outpatient adult CF patients. Our data reveal a relative paucity of the anti-inflammatory lipid mediator lipoxin A4 in CF sputum. Patients displaying detectable levels of the anti-inflammatory lipid mediator resolvin E1 demonstrated a better lung function compared to those patients with undetectable levels. Our data suggest that comprehensive metabolomic profiling of regulatory lipid mediators in CF sputum should contribute to a better understanding of the molecular mechanisms underlying CF RT inflammatory pathobiology. Further studies are required to determine the extent to which nutritional or pharmacological interventions alter the regulatory lipid mediators profile of the CF RT and the impact of potential modulations of RT regulatory lipid mediators on the clinical progression of CF lung disease.     

Infection control and the significance of sputum and other respiratory secretions from adult patients with cystic fibrosis

Background

Although various hematologic abnormalities are seen in tuberculosis, immune thrombocytopenic purpura is a rare event.

Case Presentation

We report a case of a 29 year-old male who was presented with immune thrombocytopenia-induced hemoptysis, macroscopic hematuria and generalized petechiae. The patient was found to have clinical, microbiological and radiological evidence of active pulmonary tuberculosis. The immune thrombocytopenic purpura was successfully treated with anti-tuberculous drugs combined with corticosteroids and high dose immune globulin therapy.

Conclusion

Immune thrombocytopenic purpura can be one of the hematological manifestations of tuberculosis which has a global prevalence with increasing incidence secondary to HIV infection.     

Superantigen types inStaphylococcus aureus isolated from patients with cystic fibrosis

The screening of 17 SAg genes of S. aureus isolated from the sputum of cystic fibrosis (CF) patients revealed that among 47 genetically different strains, 39 (83 %) carried SAg genes. Superantigens forming enterotoxin gene cluster were detected in 20 strains. The 2nd most common superantigen type was selk detected in 13 strains. In 9 strains, selk occurred together with the sea gene. Out of 74 strains recovered from nasal carriers, 56 (75 %) were found to carry SAg genes, 38 carried egc genes, while selk was detected in 5 strains. The predominant SAg types in both investigated S. aureus populations were egc and selk/sea, but selk gene frequency was significantly higher in the CF-derived strains.     

AP-PCR typing of Pseudomonas aeruginosa isolated from patients with cystic fibrosis

Arbitrarily Primed Polymerase Chain Reaction has been used for an epidemiological evaluation of 42 strains of P. aeruginosa isolated from nine cystic fibrosis patients during a three-year investigation period. The resistance patterns of the same strains have also been evaluated. The AP-PCR type fingerprinting was perfomed with primers 10514 and 208. Resistance was evaluated by the Minimal Inhibitory Concentration method. With 10514 eleven different genotypes could be evidenced, while with 208 only five of them could be detected. During the investigation period patients were always colonised by the same genotype. A possible correlation between resistance pattern and genotype with both primers has shown, within the same patient, a correspondence of about 20% for 10514 and a correspondence of only 10% for 208. Patients are colonised by one or two strains of P. aeruginosa and there is no relation between genotype and resistance pattern.     

Prostanoid biosynthesis in patients with cystic fibrosis

The urinary excretion rate (ng/h/1.73 m²) of prostanoids was determined with a capillary gas-liquid chromatographic mass spectrometric method in 19 patients with cystic fibrosis (CF) aged 1–29 years. Patients with CF showed an increased excretion of prostaglandin E₂ metabolites (PGE-M) and thromboxane B₂ and its metabolites at all ages. An imbalance in the excretion pattern of thromboxane B₂ metabolites also suggested a relative impairment of β-oxidation. There was no increased excretion of dinor-6-keto-PGF_1α, indicating normal prostacyclin biosynthesis. No correlation was found to genotype, clinical score, lung function or bacterial colonization but a significant negative relation was found between the main prostanoids in the urine and serum phospholipid levels of essential fatty acids. The results show that, contrary to the generally accepted decrease of prostanoid excretion in essential fatty acid deficiency, patients with CF increase their production parallel to the development of the deficiency. Since prostanoid synthesis is rate limited by arachidonic acid release, our data support a previously presented hypothesis about a pathological regulation of the release of arachidonic acid in CF.     

Altered intracellular pH regulation in neutrophils from patients with cystic fibrosis

Cystic fibrosis (CF) is a condition characterized by neutrophil-mediated lung damage and bacterial colonization. The physiological basis for reported functional alterations in CF neutrophils, including increased release of neutrophil elastase, myeloperoxidase, and oxidants, is unknown. These processes are, however, regulated by intracellular pH (pH(i)). We demonstrate here that pH(i) regulation is altered in neutrophils from CF patients. Although resting pH(i) is similar, pH(i) after acid loading and activation (N-formyl-methionyl-leucyl-phenylalanine and phorbol 12-myristate 13-acetate) is more acidic in CF cells than in normal cells. Furthermore, patients with non-CF-related bronchiectasis handle acid loading and activation in a fashion similar to subjects with normal neutrophils, suggesting that chronic pulmonary inflammation alone does not explain the difference in pH(i). This is further supported by data showing that normal neutrophils exposed to the CF pulmonary milieu respond by increasing pH(i) as opposed to decreasing pH(i) as seen in activated CF neutrophils. These pH(i) differences in activated or acid-loaded CF neutrophils are abrogated by ZnCl(2) but not by amiloride and bafilomycin A(1), suggesting that passive proton conductance is abnormal in CF. In addition, DIDS, which inhibits HCO(3)(-)/Cl(-) exchange, causes alkalinization of control but not of CF neutrophils, suggesting that anion transport is also abnormal in CF neutrophils. In summary, we have shown that pH(i) regulation in CF neutrophils is intrinsically abnormal, potentially contributing to the pulmonary manifestations of the condition.     

First-phase insulin release in adult cystic fibrosis patients: correlation with clinical and biological parameters.

Adult patients with cystic fibrosis (CF) are at high risk for developing insulin-dependent diabetes mellitus. Therefore, the fast insulin release (FIR) to intravenously administered glucose was measured in 23 adult CF patients. The influence of the clinical parameters and type of gene deletion on the amplitude of the FIR, defined by the sum of the 1st- and 3rd-minute insulin concentrations was analyzed. In 11 of the 18 normoglycemic patients with exocrine pancreatic insufficiency and the 3 nontreated diabetic CF patients studied, an FIR value lower than the 3rd percentile was found. The female patients had higher mean FIR values than the male patients (62.8 +/- 39.6 vs. 27.9 +/- 17.9 mU/l; p < 0.05). No influence of age, body mass index, or pulmonary or liver involvement on the FIR was found. Subjects heterozygous for the delta F508 deletion had a similar insulin response as homozygous patients. The FIR level correlated negatively with the basal glucose level (r = 0.4; p < 0.001). In conclusion, 61% of the adult nondiabetic CF patients with exocrine pancreatic insufficiency presented a loss in acute insulin response, which could not be predicted by clinical or genetic parameters.