Journal Article

Initial acquisition and succession of the cystic fibrosis lung microbiome is associated with disease progression in infants and preschool children

Ranganathan, Sarath C., Wolfgang, Matthew C., Muhlebach, Marianne S., Hatch, Joseph E., Boucher, Richard C., Zorn, Bryan T., Esther, Charles R., Murray, Conor P., Turkovic, Lidija, Stick, Stephen M.

2018

Overview

The cystic fibrosis (CF) lung microbiome has been studied in children and adults; however, little is known about its relationship to early disease progression. To better understand the relationship between the lung microbiome and early respiratory disease, we characterized the lower airways microbiome using bronchoalveolar lavage (BAL) samples obtained from clinically stable CF infants and preschoolers who underwent bronchoscopy and chest computed tomography (CT). Cross-sectional samples suggested a progression of the lower airways microbiome with age, beginning with relatively sterile airways in infancy. By age two, bacterial sequences typically associated with the oral cavity dominated lower airways samples in many CF subjects. The presence of an oral-like lower airways microbiome correlated with a significant increase in bacterial density and inflammation. These early changes occurred in many patients, despite the use of antibiotic prophylaxis in our cohort during the first two years of life. The majority of CF subjects older than four harbored a pathogen dominated airway microbiome, which was associated with a further increase in inflammation and the onset of structural lung disease, despite a negligible increase in bacterial density compared to younger patients with an oral-like airway microbiome. Our findings suggest that changes within the CF lower airways microbiome occur during the first years of life and that distinct microbial signatures are associated with the progression of early CF lung disease.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adults / Alveoli / Antibiotics / Bacteria / Biology and Life Sciences / Bronchoalveolar Lavage / Bronchoalveolar Lavage Fluid - microbiology / Bronchoscopy / Bronchus / Case-Control Studies / Cells, Cultured / Child, Preschool / Children / Computed tomography / Cross-Sectional Studies / Cystic fibrosis / Cystic Fibrosis - microbiology / Cystic Fibrosis - pathology / Development and progression / Disease prevention / Disease Progression / Female / Funding / Health aspects / Hospitals / Humans / Infant / Infants / Infections / Inflammation / Investigations / Lung - microbiology / Lung diseases / Male / Medical screening / Medicine and Health Sciences / Microbiomes / Microbiota / Microbiota - genetics / Microbiota - physiology / Microorganisms / Newborn babies / Oral cavity / Pathogens / Patients / Pediatrics / People and Places / Preschool children / Prophylaxis / Research and Analysis Methods / Respiratory diseases / Respiratory tract