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J Pediatr. 2015 Jul;167(1):138-47.e1-3. doi: 10.1016/j.jpeds.2015.02.049. Epub 2015 Mar 26.

Associations between Gut Microbial Colonization in Early Life and Respiratory Outcomes in Cystic Fibrosis.

Author information

1
Computational Genetics Laboratory, Institute for Quantitative Biomedical Sciences, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH; Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH.
2
Computational Genetics Laboratory, Institute for Quantitative Biomedical Sciences, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH.
3
Division of Allergy and Pediatric Pulmonology, Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, NH.
4
Department of Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Hanover, NH.
5
Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS.
6
Division of Global Health, Department of Pediatrics, Massachusetts General Hospital, Boston, MA.
7
Josephine Bay Paul Center for Comparative Molecular Biology and Evolution, Marine Biological Laboratory, Woods Hole, MA.
8
Department of Epidemiology, Geisel School of Medicine at Dartmouth, Dartmouth College, Hanover, NH.
9
Division of Neonatology, Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, NH. Electronic address: Juliette.C.Madan@Dartmouth.Edu.

Abstract

OBJECTIVE:

To examine patterns of microbial colonization of the respiratory and intestinal tracts in early life in infants with cystic fibrosis (CF) and their associations with breastfeeding and clinical outcomes.

STUDY DESIGN:

A comprehensive, prospective longitudinal analysis of the upper respiratory and intestinal microbiota in a cohort of infants and young children with CF followed from birth was performed. Genus-level microbial community composition was characterized using 16S-targeted pyrosequencing, and relationships with exposures and outcomes were assessed using linear mixed-effects models, time-to-event analysis, and principal components analysis.

RESULTS:

Sequencing of 120 samples from 13 subjects collected from birth to 34 months revealed relationships between breastfeeding, microbial diversity in the respiratory and intestinal tracts, and the timing of onset of respiratory complications, including exacerbations and colonization with Pseudomonas aeruginosa. Fluctuations in the abundance of specific bacterial taxa preceded clinical outcomes, including a significant decrease in bacteria of the genus Parabacteroides within the intestinal tract prior to the onset of chronic P aeruginosa colonization. Specific assemblages of bacteria in intestinal samples, but not respiratory samples, were associated with CF exacerbation in early life, indicating that the intestinal microbiome may play a role in lung health.

CONCLUSIONS:

Our findings relating breastfeeding to respiratory outcomes, gut diversity to prolonged periods of health, and specific bacterial communities in the gut prior to respiratory complications in CF highlight a connection between the intestinal microbiome and health and point to potential opportunities for antibiotic or probiotic interventions. Further studies in larger cohorts validating these findings are needed.

PMID:
25818499
PMCID:
PMC4674690
DOI:
10.1016/j.jpeds.2015.02.049
[Indexed for MEDLINE]
Free PMC Article

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