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Sci Rep. 2016 Aug 4;6:31023. doi: 10.1038/srep31023.

The Airway Microbiome at Birth.

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Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, AL, USA.
Translational Research in Normal and Disordered Development Program (TReNDD) University of Alabama at Birmingham, AL, USA.
Program in Protease and Matrix Biology, University of Alabama at Birmingham, AL, USA.
Department of Pediatrics, Thomas Jefferson University/Nemours, Philadelphia, PA, USA.
Department of Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, AL, USA.
Center for Clinical and Translational Sciences, University of Alabama at Birmingham, AL, USA.
Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA, USA.


Alterations of pulmonary microbiome have been recognized in multiple respiratory disorders. It is critically important to ascertain if an airway microbiome exists at birth and if so, whether it is associated with subsequent lung disease. We found an established diverse and similar airway microbiome at birth in both preterm and term infants, which was more diverse and different from that of older preterm infants with established chronic lung disease (bronchopulmonary dysplasia). Consistent temporal dysbiotic changes in the airway microbiome were seen from birth to the development of bronchopulmonary dysplasia in extremely preterm infants. Genus Lactobacillus was decreased at birth in infants with chorioamnionitis and in preterm infants who subsequently went on to develop lung disease. Our results, taken together with previous literature indicating a placental and amniotic fluid microbiome, suggest fetal acquisition of an airway microbiome. We speculate that the early airway microbiome may prime the developing pulmonary immune system, and dysbiosis in its development may set the stage for subsequent lung disease.

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