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Blood. 2018 Jun 28;131(26):2978-2986. doi: 10.1182/blood-2018-01-828996. Epub 2018 Apr 19.

Impact of gut colonization with butyrate-producing microbiota on respiratory viral infection following allo-HCT.

Author information

1
Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
2
Center for Experimental and Molecular Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
3
Center for Microbes, Inflammation, and Cancer and.
4
Donald B. and Catherine C. Marron Cancer Metabolism Center, Memorial Sloan Kettering Cancer Center, New York, NY.
5
Infectious Diseases Service, New York University School of Medicine, New York, NY.
6
Weill Cornell Medical College, New York, NY; and.
7
Adult Bone Marrow Transplant Service and.
8
Pulmonary Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.

Abstract

Respiratory viral infections are frequent in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HCT) and can potentially progress to lower respiratory tract infection (LRTI). The intestinal microbiota contributes to resistance against viral and bacterial pathogens in the lung. However, whether intestinal microbiota composition and associated changes in microbe-derived metabolites contribute to the risk of LRTI following upper respiratory tract viral infection remains unexplored in the setting of allo-HCT. Fecal samples from 360 allo-HCT patients were collected at the time of stem cell engraftment and subjected to deep, 16S ribosomal RNA gene sequencing to determine microbiota composition, and short-chain fatty acid levels were determined in a nested subset of fecal samples. The development of respiratory viral infections and LRTI was determined for 180 days following allo-HCT. Clinical and microbiota risk factors for LRTI were subsequently evaluated using survival analysis. Respiratory viral infection occurred in 149 (41.4%) patients. Of those, 47 (31.5%) developed LRTI. Patients with higher abundances of butyrate-producing bacteria were fivefold less likely to develop viral LRTI, independent of other factors (adjusted hazard ratio = 0.22, 95% confidence interval 0.04-0.69). Higher representation of butyrate-producing bacteria in the fecal microbiota is associated with increased resistance against respiratory viral infection with LRTI in allo-HCT patients.

PMID:
29674425
PMCID:
PMC6024637
DOI:
10.1182/blood-2018-01-828996
[Indexed for MEDLINE]
Free PMC Article

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