Mohan Pammi1, Charitharth Vivek Lal2, Brandie D Wagner3, Peter M Mourani4, Pablo Lohmann5, Ruth Ann Luna6, Amy Sisson7, Binoy Shivanna5, Emily B Hollister6, Steven H Abman8, James Versalovic6, Gary J Connett9, Vineet Bhandari10, Namasivayam Ambalavanan2. 1. Section of Neonatology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX. Electronic address: mohanv@bcm.edu. 2. Division of Neonatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL. 3. Section of Pulmonary Medicine, Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO. 4. Pediatric Heart Lung Center, Section of Critical Care Medicine, Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO. 5. Section of Neonatology, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX. 6. Texas Children's Microbiome Center, Texas Children's Hospital and Department of Pathology, Baylor College of Medicine, Houston, TX. 7. Texas Medical Center Library, Houston, TX. 8. Section of Pulmonary Medicine, Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO; Pediatric Heart Lung Center, Section of Critical Care Medicine, Department of Pediatrics, School of Medicine, University of Colorado, Aurora, CO. 9. Department of Pediatrics, Southampton University Hospitals NHS Trust, Southampton, United Kingdom. 10. Department of Pediatrics, Drexel University College of Medicine, Philadelphia, PA.
Abstract
OBJECTIVES: To summarize evidence regarding microbial dysbiosis of the airway associated with bronchopulmonary dysplasia (BPD) and to explore heterogeneity among studies. STUDY DESIGN: We included studies that evaluated the airway microbiome in preterm infants who developed BPD using culture-independent molecular techniques and reported alpha- and beta-diversity metrics and microbial profiles. RESULTS: The 6 included studies had substantial clinical and methodological heterogeneity. Most studies reported the presence of an airway microbiome early after birth and an evolution in the first weeks of life with increasing bacterial loads. The early airway microbiome was dominated by Staphylococcus and Ureaplasma spp. Two studies reported differences in alpha- and beta- diversity indices in preterm infants with BPD compared with those who did not develop BPD. Increased microbial community turnover, changes in the relative abundance of Proteobacteria and Firmicutes, and decreased Lactobacilli were reported with BPD progression. Most included infants were born by cesarean delivery, and a majority were exposed to postnatal antibiotics. No data regarding feeding human milk or correlations with the development of gut microbiota (gut-lung axis) were available. CONCLUSIONS: Microbial dysbiosis may be associated with BPD progression and severity, and further study of microbiome optimization in preterm infants at risk for BPD is warranted.
OBJECTIVES: To summarize evidence regarding microbial dysbiosis of the airway associated with bronchopulmonary dysplasia (BPD) and to explore heterogeneity among studies. STUDY DESIGN: We included studies that evaluated the airway microbiome in preterm infants who developed BPD using culture-independent molecular techniques and reported alpha- and beta-diversity metrics and microbial profiles. RESULTS: The 6 included studies had substantial clinical and methodological heterogeneity. Most studies reported the presence of an airway microbiome early after birth and an evolution in the first weeks of life with increasing bacterial loads. The early airway microbiome was dominated by Staphylococcus and Ureaplasma spp. Two studies reported differences in alpha- and beta- diversity indices in preterm infants with BPD compared with those who did not develop BPD. Increased microbial community turnover, changes in the relative abundance of Proteobacteria and Firmicutes, and decreased Lactobacilli were reported with BPD progression. Most included infants were born by cesarean delivery, and a majority were exposed to postnatal antibiotics. No data regarding feeding human milk or correlations with the development of gut microbiota (gut-lung axis) were available. CONCLUSIONS:Microbial dysbiosis may be associated with BPD progression and severity, and further study of microbiome optimization in preterm infants at risk for BPD is warranted.
Authors: Kent A Willis; Joseph F Pierre; Stephania A Cormier; Ajay J Talati Journal: Am J Physiol Lung Cell Mol Physiol Date: 2019-10-30 Impact factor: 5.464
Authors: Bernard Thébaud; Kara N Goss; Matthew Laughon; Jeffrey A Whitsett; Steven H Abman; Robin H Steinhorn; Judy L Aschner; Peter G Davis; Sharon A McGrath-Morrow; Roger F Soll; Alan H Jobe Journal: Nat Rev Dis Primers Date: 2019-11-14 Impact factor: 52.329