非嗜酸性粒细胞与嗜酸性粒细胞炎症表型的支气管哮喘患者下呼吸道微生物群的差异

汪群智 盛美玲 郭安

[摘要] 目的 基于宏基因組高通量测序探讨非嗜酸性粒细胞与嗜酸性粒细胞炎症表型的支气管哮喘患者下呼吸道微生物群差异，进一步了解呼吸道微生物群变化与哮喘炎症表型的关系。 方法 选取2019年1—12月间我院就诊的支气管哮喘患者80例作为研究对象，对所有患者行诱导痰检查，利用Miseq PE300平台进行诱导痰标本上机高通量测序。 结果 支气管哮喘患者下呼吸道微生物群组成非常丰富，门水平上主要以厚壁菌门（45.35%）、拟杆菌门（18.12%）、变形菌门（16.48%）、放线菌门（10.47%）、梭杆菌门（4.50%）为主，属水平上主要以链球菌属（24.35%）、韦荣氏球菌属（12.91%）、普雷沃氏菌属（7.72%）、假单胞菌属（4.03%）、罗氏菌属（3.92%）、嗜血杆菌属（3.17%）为主。非嗜酸性粒细胞与嗜酸性粒细胞哮喘患者诱导痰中微生物多样性比较，差异无统计学意义（P>0.05）。门水平上，非嗜酸性粒细胞型哮喘患者诱导痰中拟杆菌门、梭杆菌门丰度明显升高[（21.43±3.95）% vs. （14.77±3.16）%，P=0.0318;（6.58±1.02）% vs. （3.27±0.74）%，P=0.0443）];属水平上，非嗜酸性粒细胞型哮喘患者诱导痰中假单胞菌属、嗜血杆菌属、葡萄球菌属丰度明显升高[（8.51±1.27）% vs. （1.77±0.44）%，P=0.0325;（8.22±1.04）% vs. （1.53±0.36）%，P=0.0223;（4.11±0.65）% vs. （2.43±0.37）%，P=0.0492]。 结论 非嗜酸性粒细胞型哮喘与嗜酸性粒细胞型哮喘患者诱导痰中拟杆菌门、梭杆菌门，假单胞菌属、嗜血杆菌属、葡萄球菌属丰度存在明显差异。

[关键词] 微生物群;呼吸道;支气管哮喘;高通量测序

[中图分类号] R731.4          [文献标识码] A          [文章编号] 1673-9701（2021）31-0031-05

[Abstract] Objective To investigate the difference of lower respiratory tract microbiota in bronchial asthma patients with non-eosinophil and eosinophil inflammatory phenotypes based on metagenomic high-throughput sequencing，and to further understand the relationship between respiratory microbiota changes and inflammatory asthma phenotypes. Methods A total of 80 patients with bronchial asthma who visited our hospital from January to December 2019 were selected as the study subjects.All patients underwent induced sputum examination.High-throughput sequencing of induced sputum samples was performed using MiseqPE300 platform. Results The composition of lower respiratory tract microbiota in patients with bronchial asthma was very abundant，mainly Firmicutes（45.35%），Bacteroidetes（18.12%），Proteobacteria（16.48%），Actinobacteria（10.47%），and Fusobacteria（4.50%）at the phylum level，and Streptococcus（24.35%），Veillonella（12.91%），Prevotella（7.72%），Pseudomonas（4.03%），Roche（3.92%），and Haemophilus（3.17%）at the genus level.There was no significant difference in microbial diversity in induced sputum from non-eosinophilic and eosinophilic asthma patients.At the phylum level，the abundance of Bacteroidetes and Fusobacteria in induced sputum was significantly increased in patients with non-eosinophilic asthma[（21.43±3.95）% vs. （14.77±3.16）%， P=0.0318; （6.58±1.02）% vs. （3.27±0.74%）， P=0.0443].At the genus level，the abundance of Pseudomonas，Haemophilus，and Staphylococcus species in induced sputum was significantly increased in patients with non-eosinophilic asthma[（8.51±1.27）% vs. （1.77±0.44）%，P=0.0325; （8.22±1.04）% vs. （1.53±0.36）%，P=0.0223; （4.11±0.65）% vs. （2.43±0.37）%， P=0.0492]. Conclusion There are significant differences in the abundance of Bacteroidetes，Fusobacteria，Pseudomonas，Haemophilus，and Staphylococcus in induced sputum between patients with non-eosinophilic asthma and eosinophilic asthma.

[Key words] Microbiota; Respiratory tract; Bronchial asthma; High-throughput sequencing

支气管哮喘是全球范围内最常见的呼吸道慢性炎症性疾病之一，是全球关注的重要公共卫生问题。其中重症哮喘[1]是指过去1年中一半以上的时间内需要……