Цель. Изучить изменения кишечной микробиоты у пациентов с бронхиальной астмой (БА). Материалы и методы. В исследование включены 40 больных БА и 15 клинически здоровых лиц. Исследование микробиоты в образцах кала выполнено с помощью секвенирования гена 16SрPНК. Результаты. У пациентов с БА отмечены увеличение доли Proteobacteria (Betaproteobacteria и Gammaproteobacteria при аллергической и только Gammaproteobacteria при неаллергической астме), увеличение Bacilli и снижение доли бактерий, образующих бутират (Anaerostipes, Faecalibacterium) и ацетат (Alistipes), что соответствует уменьшению доли строгих анаэробов-симбионтов и увеличению доли условно-патогенных факультативных анаэробов. В случае наличия синдрома избыточного бактериального роста (СИБР) при аллергической астме снижено относительное количество бактерий классов Negativicutes, Erysipelotrichia, Bacteroidia, семейств Erysipelotrichaceae, Pseudomonadaceae, Rhodospirillaceae, Bacillaceae, родов Barnesiella, Paraprevotella, Pyrolobus, Bifidobacterium, Pseudomonas, Coprobacter, Bacillus. При неаллергической астме наличие СИБР сопровождалось повышением относительного количества бактерий семейства Bacteroidaceae, родов Paraprevotella, Odoribacter, Bacteroides, Butyricicoccus, Parasutterella. Изменения бактериального спектра коррелировали с основными клинико-лабораторными проявлениями БА. Заключение. Полученные результаты свидетельствуют о различиях состава микрофлоры кишечника здоровых добровольцев и больных БА, в том числе при наличии СИБР. Необходимо дальнейшее изучение изменений бактериального состава кишечника при бронхолегочной патологии.
Ключевые слова: кишечная микробиота, бронхиальная астма, синдром избыточного бактериального роста в тонкой кишке, пробиотики.
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Aim. To study the intestinal microbiota changes in patients with bronchial asthma (BA).
Materials and methods. 40 patients and 15 healthy individuals were included for the study. The microbiota study in feces samples was performed by sequencing the 16SpRNA gene. Results. It was noted an increasing of the Proteobacteria proportion in the patients with BA. The fractions of Betaproteobacteria и Gammaproteobacteria were increased in the patients with allergic BA and at the same time, only the Gammaproteobacteria part was increased in patients with non-allergic form of BA. It was found an increase in Bacilli and a decrease in the proportion bacteria forming butyrate (Anaerostipes, Faecalibacterium) and acetate (Alistipes), which was corresponded to a decrease in the proportion of strict anaerobic symbionts and an increase in the proportion of opportunistic facultative anaerobes. The relative bacteria amount was reduced for the Negativicutes Erysipelotrichia, Bacteroidia classes, the Erysipelotrichaceae, Pseudomonadaceae, Rhodospirillaceae, Bacillaceae families and for the kinds of Barnesiella, Paraprevotella, Pyrolobus, Bifidobacterium, Pseudomonas, Coprobacter, Bacillus in the allergic asthma patients with syndrome of intensive bacterial overgrowth (SIBO) cases. In the non-allergic asthma case, the presence of SIBO was accompanied by the relative bacteria amount increasing of the Bacteroidaceae and the Paraprevotella families and the Odoribacter, Bacteroides, Butyricicoccus, Parasutterella genera. The bacterial spectrum changes correlated with the main clinical and laboratory manifestations of BA in the patients. Conclusion. The results have indicated the differences in the intestinal microflora composition of healthy volunteers and patients with bronchial asthma in including the SIBO presence. It is necessary more detail study of the bacterial composition changes in the intestine for the bronchopulmonary pathology case.
Keywords: intestinal microbiota, bronchial asthma, syndrome of intensive bacterial overgrowth in the small intestine, probiotics.
Список литературы
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1. Kåhrström C, Pariente N, Weiss U. Intestinal microbiota in health and disease. Nature. 2016;535(7610):47. doi: 10.1038/535047a
2. Kang YB. Gut microbiota and allergy/asthma: From pathogenesis to new therapeutic strategies. Allergol Immunopathol. 2016;3:799-804. doi: 10.1016/j.aller.2016.08.004
3. Ozdemir O. Microbial dysbiosis in allergic lower airway disease (asthma). MOJ Immunol. 2018;6(4):129-32. doi: 10.15406/moji. 2018.06.00207
4. Caricilli AM, Saad MJ. The role of gut microbiota on insulin resistance. Nutrients. 2013;5:829-51. doi: 10.3390/nu50308298
5. Mukhopadhya I, Hansen R, El-Omar EM. IBD-what role do Proteobacteria play? Nat Rev Gastroenterol Hepatol. 2012;9:219-30. doi: 10.1038/nrgastro.2012.14
6. Hevia A, Milani C, López P, Donado CD. Allergic Patients with Long-Term Asthma Display Low Levels of Bifidobacterium adolescentis. PLoS ONE. 2016;11(2):e0147809. doi: 10.1371/journal.pone.0147809
7. Chung K. Airway microbial dysbiosis in asthmatic patients: A target for prevention and treatment? Clin Rev Allergy Immunol. 2018;2:1071-81. doi: 10.1016/j.jaci.2017.02.004
8. Charlson ES, Bittinger K, Haas AR, et al. Topographical continuity of bacterial populations in the healthy human respiratory tract. Am J Respir Crit Care Med. 2011;184(8):957-63. doi: 10.1164/rccm.201104-0655OC
9. Huang YJ, Charlson ES, Collman RG, et al. The role of the lung microbiome in health and disease. A national heart, lung, and blood institute workshop report. Am J Respir Crit Care Med. 2013;187(12):1382-7. doi: 10.1164/rccm.201303-0488WS
10. Wang Q, Garrity GM, Tiedje JM, Cole JR. Naïve Bayesian classifier for rapid assignment of rRNA sequences into the new bacterial taxonomy. Appl Environ Microbiol. 2007;73(16):5261-7. doi: 10.1128/AEM. 00062-07
11. Anand S, Mande SS. Diet, Microbiota and Gut-Lung Connection. Front Microbiol. 2018;9:2147. doi: 10.3389/fmicb.2018.02147
12. Zhang J, Guo Z, Xue Z, et al. A phylofunctional core of gut microbiota in healthy young Chinese cohorts across lifestyles, geography and ethnicities. ISME J. 2015;9(9):1979-90. doi: 10.1038/ismej.2015.11
13. Potskhverashvili ND, Zolnikova ОYu, Kokina NI, et al. Small Bowel Bacterial Overgrowth Syndrome in Patients with Bronchial Asthma. Russian J Gastroenterol Hepatol Coloproctol. 2018;28(4):47-54 (In Russ.) doi: 10.22416/1382-4376-2018-28-4-47-54
1 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России
(Сеченовский Университет), Москва, Россия
2 ФГБУН «Институт молекулярной биологии им. В.А. Энгельгардта» РАН, Москва, Россия