医学
轻度链球菌
比例危险模型
微生物群
内科学
囊性纤维化
危险系数
口腔黏膜测试
链球菌
胃肠病学
生物
置信区间
生物信息学
细菌
遗传学
作者
David N. O’Dwyer,John S. Kim,Shwu‐Fan Ma,Piyush Ranjan,Dás P,Jay H Lipinski,Joseph D. Metcalf,Nicole R. Falkowski,Eric Yow,Kevin J. Anstrom,Robert P. Dickson,Yong Huang,Jack A. Gilbert,Fernando J. Martínez,Imre Noth
标识
DOI:10.1164/rccm.202308-1357oc
摘要
Oral microbiota associate with diseases of the mouth and serve as a source of lung microbiota. However, the role of oral microbiota in lung disease is unknown.To determine associations between oral microbiota and disease severity and death in idiopathic pulmonary fibrosis.We analyzed 16S rRNA gene and shotgun metagenomic sequencing data of buccal swabs from 511 patients with idiopathic pulmonary fibrosis in the multicenter CleanUP-IPF trial. Buccal swabs were collected from usual care, and antimicrobial cohorts. Microbiome data was correlated with measures of disease severity using principal component analysis and linear regression models. Associations between the buccal microbiome and mortality were determined using Cox additive models, Kaplan Meier analysis and Cox proportional hazards models.Greater buccal microbial diversity associated with lower forced vital capacity (FVC) at baseline [mean diff -3.60: 95% CI -5.92 to -1.29 percent predicted FVC per 1 unit increment]. The buccal proportion of Streptococcus correlated positively with FVC [mean diff 0.80: 95% CI 0.16-1.43 percent predicted per 10% increase] (n=490). Greater microbial diversity was associated with an increased risk of death [HR 1.73: 95% CI 1.03-2.90] while a greater proportion of Streptococcus was associated with a reduced risk of death [HR 0.85: 95% CI 0.73 to 0.99]. The Streptococcus genus was mainly comprised of Streptococcus mitis species.Increasing buccal microbial diversity predicts disease severity and death in IPF. The oral commensal Streptococcus mitis spp associates with preserved lung function and improved survival.
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