Thorax:甘露糖结合凝集素缺失与COPD患者气道菌群多样性和恶化频率减少有关!

2017-11-04 xing.T MedSci原创

由此可见,对于MBL基因缺失的COPD患者来说,病情恶化的风险和肺部微生物多样性降低,这是第一个探究基因型与COPD患者肺部菌群之间相关性的研究。

在囊性纤维化和支气管扩张症中,甘露糖结合凝集素(MBL)基因缺失与它们急性加重和早期死亡增加有关;但在COPD患者中这种相关性尚不明确。临床前数据表明MBL干扰了流感嗜血杆菌的吞噬作用,这是慢性阻塞性肺病的一种关键病原体。近日,胸部疾病领域权威杂志Thorax上发表了一篇研究文章,研究人员调查了MBL缺失是否会影响COPD患者的临床结果或菌群组成。

研究人员对COPD患者(n=1796)进行了MBL基因分型,并将这些患者与健康记录相链接,以确定病情恶化、肺功能下降和死亡率。研究人员将141例患者组成一个嵌套的亚组,随访6个月,进行评估MBL缺失是否与改变痰中的微生物有关,通过16S rRNA PCR和测序来反映,或与稳定期和急性加重期COPD的气道炎症有关。

MBL缺失的COPD患者严重恶化(发生率比为0.66,95%可信区间为0.48-0.90,P=0.009)或中度或重度急性加重(发生率比为0.77,95%可信区间为0.60-0.99,P=0.047)的几率显著降低。MBL缺失并没有影响FEV1下降率或死亡。在亚组中,MBL缺失患者肺部微生物的菌类更加丰富(P=0.008),而不太可能有嗜血杆菌定植,MBL缺失患者气道炎症水平较低。

由此可见,对于MBL基因缺失的COPD患者来说,病情恶化的风险和肺部微生物多样性降低,这是第一个探究基因型与COPD患者肺部菌群之间相关性的研究。

原始出处:

Alison J Dicker, et al. Genetic mannose binding lectin deficiency is associated with airway microbiota diversity and reduced exacerbation frequency in COPD.Thorax. 2017. http://dx.doi.org/10.1136/thoraxjnl-2016-209931

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    2018-04-12 871538379

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    2017-11-06 gous