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Lung Allograft Microbiome Association with Gastroesophageal Reflux, Inflammation, and Allograft Dysfunction.

Publication ,  Journal Article
Schneeberger, PHH; Zhang, CYK; Santilli, J; Chen, B; Xu, W; Lee, Y; Wijesinha, Z; Reguera-Nuñez, E; Yee, N; Ahmed, M; Boonstra, K; Ramendra, R ...
Published in: Am J Respir Crit Care Med
December 15, 2022

Rationale: It remains unclear how gastroesophageal reflux disease (GERD) affects allograft microbial community composition in lung transplant recipients and its impact on lung allograft inflammation and function. Objectives: Our objective was to compare the allograft microbiota in lung transplant recipients with or without clinically diagnosed GERD in the first year after transplant and assess associations between GERD, allograft microbiota, inflammation, and acute and chronic lung allograft dysfunction (ALAD and CLAD). Methods: A total of 268 BAL samples were collected from 75 lung transplant recipients at a single transplant center every 3 months after transplant for 1 year. Ten transplant recipients from a separate transplant center provided samples before and after antireflux Nissen fundoplication surgery. Microbial community composition and density were measured using 16S ribosomal RNA gene sequencing and quantitative polymerase chain reaction, respectively, and inflammatory markers and bile acids were quantified. Measurements and Main Results: We observed a range of allograft community composition with three discernible types (labeled community state types [CSTs] 1-3). Transplant recipients with GERD were more likely to have CST1, characterized by high bacterial density and relative abundance of the oropharyngeal colonizing genera Prevotella and Veillonella. GERD was associated with more frequent transitions to CST1. CST1 was associated with lower inflammatory cytokine concentrations than pathogen-dominated CST3 across the range of microbial densities observed. Cox proportional hazard models revealed associations between CST3 and the development of ALAD/CLAD. Nissen fundoplication decreased bacterial load and proinflammatory cytokines. Conclusions: GERD was associated with a high bacterial density, Prevotella- and Veillonella-dominated CST1. CST3, but not CST1 or GERD, was associated with inflammation and early development of ALAD and CLAD. Nissen fundoplication was associated with a reduction in microbial density in BAL fluid samples, especially the CST1-specific genus, Prevotella.

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Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

December 15, 2022

Volume

206

Issue

12

Start / End Page

1495 / 1507

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Respiratory System
  • Microbiota
  • Lung Transplantation
  • Lung
  • Inflammation
  • Humans
  • Gastroesophageal Reflux
  • Allografts
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Schneeberger, P. H. H., Zhang, C. Y. K., Santilli, J., Chen, B., Xu, W., Lee, Y., … Coburn, B. (2022). Lung Allograft Microbiome Association with Gastroesophageal Reflux, Inflammation, and Allograft Dysfunction. Am J Respir Crit Care Med, 206(12), 1495–1507. https://doi.org/10.1164/rccm.202110-2413OC
Schneeberger, Pierre H. H., Chen Yang Kevin Zhang, Jessica Santilli, Bo Chen, Wei Xu, Youngho Lee, Zonelle Wijesinha, et al. “Lung Allograft Microbiome Association with Gastroesophageal Reflux, Inflammation, and Allograft Dysfunction.Am J Respir Crit Care Med 206, no. 12 (December 15, 2022): 1495–1507. https://doi.org/10.1164/rccm.202110-2413OC.
Schneeberger PHH, Zhang CYK, Santilli J, Chen B, Xu W, Lee Y, et al. Lung Allograft Microbiome Association with Gastroesophageal Reflux, Inflammation, and Allograft Dysfunction. Am J Respir Crit Care Med. 2022 Dec 15;206(12):1495–507.
Schneeberger, Pierre H. H., et al. “Lung Allograft Microbiome Association with Gastroesophageal Reflux, Inflammation, and Allograft Dysfunction.Am J Respir Crit Care Med, vol. 206, no. 12, Dec. 2022, pp. 1495–507. Pubmed, doi:10.1164/rccm.202110-2413OC.
Schneeberger PHH, Zhang CYK, Santilli J, Chen B, Xu W, Lee Y, Wijesinha Z, Reguera-Nuñez E, Yee N, Ahmed M, Boonstra K, Ramendra R, Frankel CW, Palmer SM, Todd JL, Martinu T, Coburn B. Lung Allograft Microbiome Association with Gastroesophageal Reflux, Inflammation, and Allograft Dysfunction. Am J Respir Crit Care Med. 2022 Dec 15;206(12):1495–1507.

Published In

Am J Respir Crit Care Med

DOI

EISSN

1535-4970

Publication Date

December 15, 2022

Volume

206

Issue

12

Start / End Page

1495 / 1507

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Respiratory System
  • Microbiota
  • Lung Transplantation
  • Lung
  • Inflammation
  • Humans
  • Gastroesophageal Reflux
  • Allografts
  • 3202 Clinical sciences