Neonatal Gastrointestinal and Respiratory Microbiome in Cystic Fibrosis: Potential Interactions and Implications for Systemic Health

Abstract

Purpose The gastrointestinal microbiome plays a critical role in nutrition and metabolic and immune functions in infants and young children and has implications for lifelong health. Cystic fibrosis (CF) transmembrane conductance regulator (CFTR) mutations in CF result in viscous mucous production, frequent exposure to antibiotics, and atypical colonization patterns, resulting in an evolving dysbiosis of the gastrointestinal and respiratory microsystems; dysbiosis in CF results in systemic inflammation, chronic infection, and dysregulation of immune function. Dysbiosis in both the respiratory system and gut contributes to undernutrition, growth failure, and long-term respiratory and systemic morbidity in infants and children with CF. Understanding the role that the gut and respiratory microbiome plays in health or disease progression in CF will afford opportunities to better identify interventions to affect clinical changes. Methods Summary was done of the pertinent literature in CF and the study of the microbiome and probiotics. Findings New studies have identified bacteria in the respiratory tract in CF that are typically members of the intestinal microbiota, and enteral exposures to breast milk and probiotics are associated with prolonged periods of respiratory stability in CF. Implications Understanding the complex interactions between the CFTR mutations, microbial colonization, and mucosal and systemic immunity is of major importance to inform new treatment strategies (such as restoring a healthier microbiome with probiotics or dietary interventions) to improve nutritional status and immune competence and to decrease morbidity and mortality in CF.

The fermentation product 2,3-butanediol alters P. aeruginosa clearance, cytokine response and the lung microbiome

“…In fact, the corresponding absolute abundance of P. aeruginosa was still higher in murine lungs treated with PA14 in 2,3-butanediol even with the increased colonization of environmental microbes (Supplementary Figure S3C). Our results are also consistent with the recent studies that have shown the impact of gut microbiome on acquisition of the lung microbiome in CF (Madan, 2016).…”

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The CF gastrointestinal microbiome: Structure and clinical impact

“…In turn, the GI physicochemical environment, which is decidedly altered in people with CF, shapes both the constituency and behavior of the GI microbiota. Recent evidence shows that CF GI microbiota are indeed different from people without CF, potentially with pathological consequences within and beyond the CF GI tract . In this article, we will review the recent literature on the CF GI microbiome and its clinical impact, as well as how we might use these recent discoveries to prevent a host of CF disease manifestations.…”