The Airway Microbiome at Birth

Lal, Charitharth Vivek; Travers, Colm P.; Aghai, Zubair H.; Eipers, Peter; Jilling, Tamás; Halloran, Brian; Carlo, Waldemar A.; Keeley, Jordan M.; Rezonzew, Gabriel; Kumar, Ranjit; Morrow, Casey D.; Bhandari, Vineet; Ambalavanan, Namasivayam

doi:10.1038/srep31023

Cited by 152 publications

(158 citation statements)

References 43 publications

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“…Contrary to the traditional belief that the human neonatal respiratory tract is sterile at birth, current studies indicate that the human respiratory tract microbial colonization begins in utero 100,101 or shortly after birth 102,103 . A recent study demonstrated that the lung microbiome, including the relative abundance of bacterial phyla and diversity index of the preterm and term neonates were similar at birth irrespective of the gestational age and the mode of delivery.…”

Section: Pathogenesiscontrasting

confidence: 90%

“…A recent study demonstrated that the lung microbiome, including the relative abundance of bacterial phyla and diversity index of the preterm and term neonates were similar at birth irrespective of the gestational age and the mode of delivery. Firmicutes and Proteobacteria were the predominant microbes at birth 103 . Factors such as chorioamnionitis, antibiotic exposure, mode of delivery, method of feeding, and bowel colonization can decrease bacterial diversity and increase pathogenic microbial colonization in the lungs 104 , which may potentially lead to an inflammatory lung phenotype that ultimately contributes to the development of BPD.…”

Section: Pathogenesismentioning

confidence: 98%

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Bronchopulmonary dysplasia: A review of pathogenesis and pathophysiology

Thekkeveedu

Guamán

Shivanna

2017

Respiratory Medicine

263

190

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Bronchopulmonary dysplasia (BPD) is a chronic lung disease of primarily premature infants that results from an imbalance between lung injury and repair in the developing lung. BPD is the most common respiratory morbidity in preterm infants, which affects nearly 10, 000 neonates each year in the United States. Over the last two decades, the incidence of BPD has largely been unchanged; however, the pathophysiology has changed with the substantial improvement in the respiratory management of extremely low birth weight (ELBW) infants. Here we have attempted to comprehensively review and summarize the current literature on the pathogenesis and pathophysiology of BPD. Our goal is to provide insight to help further progress in preventing and managing severe BPD in the ELBW infants.

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Section: Pathogenesiscontrasting

confidence: 90%

Section: Pathogenesismentioning

confidence: 98%

Bronchopulmonary dysplasia: A review of pathogenesis and pathophysiology

Thekkeveedu

Guamán

Shivanna

2017

Respiratory Medicine

263

190

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“…2930 The abnormal immune responses and enhanced inflammatory responses of prematurity generate a unique host environment, which, in combination with early nosocomial exposures, results in distinct microbial communities colonizing different systems. 31 32 An example is the increasingly clear link between the abnormal gut microbiota composition in PM infants and the development of necrotizing enterocolitis. 32 In addition, abnormalities in the airway microbiome diversity of PM infants have also been described in association with the development of bronchopulmonary dysplasia (BPD), 31 the most common chronic respiratory complication in this vulnerable population.…”

Section: Discussionmentioning

confidence: 99%

“…At the phylum level, PM infants showed increased Proteobacteria (major group of Gram-negative bacteria) and decreased Firmicute (Gram-positive bacteria such as Clostridium and Lactobacillus ), which is an airway microbiome signature recently described in PM newborns, particularly in those with increased BPD risk. 31 …”

Section: Discussionmentioning

confidence: 99%

Nasopharyngeal Microbiome in Premature Infants and Stability during Rhinovirus Infection

Pérez

Pérez‐Losada

Isaza

et al. 2017

Journal of Investigative Medicine

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Rationale The nasopharyngeal (NP) microbiota of newborns and infants plays a key role in modulating airway inflammation and respiratory symptoms during viral infections. Premature (PM) birth modifies the early NP environment and is a major risk factor for severe viral respiratory infections. However, it is currently unknown if the NP microbiota of PM infants is altered relative to full-term (FT) individuals. Objectives To characterize the NP microbiota differences in preterm and FT infants during rhinovirus (RV) infection. Methods We determined the NP microbiota of infants 6 months to ≤2 years of age born FT (n=6) or severely PM<32 weeks gestation (n=7). We compared microbiota composition in healthy NP samples and performed a longitudinal analysis during naturally occurring RV infections to contrast the microbiota dynamics in PM versus FT infants. Results We observed significant differences in the NP bacterial community of PM versus FT. NP from PM infants had higher within-group dissimilarity (heterogeneity) relative to FT infants. Bacterial composition of NP samples from PM infants showed increased Proteobacteria and decreased in Firmicutes. There were also differences in the major taxonomic groups identified, including Streptococcus, Moraxella, and Haemophilus. Longitudinal data showed that these prematurity-related microbiota features persisted during RV infection. Conclusions PM is associated with NP microbiota changes beyond the neonatal stage. PM infants have an NP microbiota with high heterogeneity relative to FT infants. These prematurity-related microbiota features persisted during RV infection, suggesting that the NP microbiota of PM may play an important role in modulating airway inflammatory and immune responses in this vulnerable group.

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“…There is increasing interest in the possible role of lung microbiome in the risk for BPD with several studies showing that multiple antenatal and postnatal factors, such as antibiotic use, nutrition, and sepsis can alter the normal development of lung microbiome [25, 26]. The potential role of lung dysbiosis in the development of BPD needs to be further elucidated.…”

Section: Changes In the Pathogenesis Of Bpdmentioning

confidence: 99%

Bronchopulmonary Dysplasia: 50 Years after the Original Description

2019

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Bronchopulmonary dysplasia (BPD) is one of the few diseases in neonatal medicine that has continued to evolve since its first description about 50 years ago. Over these years, advancements in neonatal medicine such as antenatal steroids and exogenous surfactant therapy have significantly reduced neonatal mortality and lowered the limits of viability for preterm infants. Although the incidence of BPD continues to be high, especially in extremely low birth weight infants, the clinical picture has evolved into a milder disease with low mortality or significant morbidities. This new BPD is the result of complex interactions between altered alveolar and vascular development, injury by ante- and postnatal pathogenic factors, and reparative processes in the lung. There has been significant progress in our understanding of risk factors for BPD, but challenges persist in its definition, and in finding effective preventive strategies. There are promising developments with newer preventive interventions such as mesenchymal stem cells, exosomes, immunomodulators, and growth factors, but they are still in preclinical stage. The future challenges include finding ways to define BPD based on the severity of lung pathology, which can better predict long-term outcomes, development of early predictors of lung disease, and finding innovative and evidence-based preventive and management strategies.

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The Airway Microbiome at Birth

Cited by 152 publications

References 43 publications

Bronchopulmonary dysplasia: A review of pathogenesis and pathophysiology

Bronchopulmonary dysplasia: A review of pathogenesis and pathophysiology

Nasopharyngeal Microbiome in Premature Infants and Stability during Rhinovirus Infection

Bronchopulmonary Dysplasia: 50 Years after the Original Description

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