Exposure to bile and gastric juice can impact the aerodigestive microbiome in people with cystic fibrosis

Hafez Al-Momani, Audrey Perry, Andrew Nelson, Christopher J. Stewart, Rhys Jones, Amaran Krishnan, Andrew Robertson, Stephen Bourke, Simon Doe, Stephen Cummings, Alan Anderson, Tara Forrest, Ian Forrest, Michael Griffin, Matthew Wilcox, Malcolm Brodlie, Jeffrey Pearson, Christopher Ward

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    Studies of microbiota reveal inter-relationships between the microbiomes of the gut and lungs. This relationship may influence the progression of lung disease, particularly in patients with cystic fibrosis (CF), who often experience extraoesophageal reflux (EOR). Despite identifying this relationship, it is not well characterised. Our hypothesis is that the gastric and lung microbiomes in CF are related, with the potential for aerodigestive pathophysiology. We evaluated gastric and sputum bacterial communities by culture and 16S rRNA gene sequencing in 13 CF patients. Impacts of varying levels of bile acids, pepsin and pH on patient isolates of Pseudomonas aeruginosa (Pa) were evaluated. Clonally related strains of Pa and NTM were identified in gastric and sputum samples from patients with symptoms of EOR. Bacterial diversity was more pronounced in sputa compared to gastric juice. Gastric and lung bile and pepsin levels were associated with Pa biofilm formation. Analysis of the aerodigestive microbiomes of CF patients with negative sputa indicates that the gut can be a reservoir of Pa and NTM. This combined with the CF patient’s symptoms of reflux and potential aspiration, highlights the possibility of communication between microorganisms of the gut and the lungs. This phenomenon merits further research.

    Original languageEnglish
    Article number11114
    Number of pages11
    JournalScientific Reports
    Issue number1
    Publication statusPublished - 30 Jun 2022


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