口服益生菌向分泌性中耳炎儿童上呼吸道潜在转移的研究

文献信息

中文摘要

背景： 上呼吸道（URT）微生物组日益被认为是气道健康的关键决定因素，然而益生菌有益调节这些菌群的潜力在很大程度上仍未得到探索，尽管中耳炎（OM）等URT感染负担很高。本随机对照试验研究了两种模型益生菌菌株——鼠李糖乳酪杆菌GG和动物双歧杆菌乳亚种BB-12——向37名分泌性中耳炎（OME）儿童不同URT生态位的迁移情况，这些儿童每日接受口服油滴治疗一个月。方法：对来自腺样体和鼻咽部的URT样本采用种特异性qRT-PCR和16S扩增子测序进行分析。结果：在4/19的治疗患者中检测到类鼠李糖乳酪杆菌GG细菌，而对照组为0/18。口服油滴益生菌治疗适度增加了鼻咽部和腺样体中类鼠李糖乳酪杆菌GG细菌的流行率（分别从0%增至16.67%和15.79%），并观察到与Dolosigranulum pigrum丰度呈轻微正相关（效应量=0.13）。有趣的是，其他因素，如出生后母亲抗生素使用，与卡他莫拉菌/非液化莫拉菌丰度显著较高相关（Maaslin效应量=5.10），与肺炎链球菌/假肺炎链球菌丰度较低相关（Maaslin效应量=-2.27）。结论：总之，本研究表明口服益生菌可能以与OM相关的方式调节URT微生物组，尽管效应的幅度和方向可能取决于所使用的特定菌株。该试验在ClinicalTrials.gov注册，注册号为B300201731908。

英文摘要

The upper respiratory tract (URT) microbiome is increasingly recognised as a key determinant of airway health, yet the potential of probiotics to beneficially modulate these communities remains largely unexplored, despite the high burden of URT infections such as otitis media (OM). This randomised controlled trial investigated the migration of two model probiotic strains, Lacticaseibacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12, to different URT niches in 37 children with otitis media with effusion (OME) treated daily with oral oil drops for one month. URT samples from the adenoids, and nasopharynx were analysed with species-specific qRT-PCR and 16S amplicon sequencing. L. rhamnosus GG-like bacteria were detected in 4/19 of treated patients compared to 0/18 in the control group. Probiotic treatment with oral oil droplets modestly increased the prevalence of L. rhamnosus GG-like bacteria in the nasopharynx and adenoids (from 0% to 16.67% and 15.79% respectively), and a slight positive association was observed with the abundance of Dolosigranulum pigrum (effect size = 0.13). Interestingly, other factors, such as maternal antibiotic use after birth, were associated with a notable higher abundance of Moraxella catarrhalis/nonliquefaciens (Maaslin effect size = 5.10), and a lower abundance of Streptococcus pneumoniae/pseudopneumoniae (Maaslin effect size = -2.27). In conclusion, this study suggests that oral probiotics might modulate the URT microbiome in ways relevant to OM, although the magnitude and direction of effects likely depend on the specific strains used. The trial was registered at ClinicalTrials.gov under B300201731908.