16S rRNA测序鉴定的扁桃体假单胞菌与IgA肾病扁桃体切除术后临床缓解的关联：一种机器学习方法
Association of tonsillar Pseudomonas identified by 16S rRNA sequencing with clinical remission after tonsillectomy in IgA nephropathy: a machine learning approach.
文献信息
| PMID | 42970196 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Ryosuke Sato |
| 作者单位 | Department of Otolaryngology-Head & Neck Surgery, Asahikawa Medical University, 2-1-1-1 Midorigaoka-Higashi, Asahikawa, 078-8510, Japan. rsato@asahikawa-med.ac.jp. |
| 期刊 | Clinical and experimental nephrology |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 新出现的证据提示扁桃体黏膜免疫反应可能与免疫球蛋白A肾病（IgAN）的临床特征相关。本研究采用16S核糖体RNA基因测序表征与IgAN相关的扁桃体微生物群。
方法： 我们回顾性分析了20例经活检证实的IgAN患者和19例接受扁桃体切除术的复发性扁桃体炎（RT）患者的扁桃体组织。通过16S rRNA测序确定微生物群组成，并使用Boruta特征选择算法鉴定疾病相关菌属。采用受试者工作特征曲线分析、Kaplan-Meier分析和log-rank检验评估其与扁桃体切除术后临床结局的关联。
结果： IgAN和RT分别检出194和190个菌属。α多样性在两组间无显著差异，但β多样性分析显示微生物群落结构存在差异（p < 0.01）。Boruta鉴定出放线菌属、微小单胞菌属、链球菌属、Catonella、芽孢杆菌属和假单胞菌属为关键鉴别菌属。假单胞菌属和芽孢杆菌属在IgAN组中富集。基于假单胞菌属丰度预测3年完全缓解的曲线下面积为0.712。假单胞菌属阳性患者的完全缓解率和蛋白尿缓解率均显著更高（两者p = 0.03）。
结论： 本研究揭示了IgAN患者与RT患者之间不同的扁桃体微生物群特征，并显示扁桃体假单胞菌属富集与扁桃体切除术后良好结局相关。这些发现提示扁桃体假单胞菌属可能与IgAN扁桃体切除术后的临床缓解相关。
英文摘要
BACKGROUND: Emerging evidence suggests that mucosal immune responses in the tonsils may be associated with clinical features of immunoglobulin A nephropathy (IgAN). This study characterised the tonsillar microbiota implicated in IgAN using 16S ribosomal RNA gene sequencing.
METHODS: We retrospectively analysed tonsillar tissues from 20 patients with biopsy-proven IgAN and 19 patients with recurrent tonsillitis (RT) who underwent tonsillectomy. The microbiota composition was determined via 16S rRNA sequencing, and the disease-associated genera were identified using the Boruta feature selection algorithm. Their associations with clinical outcomes after tonsillectomy were evaluated using receiver operating characteristic curve analysis, Kaplan-Meier analysis, and log-rank tests.
RESULTS: A total of 194 and 190 genera were detected for IgAN and RT. The α-diversity did not differ significantly between the groups, but the β-diversity analysis revealed distinct microbial community structures (p < 0.01). Boruta identified Actinomyces, Parvimonas, Streptococcus, Catonella, Bacillus, and Pseudomonas as key discriminating genera. Pseudomonas and Bacillus were enriched in the IgAN group. The area under the curve for the prediction of complete remission at 3 years based on Pseudomonas abundance was 0.712. The complete remission and proteinuria remission rates were significantly higher for the patients with Pseudomonas (p = 0.03 for both).
CONCLUSION: This study reveals distinct tonsillar microbiota profiles between patients with IgAN and those with RT and shows that tonsillar Pseudomonas enrichment was associated with favourable outcomes after tonsillectomy. These findings suggest that tonsillar Pseudomonas may be associated with clinical remission after tonsillectomy in IgAN.