常规抗结核化疗对肺结核患者痰液菌群的影响  

Analysis of the changes of sputum microbiota in patients with pulmonary tuberculosis during anti-tuberculosis chemotherapy

作　　者：董文雅 魏文静 谭卫国[3] 张晨晨 徐华丽 余美玲 江振友 周琳 陈亮 DONG Wenya;WEI Wenjing;TAN Weiguo;ZHANG Chenchen;XU Huali;YU Meiling;JIANG Zhenyou;ZHOU Lin;CHEN Liang(Basic Medical College,Jinan University,Guangzhou 510632,China;不详)

机构地区：[1]暨南大学基础医学院,广州510632 [2]广东省结核病控制中心,广州510630 [3]深圳市慢性病防治中心,广东深圳518020

出　　处：《实用医学杂志》2021年第3期336-342,共7页The Journal of Practical Medicine

基　　金：“十三五”国家科技重大专项(编号:2018ZX10715004-002,2017ZX10201302-005);广东省自然科学基金-博士启动基金(编号:2018A030310677)。

摘　　要：目的探索初诊肺结核患者在常规抗结核化疗过程中痰液菌群的变化。方法通过对103份痰液样本16S rRNA(V4-V5区)进行测序分析来研究异烟肼-利福平-吡嗪酰胺-乙胺丁醇(HRZE)标准抗结核治疗引起的结核患者痰液菌群的变化。结果HRZE治疗可改变肺结核患者痰液菌群的整体多样性及菌群结构。经过常规抗结核化疗后,痰液菌群的Shannon、Chao1和Observed_OTUs指数均显著下降,而且随着治疗时间的延长,物种丰富度下降的也越明显。PERMANOVA分析结果显示,未治组与治疗组的菌群结构存在显著差异。在抗结核治疗后,结核患者痰菌中的韦荣氏球菌科、韦荣氏球菌属及它的亚种殊异韦荣菌均显著增加,提示其可能是评价结核病治疗的潜在标志物。结论HRZE抗结核治疗可以引起患者痰液菌群紊乱。其中一些特定的菌种在治疗后被消耗或富集,可为评估抗结核治疗效果提供潜在的生物标志物。Objective To explore the alterations of sputum microbiota in newly diagnosed pulmonary tuberculosis patients during the conventional anti-tuberculosis chemotherapy.Methods In this study,16 S rRNA gene sequencing was used in 103 sputum samples(V4-V5 region)to characterize the diversity and composition of sputum microbiota caused by standard anti-TB treatment with isoniazid-rifampin-pyrazinamide-ethambutol(HRZE).Results HRZE treatment could alter taxonomic compositions and overall diversity of sputum microbiota of TB patients.After routine anti-TB chemotherapy,Shannon,Chao 1 and ObservedOTUs indexes of sputum flora declined significantly,and the species richness declined more significantly with the extension of treatment time.PERMANOVA analysis showed that there were significant differences in the structure of the bacteria in the untreated group and the treated groups.Furthermore,there was a significant increase of family Veillonellacea,its genera Veillonella and species veillonella dispar post treatment,indicating that they may be a potential markers for evaluating TB treatment.Conclusions TB treatment with HRZE can disrupt sputum microbiotas in patients.Some specific genera are depleted or enriched post treatment,providing potential biomarkers for evaluating the treatment efficacy.

关 键 词：结核病 痰液菌群 菌群结构 常规抗结核化疗 16S rRNA 

分 类 号：R372[医药卫生—病原生物学]