Solunum Sistemi Mikrobiyotası

Dr. Haluk TürktaşGazi Üniversitesi

Göğüs Hastalıkları Anabilim DalıAnkara

NIH Human Microbiome Project (2007)

1. Bacteroides2. Streptococcus3. Veilonella4. Neisseria5. Haemophilus

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Microbial communities in healthy controlsand asthmatic airways

Markus Hilty PLoS ONE 2010:5;8578

1- Üst solunum yolu mikrobiyotası ile alt solunum yolu mikrobiyotası aynı mıdır?

2- Alt solunum yollarının örneklenmesi için uygun yöntem hangisidir?

Topographical Continuity of Bacterial Populations in the Healthy Human Respiratory Tract

Charlson ES. Am J Respir Crit Care Med 2011:184; 957–963

Analysis of the Upper Respiratory Tract Microbiotas as the Source of the Lung and Gastric Microbiotas in Healthy Individuals

Bassis CM. mBio 2015:6;e00037-15

Analysis of the Upper Respiratory Tract Microbiotas as the Source of the Lung and Gastric Microbiotas in Healthy Individuals

Bassis CM. mBio 2015:6;e00037-15

Comparison of the Respiratory Microbiome in HealthyNonsmokers and Smokers

Morris A Am J Respir Crit Care Med 2013:187;1067–1075

Üst solunum yolu mikrobiyotasının bronkoskopik örnek mikrobiyotasına etkisi

Lancet 2014:23; 384(9944): 691–702

Bassis CM. mBio 2015:6;e00037-15

1. Alt solunum yolları mikrobiyotası üst solunum yolları mikrobiyotasına büyük oranda benzerlik göstermekle birlikte farklılıklar da mevcuttur

2. Alt solunum yollarında bakteri yükü ve diversity çok daha düşüktür

3. Alt solunum yollarının örneklenmesinde bronş lavajı ve fırçalama uygun bir yöntemdir

Ecological determinants of the respiratory microbiome

PLOS Pathogens 2015

Sağlıklı kişilerde, astım ve KOAH’da solunum yolları mikrobiyotası(en sık görülen yedi genera)

Markus Hilty PLoS ONE 2010:5;8578

Solunum sistemi mikrobiyotası

Astım

KOAH

Bronşektazi

Kistik fibrozis

İPF

Patogenez

Prognoz

Fenotipler

Ataklar

Tedaviye yanıt

Microbiota

0 – 12 ay

Maternalantibiyotik kullanımı

Doğum şekli• Vaginal• Sezaryen• Hastanede• Evde

Bebeğin beslenmesi• Anne sütü• Formula • Ek gıda

Neonatalantibiyotik kullanımı

Çevresel mikroplarla karşılaşma

Kardeş sayısı

Evde hayvan besleme

Yaşanan ortam • Çiftlik• Şehir

Temizlik alışkanlıkları• Emzik• Bulaşık vb

Diversity

Disbiozis

astım patogenezi

Early life enviroment and

potential microbialexposures

Shaping of gut

microbiome

Shaping of airway

microbiome?

Immunesystem

development

Asthmaand/or

Allergy

Living environment

Mode of birth

Animal or pet keeping

Antibiotic use

Breast feeding

Respiratory infections

Curr Allergy Asthma Rep 2013:13;453–461

Airway Microbiota in Severe Asthma and Relationship to Asthma Severity and Phenotypes

Zhang Q. PLoS ONE 2016:11(4): e0152724

Features of the bronchial bacterial microbiome associated with atopy, asthma and responsiveness to inhaled corticosteroid treatment

Durack J J Allergy Clin Immunol 2016 in press

Features of the bronchial bacterial microbiome associated with atopy, asthma and responsiveness to inhaled corticosteroid treatment

Durack J J Allergy Clin Immunol 2016 in press

Features of the bronchial bacterial microbiome associated with atopy, asthma and responsiveness to inhaled corticosteroid treatment

Durack J J Allergy Clin Immunol 2016 in press

Potentially Pathogenic Airway Bacteria and Neutrophilic Inflammation in Treatment Resistant Severe Asthma

Benjamin J. Green. PlosOne 2014:9;1-7

28 tedaviye dirençli astımlı hastanın onyedisi Moraxella catarrhalis, Haemophilus, Streptococcus ile kolonize

Lung microbiome dynamics in COPD exacerbations

Wang Z. Eur Respir J 2016; 47: 1034–1036

Stable stateExacerbationTwo weeks post-therapySix weeks recovery

B: bacterialV: viralE: eosinophilicBE: bacterial and eosinophilicBV: bacterial and viralPauci: pauci-inflammatory

Lung microbiome dynamics in COPD exacerbations

Wang Z. Eur Respir J 2016; 47: 1034–1036

The Role of Bacteria in the Pathogenesis and Progression of Idiopathic Pulmonary Fibrosis

Molyneaux PL. Am J Respir Crit Care Med 2014:190; 906–913

The Role of Bacteria in the Pathogenesis and Progression of Idiopathic Pulmonary Fibrosis

Molyneaux PL. Am J Respir Crit Care Med 2014:190; 906–913

Increased nutrient density

Increased temperature

Local anoxic zones

Selective growth promotion

Selective killing and clearance

Increased mucusproduction

Vascular permeabilityCatecholamines

Inflammatory cytokinesFree ATP

Inflammatory cellrecruitment and

activation

Inflammatory TriggersViral infection

Allergic exposureToxic inhalation

Air pollution

InflammationDysbiosisMicrobial metabolites

Mic

rob

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Mic

rob

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Lancet 2014:23; 384: 691–702, Ann Am Thorac Soc 2014:11;108–116