The upper-airway microbiota and loss of asthma control among asthmatic children

• Published in: Nature communications Vol. 10; no. 1; pp. 5714 - 10
• Main Authors: Zhou, Yanjiao, Jackson, Daniel, Bacharier, Leonard B., Mauger, David, Boushey, Homer, Castro, Mario, Durack, Juliana, Huang, Yvonne, Lemanske, Robert F., Storch, Gregory A., Weinstock, George M., Wylie, Kristine, Covar, Ronina, Fitzpatrick, Anne M., Phipatanakul, Wanda, Robison, Rachel G., Beigelman, Avraham
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 16.12.2019; Nature Publishing Group; Nature Portfolio
• Subjects: 45/23; 692/308/3187; 692/308/575; Administration, Inhalation; Asthma; Asthma - diagnosis; Asthma - drug therapy; Asthma - immunology; Asthma - microbiology; Carnobacteriaceae - immunology; Carnobacteriaceae - isolation & purification; Child; Child, Preschool; Children; Female; Fluticasone - therapeutic use; Host Microbial Interactions - immunology; Humanities and Social Sciences; Humans; Male; Microbiomes; Microbiota; Microbiota - immunology; Moraxella - immunology; Moraxella - isolation & purification; multidisciplinary; Nasal Mucosa - immunology; Nasal Mucosa - microbiology; Prospective Studies; Respiratory tract; Science; Science (multidisciplinary); Severity of Illness Index; Staphylococcus - immunology; Staphylococcus - isolation & purification; Streptococcus - immunology; Streptococcus - isolation & purification; Symbiosis - immunology; Symptom Flare Up; Treatment Outcome
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-019-13698-x

The airway microbiome has an important role in asthma pathophysiology. However, little is known on the relationships between the airway microbiome of asthmatic children, loss of asthma control, and severe exacerbations. Here we report that the microbiota’s dynamic patterns and compositions are related to asthma exacerbations. We collected nasal blow samples (n = 319) longitudinally during a clinical trial at 2 time-points within one year: randomization when asthma is under control, and at time of early loss of asthma control (yellow zone (YZ)). We report that participants whose microbiota was dominated by the commensal Corynebacterium   +   Dolosigranulum cluster at RD experience the lowest rates of YZs (p = 0.005) and have longer time to develop at least 2 episodes of YZ (p = 0.03). The airway microbiota have changed from randomization to YZ. A switch from the Corynebacterium   +   Dolosigranulum cluster at randomization to the Moraxella- cluster at YZ poses the highest risk of severe asthma exacerbation (p = 0.04). Corynebacterium’s relative abundance at YZ is inversely associated with severe exacerbation (p = 0.002). How the airway microbiome influences asthma pathophysiology remains unclear. Here, the authors analyse nasal samples of cohort of school-age children with persistent asthma and find that the microbiota’s patterns and composition at time of early loss of asthma control associate with severe asthma exacerbations.