Nasopharyngeal Lactobacillus is associated with a reduced risk of childhood wheezing illnesses following acute respiratory syncytial virus infection in infancy

• Authors: Christian Rosas-Salazar, Vanderbilt University; Meghan H. Shilts, Vanderbilt University; Andrey Tovchigrechko, J. Craig Venter Institute; Seth Schobel, J. Craig Venter Institute; James D. Chappell, Vanderbilt University; Emma K. Larkin, Vanderbilt University; Tebeb Gebretsadik, Vanderbilt University; Rebecca A. Halpin, J. Craig Venter Institute; Karen E. Nelson, J. Craig Venter Institute; Martin Moore, Emory University; Larry Anderson, Emory University; R. Stokes Peebles Jr., Vanderbilt University; Suman R. Das, Vanderbilt University; Tina V. Hartert, Vanderbilt University
• Journal Title: Journal of Allergy and Clinical Immunology
• Volume: Volume 142, Number 5
• Publisher: Elsevier | 2018-11-01, Pages 1447-+
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.jaci.2017.10.049
• Subjects: Health Sciences, Immunology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Allergy; Immunology; Microbiome; Lactobacillus; Staphylococcus; nasopharynx; respiratory syncytial virus; asthma; wheezing; 16S ribosomal RNA sequencing; infants; EARLY-LIFE; ASTHMA; CHILDREN; MICROBIOME; HOSPITALIZATIONS; STABILITY; SEVERITY; HEALTH; METAANALYSIS; ATOPY

Abstract

Background: Early life acute respiratory infection (ARI) with respiratory syncytial virus (RSV) has been strongly associated with the development of childhood wheezing illnesses, but the pathways underlying this association are poorly understood. Objective: To examine the role of the nasopharyngeal microbiome in the development of childhood wheezing illnesses following RSV ARI in infancy. Methods: We conducted a nested cohort study of 118 previously healthy, term infants with confirmed RSV ARI by RT-PCR. We used next-generation sequencing of the V4 region of the 16S ribosomal RNA gene to characterize the nasopharyngeal microbiome during RSV ARI. Our main outcome of interest was 2-year subsequent wheeze. Results: Of the 118 infants, 113 (95.8%) had 2-year outcome data. Of these, 46 (40.7%) had parental report of subsequent wheeze. There was no association between the overall taxonomic composition, diversity, and richness of the nasopharyngeal microbiome during RSV ARI with the development of subsequent wheeze. However, the nasopharyngeal detection and abundance of Lactobacillus was consistently higher in infants who did not develop this outcome. Lactobacillus also ranked first among the different genera in a model distinguishing infants with and without subsequent wheeze. Conclusions: The nasopharyngeal detection and increased abundance of Lactobacillus during RSV ARI in infancy are associated with a reduced risk of childhood wheezing illnesses at age 2 years.