Changes in intestinal microbiota in pediatric cystic fibrosis patients after 6 months of elexacaftor-tezacaftor-ivacaftor therapy.

IF 2.6 3区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Isabel Gutiérrez-Díaz, Jose R Gutiérrez-Martinez, Ruth García-Romero, Saioa Vicente-Santamaría, Agustin De La Mano-Hernández, Encarnación Torcuato-Rubio, Maria Garriga-Garcia, Carmen Martin-Fernández, Natalia Baston-Paz, Clara Simon-Bernaldo de Quiros, Juan J Díaz-Martín, Susana Delgado-Palacios, David González-Jiménez
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引用次数: 0

Abstract

Objectives: Cystic fibrosis (CF) is frequently associated with gastrointestinal problems, including intestinal microbiota dysbiosis. Cystic fibrosis transmembrane conductance regulator (CFTR) modulator therapies, such as elexacaftor-tezacaftor-ivacaftor (ELX/TEZ/IVA), have demonstrated improvements in lung function, abdominal symptoms, and quality of life in patients with CF. However, the impact of these modulators on the intestinal microbiota in the pediatric population remains incompletely understood. The objective of this study was to characterize the changes in the intestinal microbiota of pediatric patients with CF after 6 months of treatment with ELX/TEZ/IVA.

Methods: Thirty-one patients with CF, aged 6-18 years, were recruited. Stool samples were collected before the initiation of treatment and approximately 6 months thereafter. Microbiota analysis was performed using 16S rRNA gene amplicon sequencing. Statistical analyses were employed to evaluate changes in alpha and beta diversity and variations in the relative abundance of different bacterial taxa. Clinical variables such as concomitant use of azithromycin and probiotics were considered.

Results: After 6 months of treatment, no significant changes in the alpha diversity were observed. However, alterations in bacterial composition were detected. A decrease in the abundance of potentially pathogenic bacteria, such as Enterobacteriaceae members (Escherichia/Shigella) was observed. The abundance of genus Blautia increased. Differential analysis according to antibiotic and probiotic consumption revealed specific changes in microbiota composition.

Conclusions: ELX/TEZ/IVA therapy for 6 months induces changes in the intestinal microbiota composition of pediatric patients with CF, characterized by a reduction in potentially harmful bacteria and an increase in potentially beneficial bacteria. These findings suggest a modulation towards a healthier intestinal microbiota profile.

儿童囊性纤维化患者6个月后肠道微生物群的变化。
目的:囊性纤维化(CF)经常与胃肠道问题相关,包括肠道菌群失调。囊性纤维化跨膜传导调节剂(CFTR)调节剂疗法,如ELX/TEZ/IVA,已被证明可改善CF患者的肺功能、腹部症状和生活质量。然而,这些调节剂对儿科人群肠道微生物群的影响仍不完全清楚。本研究的目的是表征儿童CF患者在接受ELX/TEZ/IVA治疗6个月后肠道微生物群的变化。方法:招募31例CF患者,年龄6-18岁。在开始治疗前和大约6个月后收集粪便样本。微生物群分析采用16S rRNA基因扩增子测序。采用统计学方法对不同细菌类群的α和β多样性变化及相对丰度变化进行了评价。临床变量,如阿奇霉素和益生菌的同时使用被考虑。结果:治疗6个月后,α多样性未见明显变化。然而,检测到细菌组成的变化。观察到潜在致病菌的丰度减少,例如肠杆菌科成员(埃希氏菌/志贺氏菌)。蓝藻属的丰富度增加了。根据抗生素和益生菌消耗的差异分析揭示了微生物群组成的特定变化。结论:ELX/TEZ/IVA治疗6个月可诱导CF患儿肠道菌群组成发生变化,其特征是潜在有害细菌减少,潜在有益细菌增加。这些发现表明,对更健康的肠道微生物群的调节。
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来源期刊
CiteScore
5.30
自引率
13.80%
发文量
467
审稿时长
3-6 weeks
期刊介绍: ​The Journal of Pediatric Gastroenterology and Nutrition (JPGN) provides a forum for original papers and reviews dealing with pediatric gastroenterology and nutrition, including normal and abnormal functions of the alimentary tract and its associated organs, including the salivary glands, pancreas, gallbladder, and liver. Particular emphasis is on development and its relation to infant and childhood nutrition.
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