Nasal lavage microbiome, but not nasal swab microbiome, correlates with sinonasal inflammation in children with cystic fibrosis

Jaehi Chung; Sébastien Boutin; Dario L Frey; Cornelia Joachim; Marcus A Mall; Olaf Sommerburg

doi:10.1016/j.jcf.2023.12.011

Nasal lavage microbiome, but not nasal swab microbiome, correlates with sinonasal inflammation in children with cystic fibrosis

J Cyst Fibros. 2024 Jan 9:S1569-1993(23)01735-6. doi: 10.1016/j.jcf.2023.12.011. Online ahead of print.

Authors

Jaehi Chung¹, Sébastien Boutin², Dario L Frey³, Cornelia Joachim⁴, Marcus A Mall⁵, Olaf Sommerburg⁶

Affiliations

¹ Division of Pediatric Pulmonology & Allergy and Cystic Fibrosis Center, Department of Pediatrics III, University of Heidelberg, Im Neuenheimer Feld 430, Heidelberg 69120, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, Heidelberg 69120, Germany. Electronic address: Jaehi.Chung@med.uni-heidelberg.de.
² Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, Heidelberg 69120, Germany; Department of Infectiology and Microbiology, University Hospital Schleswig Holstein, Lübeck 23538, Germany.
³ Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, Heidelberg 69120, Germany; Division Systems Biology of Signal Transduction, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
⁴ Division of Pediatric Pulmonology & Allergy and Cystic Fibrosis Center, Department of Pediatrics III, University of Heidelberg, Im Neuenheimer Feld 430, Heidelberg 69120, Germany.
⁵ Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine and Cystic Fibrosis Center, Charité-Universitätsmedizin Berlin, Berlin 13353, Germany; Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin 10178, Germany; German Center for Lung Research (DZL), Associated Partner Site, Berlin 13353, Germany.
⁶ Division of Pediatric Pulmonology & Allergy and Cystic Fibrosis Center, Department of Pediatrics III, University of Heidelberg, Im Neuenheimer Feld 430, Heidelberg 69120, Germany; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Im Neuenheimer Feld 156, Heidelberg 69120, Germany.

PMID: 38199892
DOI: 10.1016/j.jcf.2023.12.011

Abstract

Background: Cystic fibrosis (CF) is characterized by highly viscous mucus obstructing the lower and upper airways, chronic neutrophil inflammation and infection resulting not only in lung destruction but also in paranasal sinus involvement. The pathogenesis of CF-associated chronic rhinosinusitis (CRS) is still not well understood, and it remains unclear how the microbiome in the upper airways (UAW) influences paranasal sinus inflammation.

Methods: In a cross-sectional study in pediatric patients with CF under stable disease conditions, we examined the microbiome in relation to inflammation by comparing nasal swabs (NS) and nasal lavage (NL) as two UAW sampling methods. The microbiota structure of both NS and NL was determined by 16S rRNA gene amplicon sequencing. In addition, pro-inflammatory cytokines (IL-1β, IL-6, IL-8, TNF-α) and proteases (SLPI, TIMP-1, NE/A1-AT complex) as well as neutrophil elastase activity were measured in NL.

Results: Simultaneous NS and NL samples were collected from 36 patients with CF (age range: 7 - 19 years). The microbiome of NS samples was shown to be significantly lower in α-diversity and evenness compared to NL samples. NS samples were particularly found to be colonized with Staphylococcus species. NL microbiome was shown to correlate much better with the sinonasal inflammation status than NS microbiome. Especially the detection of Moraxella in NL was associated with increased inflammatory response.

Conclusion: Our results show that the NL microbiome reflects sinonasal inflammation better than NS and support NL as a promising tool for simultaneous assessment of the UAW microbiome and inflammation in children with CF.

Keywords: Cystic fibrosis; Inflammation; Microbiome; Nasal lavage; Nasal swabs.