山东大学耳鼻喉眼学报 ›› 2024, Vol. 38 ›› Issue (6): 78-84.doi: 10.6040/j.issn.1673-3770.0.2024.111
• 临床研究 • 上一篇
崔小缓1-6,尹龙龙7,张延平1-6,蒋兴旺1-6,李丽娜1-6
CUI Xiaohuan1-6, YIN Longlong7, ZHANG Yanping1-6, JIANG Xingwang1-6, LI Lina1-6
摘要: 目的 研究咽喉反流(laryngopharyngeal reflux, LPR)患者唾液菌群与反流症状的相关性。 方法 选取2022年2月至2022年11月就诊于解放军总医院第八医学中心耳鼻咽喉头颈外科门诊反流症状指数(reflux symptom index, RSI)评分>13分、质子泵抑制剂诊断性治疗显效的34例患者为LPR组, 34例健康志愿者为对照组,留取唾液标本,提取 DNA,扩增 16S 片段V3-V4区并进行测序,对测序结果进行生物信息学分析,对LEfSe分析的差异菌与RSI评分中9个症状评分及总分的相关性进行分析,使用 SPSS 25.0 软件对数据进行统计学处理。 结果 LEfSe分析显示鼠乳杆菌、乳酸杆菌科、乳酸杆菌属、普雷沃菌科、普雷沃菌属、拟杆菌目、拟杆菌纲、拟杆菌门等30个物种在LPR组患者唾液中富集,厚壁菌门、杆菌纲、假单胞菌属等28个物种在对照组唾液中富集。相关分析显示拟杆菌门、拟杆菌纲、拟杆菌目、普雷沃菌科、普雷沃菌属相对丰度与胃烧灼感、胸痛、消化不良或胃疼症状评分呈现正相关,普雷沃菌属的相对丰度与该症状的相关系数具有统计学意义(P<0.05),口腔普雷沃菌相对丰度与吞咽食物、液体和药片困难呈正相关(P<0.05),乳酸杆菌科、乳酸杆菌属相对丰度与RSI 总分呈负相关(P<0.05)。 结论 LPR患者唾液菌群失调与反流症状相关,调整菌群失调可能有助于减轻患者症状。
中图分类号:
[1] Lechien JR, Akst LM, Hamdan AL, et al. Evaluation and management of laryngopharyngeal reflux disease: state of the art review[J]. Otolaryngol Head Neck Surg, 2019, 160(5): 762-782. doi:10.1177/0194599819827488 [2] Xiao SF, Li JR, Zheng HL, et al. An epidemiological survey of laryngopharyngeal reflux disease at the otorhinolaryngology-head and neck surgery clinics in China[J]. Eur Arch Otorhinolaryngol, 2020, 277(10): 2829-2838. doi:10.1007/s00405-020-06045-0 [3] Belstrøm D. The salivary microbiota in health and disease[J]. J Oral Microbiol, 2020, 12(1): 1723975. doi:10.1080/20002297.2020.1723975 [4] Chen T, Yu WH, Izard J, et al. The Human Oral Microbiome Database: a web accessible resource for investigating oral microbe taxonomic and genomic information[J]. Database, 2010, 2010: baq013. doi:10.1093/database/baq013 [5] Graves DT, Corrêa JD, Silva TA. The oral microbiota is modified by systemic diseases[J]. J Dent Res, 2019, 98(2): 148-156. doi:10.1177/0022034518805739 [6] Li X, Kolltveit KM, Tronstad L, et al. Systemic diseases caused by oral infection[J]. Clin Microbiol Rev, 2000, 13(4): 547-558. doi:10.1128/CMR.13.4.547 [7] Nakano K, Hokamura K, Taniguchi N, et al. The collagen-binding protein of Streptococcus mutans is involved in haemorrhagic stroke[J]. Nat Commun, 2011, 2: 485. doi:10.1038/ncomms1491 [8] 崔小缓, 尹龙龙, 张延平, 等. 咽喉反流患者唾液菌群初步研究[J]. 中华耳鼻咽喉头颈外科杂志, 2023, 58(6): 572-578. doi:10.3760/cma.j.cn115330-20230224-00084 CUI Xiaohuan, YIN Longlong, ZHANG Yanping, et al. A preliminary study on salivary microbiota of patients with laryngopharyngeal reflux[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2023, 58(6): 572-578. doi:10.3760/cma.j.cn115330-20230224-00084 [9] Chen H, Wang H, Yang F, et al. Distinct microbiota dysbiosis in patients with. laryngopharynx reflux disease compared to healthy controls[J]. Eur Arch Otorhinolaryngol, 2022, 279(7): 3569-3579. doi: 10.1007/s00405-022-07327-5. [10] 陈函, 杨帆, 王茂鑫, 等. 咽喉反流性疾病患者症状与体征的关系及相关危险因素研究[J]. 听力学及言语疾病杂志, 2022, 30(6): 573-576. doi:10.3969/j.issn.1006-7299.2022.06.001 CHEN Han, YANG Fan, WANG Maoxin, et al. Study on the relationship between symptoms and signs and related risk factors in patients with laryngopharyngeal reflux disease[J]. Journal of Audiology and Speech Pathology, 2022, 30(6): 573-576. doi:10.3969/j.issn.1006-7299.2022.06.001 [11] 崔小缓, 张延平, 阎小妍, 等. 耳鼻咽喉科门诊成年患者的睡眠状况与咽喉反流性疾病的相关性[J]. 中华耳鼻咽喉头颈外科杂志, 2019, 54(10): 754-759. doi:10.3760/cma.j.issn.1673-0860.2019.10.009 CUI Xiaohuan, ZHANG Yanping, YAN Xiaoyan, et al. Relationship between sleep status and laryngopharyngeal reflux disease in adult patients in Otolaryngology clinic[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2019, 54(10): 754-759. doi:10.3760/cma.j.issn.1673-0860.2019.10.009 [12] Haworth JJ, Boyle N, Vales A, et al. The prevalence of intestinal dysbiosis in patients referred for antireflux surgery[J]. Surg Endosc. 2021;35(12):7112-7119. doi:10.1007/s00464-020-08229-5 [13] Zhong L, Shanahan ER, Raj A, et al. Dyspepsia and the microbiome: time to focus on the small intestine[J]. Gut. 2017;66(6):1168-1169. doi:10.1136/gutjnl-2016-312574 [14] Zhu H, Yip H C, Cheung M K, et al. Convergent dysbiosis of upper aerodigestive microbiota between patients with esophageal and oral cavity squamous cell carcinoma[J]. Int J Cancer, 2023. 152(9):1903-1915,doi:/10.1002/ijc.34460. [15] Copeland E, Leonard K, Carney R, et al. Chronic rhinosinusitis: potential role of microbial dysbiosis and recommendations for sampling sites[J]. Front Cell Infect Microbiol, 2018, 8: 57. doi:10.3389/fcimb.2018.00057 [16] Petersen C, Round JL. Defining dysbiosis and its influence on host immunity and disease[J]. Cell Microbiol, 2014, 16(7): 1024-1033. doi:10.1111/cmi.12308 [17] Zheng XW, Zheng YJ, Chen T, et al. Effect of laryngopharyngeal reflux and potassium-competitive acid blocker(P-CAB)on the microbiological comprise of the laryngopharynx[J]. Otolaryngol Head Neck Surg, 2024, 170(5): 1380-1390. doi:10.1002/ohn.682 [18] Haworth JJ, Boyle N, Vales A, et al. The prevalence of intestinal dysbiosis in patients referred for antireflux surgery[J]. Surg Endosc, 2021, 35(12): 7112-7119. doi:10.1007/s00464-020-08229-5 [19] Lechien JR, De Vos N, Everard A, et al. Laryngopharyngeal reflux: the microbiota theory[J]. Med Hypotheses, 2021, 146: 110460. doi:10.1016/j.mehy.2020.110460 [20] Tett A, Pasolli E, Masetti G, et al. Prevotella diversity, niches and interactions with the human host[J]. Nat Rev Microbiol, 2021, 19(9): 585-599. doi:10.1038/s41579-021-00559-y [21] Kianoush N, Adler CJ, Nguyen KA, et al. Bacterial profile of dentine caries and the impact of pH on bacterial population diversity[J]. PLoS One, 2014, 9(3): e92940. doi:10.1371/journal.pone.0092940 [22] Liang T, Liu F, Liu LJ, et al. Effects of Helicobacter pylori infection on the oral microbiota of reflux esophagitis patients[J]. Front Cell Infect Microbiol, 2021, 11: 732613. doi:10.3389/fcimb.2021.732613 [23] Sazanskaya LS, Gulua MM, Gilmiyarov EM, et al. The dental status of patients with gastroesophageal reflux disease depending on the intake of proton pump inhibitors[J]. Stomatologiia, 2020, 99(5): 25-31. doi:10.17116/stomat20209905125 [24] Krishnan U, Singh H, Tedla N, et al. Presence of gastric pepsinogen in the Trachea is associated with altered inflammation and microbial composition[J]. Infect Immun, 2020, 88(12): e00455-e00420. doi:10.1128/IAI.00455-20 [25] Park CH, Lee SK. Exploring esophageal microbiomes in esophageal diseases: a systematic review[J]. J Neurogastroenterol Motil, 2020, 26(2): 171-179. doi:10.5056/jnm19240 [26] Kõll P, Mändar R, Marcotte H, et al. Characterization of oral lactobacilli as potential probiotics for oral health[J]. Oral Microbiol Immunol, 2008, 23(2): 139-147. doi:10.1111/j.1399-302X.2007.00402.x [27] Ahola AJ, Yli-Knuuttila H, Suomalainen T, et al. Short-term consumption of probiotic-containing cheese and its effect on dental caries risk factors[J]. Arch Oral Biol, 2002, 47(11): 799-804. doi:10.1016/s0003-9969(02)00112-7 [28] Caglar E, Cildir SK, Ergeneli S, et al. Salivary mutans streptococci and lactobacilli levels after ingestion of the probiotic bacterium Lactobacillus reuteri ATCC 55730 by straws or tablets[J]. Acta Odontol Scand, 2006, 64(5): 314-318. doi:10.1080/00016350600801709 [29] Bernard JN, Chinnaiyan V, Almeda J, et al. Lactobacillus sp. facilitate the repair of DNA damage caused by bile-induced reactive oxygen species in experimental models of gastroesophageal reflux disease[J]. Antioxidants, 2023, 12(7): 1314. doi:10.3390/antiox12071314 [30] Aiba, Nakano Y, Koga Y, et al. A highly acid-resistant novel strain of Lactobacillus johnsonii No. 1088 has antibacterial activity, including that against Helicobacter pylori, and inhibits gastrin-mediated acid production in mice[J]. Microbiologyopen, 2015, 4(3): 465-474. doi:10.1002/mbo3.252 |
[1] | 吴玮,王磊,陈升,李连勇,王刚. 胃食管气道反流性疾病多学科研究及进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 1-14. |
[2] | 刘莲莲,李进让. 阻塞性睡眠呼吸暂停与咽喉反流[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 15-22. |
[3] | 张利,张梦茹,阿丽米热·艾尔肯,邱忠民. 咽喉反流性疾病在常见呼吸道疾病中的作用[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 23-29. |
[4] | 胡志伟,陈冬,杨栋,吴继敏. 胃食管气道反流性疾病的诊断和治疗:基于2020~2024年相关共识和指南[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 30-38. |
[5] | 赵佳宁,崔元馨,王丹,赵明. 咽喉反流与复发性呼吸道乳头状瘤病的关系及其机制探讨[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 39-45. |
[6] | 张杉,陈秋,周方伟,马亦飞. 生物标志物在咽喉反流性疾病中的研究进展[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 46-54. |
[7] | 周诗侗,杨艳艳,杨玉成,方红雁. 胃蛋白酶与咽喉反流性疾病:从致病机制到咽喉鳞状细胞癌的潜在风险因素[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 55-60. |
[8] | 席晓宇,隋昕珂,陈升,李连勇,钟长青. 咽喉反流性疾病的内镜下治疗[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 61-65. |
[9] | 牛燕燕,顾伟,金晓峰,霍红,杨大海,崔婷婷,王剑. 声带白斑组织中胃蛋白酶的表达分析[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 66-70. |
[10] | 王磊,王刚,孙喆喆,刘红丹,韩浩伦,李保卫,张晓丽,吴玮. 咽喉反流与声带良性增生性病变、声带白斑、慢性咽喉炎相关性研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(6): 71-77. |
[11] | 刘盼盼,赵赫,王琰,仇静静,刘大炜,孙岩. 基于百度指数的新型冠状病毒感染流行发生前后耳部症状健康问题网络关注度研究[J]. 山东大学耳鼻喉眼学报, 2024, 38(4): 7-14. |
[12] | 王磊,李保卫,王刚,刘红丹,韩浩伦,张晓丽,吴玮. 阻塞性睡眠呼吸暂停低通气综合征患者夜间碱反流初步研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 75-79. |
[13] | 邵娜,张青青,刘小红,谢萌,郭瑞昕,马思敬,刘海琴,任晓勇,罗花南. 幽门螺旋杆菌感染对症状性咽喉反流患者唾液胃蛋白酶浓度的影响[J]. 山东大学耳鼻喉眼学报, 2022, 36(6): 89-95. |
[14] | 秦铭,孙占伟,王卫卫,李世超,武天义,王广科. 咽喉反流症状或体征评分阳性的慢性鼻窦炎患者鼻内镜术后碱性等渗盐水冲洗的疗效观察[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 147-153. |
[15] | 曾宪廷,王广科,孙占伟,武天义,李世超,王卫卫. 伴咽喉反流的难治性鼻窦炎术后应用质子泵抑制剂的疗效观察[J]. 山东大学耳鼻喉眼学报, 2022, 36(3): 189-194. |
|