Background

Allergic diseases caused by fungi are common. The best understood conditions are allergic bronchopulmonary aspergillosis and severe asthma with fungal sensitization. Our knowledge of the fungal microbiome (mycobiome) is limited to a few studies involving healthy individuals, asthmatics, and smokers. No study has yet examined the mycobiome in fungal lung disease.

Objectives

The main aim of this study was to determine the mycobiome in lungs of individuals with well-characterized fungal disease. A secondary objective was to determine possible effects of treatment on the mycobiome.

Methods

After bronchoscopy, ribosomal internal transcribed spacer region 1 DNA was amplified and sequenced and fungal load determined by real-time PCR. Clinical and treatment variables were correlated with the main species identified. Bronchopulmonary aspergillosis (n = 16), severe asthma with fungal sensitization (n = 16), severe asthma not sensitized to fungi (n = 9), mild asthma patients (n = 7), and 10 healthy control subjects were studied.

Results

The mycobiome was highly varied with severe asthmatics carrying higher loads of fungus. Healthy individuals had low fungal loads, mostly poorly characterized Malasezziales. The most common fungus in asthmatics was Aspergillus fumigatus complex and this taxon accounted for the increased burden of fungus in the high-level samples. Corticosteroid treatment was significantly associated with increased fungal load (P < .01).

Conclusions

The mycobiome is highly variable. Highest loads of fungus are observed in severe asthmatics and the most common fungus is Aspergillus fumigatus complex. Individuals receiving steroid therapy had significantly higher levels of Aspergillus and total fungus in their bronchoalveolar lavage.

中文翻译：

---

皮质类固醇激素治疗与过敏性真菌病中丝状真菌的负担增加有关

背景

由真菌引起的过敏性疾病很常见。最好的了解条件是过敏性支气管肺曲菌病和伴有真菌致敏作用的严重哮喘。我们对真菌微生物组（霉菌组）的了解仅限于少数涉及健康个体，哮喘患者和吸烟者的研究。尚无研究检查真菌性肺疾病中的菌群。

目标

这项研究的主要目的是确定真菌病特征明确的个体的肺中的菌群。次要目标是确定治疗对霉菌生物组的可能影响。

方法

支气管镜检查后，对核糖体内部转录的间隔区1 DNA进行扩增和测序，并通过实时PCR测定真菌载量。临床和治疗变量与确定的主要物种相关。研究了支气管肺曲霉病（n = 16），对真菌致敏的重度哮喘（n = 16），对真菌不敏感的重度哮喘（n = 9），轻度哮喘患者（n = 7）和10名健康对照者。

结果

真菌组差异很大，严重的哮喘患者携带较高的真菌量。健康的人的真菌负荷低，大多是特征较弱的疟疾。哮喘患者中最常见的真菌是烟曲霉，这种分类群导致高水平样品中真菌的负担增加。皮质类固醇激素治疗与真菌负荷增加显着相关（P  <.01）。

结论

菌群是高度可变的。在严重的哮喘患者中观察到最高的真菌负荷，最常见的真菌是烟曲霉复合物。接受类固醇治疗的患者支气管肺泡灌洗液中曲霉菌和总真菌的含量明显较高。