Metagenomic sequencing and evaluation of the host response in the pediatric aerodigestive population.
Bronchoalveolar Lavage Fluid
/ immunology
Child
Child, Preschool
Deglutition Disorders
/ immunology
Female
Host Microbial Interactions
Humans
Immunity
Infant
Male
Metagenomics
Microbiota
/ genetics
Mouth
/ microbiology
Respiratory Aspiration
/ immunology
Sequence Analysis, DNA
Sequence Analysis, RNA
aerodigestive
host response
metagenomics
next-generation sequencing
Journal
Pediatric pulmonology
ISSN: 1099-0496
Titre abrégé: Pediatr Pulmonol
Pays: United States
ID NLM: 8510590
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
01
06
2020
revised:
30
10
2020
accepted:
19
11
2020
pubmed:
4
12
2020
medline:
15
7
2021
entrez:
3
12
2020
Statut:
ppublish
Résumé
To assess the diagnostic utility of metagenomic sequencing in pediatric aerodigestive clinic patients being evaluated for chronic aspiration. We hypothesize that using a metagenomics platform will aid in the identification of microbes not found on standard culture. Twenty-four children referred to an aerodigestive clinic were enrolled in a prospective, single-site, cross-sectional cohort study. At the time of clinical evaluation under anesthesia, two samples were obtained: an upper airway sample and a sample from bronchoalveolar lavage (BAL). Samples were sent for routine culture and analyzed using Explify® Respiratory, a CLIA Laboratory Developed Test which identifies respiratory commensals and pathogens through RNA and DNA sequencing. Since RNA was sequenced in the course of the metagenomic analysis to identify organisms (RNA viruses and bacteria), the sequencing approach also captured host derived messenger RNA during sample analysis. This incidentally obtained host transcriptomic data were analyzed to evaluate the host immune response. The results of these studies were correlated with the clinical presentation of the research subjects. In 10 patients, organisms primarily associated with oral flora were identified in the BAL. Standard culture was negative in three patients where clinical metagenomics led to a result with potential clinical significance. Transcriptomic data correlated with the presence or absence of dysphagia as identified on prior videofluoroscopic evaluation of swallowing. Clinical metagenomics allows for simultaneous analysis of the microbiota and the host immune response from BAL samples. As the technologies in this field continue to advance, such testing may improve the diagnostic evaluation of patients with suspected chronic aspiration.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
516-524Informations de copyright
© 2020 Wiley Periodicals LLC.
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