Open AccessInfluence of Acid Blockade on the Aerodigestive Tract Microbiome in Children With Cystic Fibrosis
Author(s) -
Khalaf Racha T.,
Furuta Glenn T.,
Wagner Brandie D.,
Robertson Charles E.,
Andrews Rachel,
Stevens Mark J.,
Fillon Sophie A.,
Zemanick Edith T.,
Harris J. Kirk
Publication year - 2021
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000003010
Subject(s) - cystic fibrosis , medicine , blockade , esophagus , microbiome , cohort , gastroenterology , respiratory tract , dysbiosis , gastrointestinal tract , respiratory system , bioinformatics , biology , receptor , disease
Background: Acid blockade is commonly prescribed in patients with cystic fibrosis (CF). Growing concerns, however, exist about its possible role in the pathophysiology of pulmonary infections. We aimed to investigate if acid blockade alters esophageal and respiratory microbiota leading to dysbiosis and inflammation. Methods: We performed a cross sectional study of children with CF who were either prescribed acid blockade or not. Samples from the gastrointestinal and respiratory tracts were obtained and microbiome analyzed. Mixed effect models were used to compare outcomes between cohorts and across sampling sites. A random subject intercept was included to account for the multiple sampling sites per individual. Results: A cohort of 25 individuals, 44% girls with median age of 13.8 years [IQR 11.2‐‐14.8] were enrolled. Alpha diversity, total bacterial load, and beta diversity were similar across anatomic compartments, across the upper gastrointestinal tract, and in respiratory samples. Similar alpha diversity, total bacterial load, and beta diversity results were also observed when comparing individuals on versus those off acid blockade. IL‐8 was elevated in the distal versus proximal esophagus in the whole cohort ( P < 0.01). IL‐8 concentrations were similar in the distal esophagus in patients on and off acid blockade, but significantly greater in the proximal esophagus of subjects on treatment ( P < 0.01). Conclusions: On the basis of these data, acid blockade use does not appear to influence the microbiome of the aerodigestive tract in children with cystic fibrosis suggesting a complex interplay between these medications and the bacterial composition of the esophagus and lung.