Author:
Fan Zeqin,Zhang Lihui,Wei Li,Huang Xiaoxian,Yang Mei,Xing Xiqian
Abstract
Abstract
Background
To study the role of microecology and metabolism in iatrogenic tracheal injury and cicatricial stenosis, we investigated the tracheal microbiome and metabolome in patients with tracheal stenosis after endotracheal intubation.
Methods
We collected 16 protected specimen brush (PSB) and 8 broncho-alveolar lavage (BAL) samples from 8 iatrogenic subglottic tracheal stenosis patients, including 8 PSB samples from tracheal scar sites, 8 PSB samples from scar-free sites and 8 BAL samples, by lavaging the subsegmental bronchi of the right-middle lobe. Metagenomic sequencing was performed to characterize the microbiome profiling of 16 PSB and 8 BAL samples. Untargeted metabolomics was performed in 6 PSB samples (3 from tracheal scar PSB and 3 from tracheal scar-free PSB) using high-performance liquid chromatography‒mass spectrometry (LC‒MS).
Results
At the species level, the top four bacterial species were Neisseria subflava, Streptococcus oralis, Capnocytophaga gingivals, and Haemophilus aegyptius. The alpha and beta diversity among tracheal scar PSB, scar-free PSB and BAL samples were compared, and no significant differences were found. Untargeted metabolomics was performed in 6 PSB samples using LC‒MS, and only one statistically significant metabolite, carnitine, was identified. Pathway enrichment analysis of carnitine revealed significant enrichment in fatty acid oxidation.
Conclusion
Our study found that carnitine levels in tracheal scar tissue were significantly lower than those in scar-free tissue, which might be a new target for the prevention and treatment of iatrogenic tracheal stenosis in the future.
Funder
the Special and Joint Program of the Yunnan Provincial Science and Technology Department and Kunming Medical University
Science Research Foundation of Yunnan Provincial Education Department
the National Natural Science Foundation of China
Famous Doctors of High-level Talent Training Support Program of Yunnan Province
Publisher
Springer Science and Business Media LLC
Subject
Pulmonary and Respiratory Medicine
Reference39 articles.
1. Gelbard A, Francis DO, Sandulache VC, et al. Causes and consequences of adult laryngotracheal stenosis. LARYNGOSCOPE. 2015;125:1137–43.
2. Su ZQ, Wei XQ, Zhong CH, et al. [The cause and efficacy of benign tracheal stenosis]. Zhonghua Jie He He Hu Xi Za Zhi. 2013;36:651–4.
3. Zhang J, Wang T, Wang J, et al. Effect of three interventional bronchoscopic methods on tracheal stenosis and the formation of granulation tissues in dogs. Chin MED J-PEKING. 2010;123:621–7.
4. Gnagi SH, Howard BE, Anderson C, Lott DG. Idiopathic subglottic and tracheal stenosis: a Survey of the patient experience. ANN OTO RHINOL LARYN. 2015;124:734–9.
5. Dorris ER, Russell J, Murphy M. Post-intubation subglottic stenosis: aetiology at the cellular and molecular level. EUR RESPIR REV 2021;30.