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Anaerobes in cystic fibrosis patients' airways.

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PubMed ID: 30663924

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Lamoureux C, Guilloux CA, Beauruelle C, Jolivet-Gougeon A, Héry-Arnaud G

Crit Rev Microbiol. Jan 2019. doi: 10.1080/1040841X.2018.1549019

COMMENT: This review is centered on the study of anaerobes in Cystic Fibrosis (CF) and tries to solve the role of them in CF pathophysiology using the information about the metabolites that anaerobes produce (metabolome) and about the anaerobe resistome.

OBJECTIVE:

The aim of this study was to summarize anaerobe diversity in the airway microbiota and its potential role in Cystic Fibrosis (CF), to provide an overview of the state of knowledge on anaerobe antibiotic resistances (resistome), and to investigate the detectable metabolites produced by anaerobes in CF airways (metabolome)

This review emphasizes key metabolites produced by strict anaerobic bacteria (sphingolipids, fermentation-induced metabolites and metabolites involved in quorum-sensing), which may be essential for the better understanding of lung disease pathophysiology in CF.

In healthy subjects, strict anaerobic genera including Veillonella, Prevotella, Fusobacterium and Porphyromonas, are also part of the core airway microbiota. However, microbiota studies highlighted a shift in composition of the CF lung microbiota compared to the healthy one, characterized by an excess growth of Proteobacteria and Actinobacteria at the expense of Bacteroidetes.

In CF, the airway microbiota is dynamic and fluctuates in relation to changes in patients’ clinical state and lung disease stage. Anaerobes are now considered as important bacteria within CF lung microbiota.

CONCLUSION:

Anaerobes role in CF is still to be deciphered: whether strict anaerobic bacteria play a beneficial or detrimental role in the CF lung remains under debate

Due to their abundant presence in the lung, involvement in lung inflammation and antibiotic resistance, anaerobes may play a crucial role in CF pathophysiology. Although a growing number of studies have focused on the impact of anaerobes, these bacteria are still the great unknowns of the lung. Metabolome studies will help shed great light on the role of anaerobes in CF. Sphingolipids, fermentation-induced metabolites (SCFAs or 2,3-butanedione/2,3-butanediol) and metabolites involved in QS (Quorum Sensing) are key metabolites in anaerobes, because of their involvement in CF inflammation and their potential use as biomarkers of CF pulmonary exacerbation

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Raquel Tobes