Resilience and stability of the CF- intestinal and respiratory microbiome during nutritional and exercise intervention.

Rebecca L Knoll, Víctor Hugo Jarquín-Díaz, Jonas Klopp, Alissa Kemper, Katja Hilbert, Barlo Hillen, Daniel Pfirrmann, Perikles Simon, Viola Bähner, Oliver Nitsche, Stephan Gehring, Lajos Markó, Sofia K Forslund, Krystyna Poplawska

Journal: BMC microbiology 2023;23(1):44

PMID: 36803565

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Abstract

BACKGROUND

Impaired respiratory and intestinal microbiome composition is linked to cystic fibrosis lung disease severity. In people with cystic fibrosis (pwCF), regular exercise is recommended to delay disease progression and preserve a stable lung function. An optimal nutritional status is vital for best clinical outcomes. Our study investigated whether regular and monitored exercise and nutritional support promotes CF microbiome health.

METHODS

A personalized nutrition and exercise program promoted nutritional intake and physical fitness in 18 pwCF for 12 months. Throughout the study, patients performed strength and endurance training monitored by a sports scientist via an internet platform. After three months, food supplementation with Lactobacillus rhamnosus LGG was introduced. Nutritional status and physical fitness were assessed before the study started, after three and nine months. Sputum and stool were collected, and microbial composition was analyzed by 16S rRNA gene sequencing.

RESULTS

Sputum and stool microbiome composition remained stable and highly specific to each patient during the study period. Disease-associated pathogens dominated sputum composition. Lung disease severity and recent antibiotic treatment had the highest impact on taxonomic composition in stool and sputum microbiome. Strikingly, the long-term antibiotic treatment burden had only a minor influence.

CONCLUSION

Despite the exercise and nutritional intervention, respiratory and intestinal microbiomes proved to be resilient. Dominant pathogens drove the composition and functionality of the microbiome. Further studies are required to understand which therapy could destabilize the dominant disease-associated microbial composition of pwCF.

Address: Pediatric Pulmonology, Allergology and Cystic Fibrosis, Children's Hospital, University Medical Center of the Johannes Gutenberg-University Mainz, Germany; Langenbeckstraße 1, 55131, Mainz, Germany.; Pediatric Immunology and Infectiology, Children's Hospital, University Medical Center of the Johannes Gutenberg-University Mainz, Germany; Langenbeckstraße 1, 55131, Mainz, Germany.; Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany.; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany.; Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.; Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany.; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany.; Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany.; Pediatric Immunology and Infectiology, Children's Hospital, University Medical Center of the Johannes Gutenberg-University Mainz, Germany; Langenbeckstraße 1, 55131, Mainz, Germany.; Pediatric Pulmonology, Allergology and Cystic Fibrosis, Children's Hospital, University Medical Center of the Johannes Gutenberg-University Mainz, Germany; Langenbeckstraße 1, 55131, Mainz, Germany.; Department of Sports Medicine, Prevention, and Rehabilitation, Faculty of Social Science, Media and Sports, Johannes Gutenberg-University Mainz, Germany; Albert-Schweitzer Str.22, 55128, Mainz, Germany.; Experimental and Clinical Research Center, a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité Universitätsmedizin Berlin, Berlin, Germany. [email protected].; Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Experimental and Clinical Research Center, Lindenberger Weg 80, 13125, Berlin, Germany. [email protected].; Max Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC), Berlin, Germany. [email protected].; Structural and Computational Biology Unit, European Molecular Biology Laboratory, Heidelberg, Meyerhofstraße 1, 69117, Heidelberg, Germany. [email protected].; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany. [email protected].; Pediatric Pulmonology, Allergology and Cystic Fibrosis, Children's Hospital, University Medical Center of the Johannes Gutenberg-University Mainz, Germany; Langenbeckstraße 1, 55131, Mainz, Germany. [email protected].

DOI: 10.1186/s12866-023-02788-y

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MeSH Terms: Humans, Cystic Fibrosis, RNA, Ribosomal, 16S, Microbiota, Sputum, Anti-Bacterial Agents, Exercise Therapy