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Stronger data needed to clarify TB’s effect on lung microbiota
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Although studies have shown changes in the lung microbiome related to pulmonary tuberculosis, weak sampling and inconsistent methodologies prevent definitive understanding of relationships between the infection, respiratory flora and patient health, according to a recently published review.
In light of this, larger and better designed studies are needed to investigate lung microbiome changes and their role in TB treatment and prevention, according to Jorge Cervantes, MD, PhD, assistant professor at Texas Tech University Health Sciences Center El Paso, and colleagues.
“The microbiome, through microbial products and immunomodulators released upon recognition of commensals and pathogens by immune cells, could have an impact in the inflammatory response in the lung,” Cervantes told Infectious Disease News. “Clinicians should be aware that both the lung and intestinal microbiota may play a role in the pathogenesis, treatment and future prevention of TB.”
Alongside their overview of the microbiome and its role in various areas of the body, Cervantes and colleagues identified studies that specifically compared the respiratory microbiota of TB patients and controls. They gauged the strength and limitations of these data in terms of sample size, study location and specimen sample type, contextualized the implications of each finding and highlighted key microbiota-related concerns yet to be explored.
Only six studies have been published exploring the lung microbiome of TB patients, according to Cervantes and colleagues. While some of these studies reported changes in microbiota diversity or composition, others found samples from patients and controls to be similar. These studies, however, were fraught with limitations, they wrote, including small sample sizes, inconsistent sequencing platforms, various study locations and methodology that frequently compared sputum microbiota with respiratory secretions or oropharyngeal samples. Although these may not be a factor when examining the flora of other body sites, controlling these variables may be necessary to correct the inconsistencies observed in these six studies.
Jorge Cervantes
In addition, none of the studies directly examined the impact of antibiotics or anti-TB treatment on taxa abundance or composition. This has recently become a growing area of research for diseases affecting gut flora, the researchers noted, and suggest a need to investigate similar concerns affecting microbes in the lung.
“There are changes in the lung microbiome associated with TB,” Cervantes said. “Better controlled and larger studies, as well as meta-analyses, are needed to elucidate the role of these changes in [Mycobacterium tuberculosis] infection and TB therapy, and to identify an overrepresentation and/or underrepresentation of particular species in TB patients and controls.” – by Dave Muoio
Disclosure: The researchers report no relevant financial disclosures
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