PMID- 25661411
OWN - NLM
STAT- MEDLINE
DCOM- 20150702
LR  - 20220310
IS  - 1097-6833 (Electronic)
IS  - 0022-3476 (Print)
IS  - 0022-3476 (Linking)
VI  - 166
IP  - 4
DP  - 2015 Apr
TI  - 16S community profiling identifies proton pump inhibitor related differences in 
      gastric, lung, and oropharyngeal microflora.
PG  - 917-23
LID - S0022-3476(14)01236-0 [pii]
LID - 10.1016/j.jpeds.2014.12.067 [doi]
AB  - OBJECTIVES: To test the hypothesis that proton pump inhibitor (PPI) use results 
      in changes in gastric microflora which, through full column reflux, results in 
      lung and oropharyngeal microflora changes. STUDY DESIGN: We performed a 
      prospective, cross-sectional cohort study of 116 children (57 off and 59 on PPIs) 
      undergoing simultaneous bronchoscopy and upper endoscopy for the evaluation of 
      chronic cough. We performed 16S sequencing on gastric, bronchoalveolar lavage, 
      and oropharyngeal fluid. Fifty patients also underwent multichannel intraluminal 
      impedance testing. RESULTS: Streptococcus was more abundant in the gastric fluid 
      of patients taking PPIs, and there was a significant correlation with PPI dose 
      (mg/kg/d) and abundance of gastric Streptococcus (P = .01). There was also a 
      significant difference in the abundance of oropharyngeal Streptococcus in 
      patients treated with PPI. Eight unique bacterial genera were found in the 
      gastric and lung fluid but not in the oropharyngeal suggesting exchange between 
      the 2 sites and 2 of the 8 (Lactococcus, Acinetobacter) were more abundant in 
      patients with more full column reflux, suggesting direct aspiration. Principal 
      component analysis revealed greater overlap between gastric and lung than 
      oropharyngeal microflora. CONCLUSIONS: PPI use was associated with differences in 
      gastric, lung, and oropharyngeal microflora. Although microflora exchange can 
      occur between all 3 sites, gastric and lung microflora are more closely related, 
      and the mechanism of exchange between sites may be aspiration of full column 
      reflux.
CI  - Copyright (c) 2015 Elsevier Inc. All rights reserved.
FAU - Rosen, Rachel
AU  - Rosen R
AD  - Aerodigestive Center, Division of Gastroenterology and Nutrition, Boston 
      Children's Hospital, Boston, MA. Electronic address: 
      rachel.rosen@childrens.harvard.edu.
FAU - Hu, Lan
AU  - Hu L
AD  - Center for Computational Cancer Biology, Dana Farber Cancer Institute, Boston, 
      MA.
FAU - Amirault, Janine
AU  - Amirault J
AD  - Aerodigestive Center, Division of Gastroenterology and Nutrition, Boston 
      Children's Hospital, Boston, MA.
FAU - Khatwa, Umakanth
AU  - Khatwa U
AD  - Aerodigestive Center, Division of Pulmonary Medicine, Boston Children's Hospital, 
      Boston, MA.
FAU - Ward, Doyle V
AU  - Ward DV
AD  - The Broad Institute, Cambridge, MA.
FAU - Onderdonk, Andrew
AU  - Onderdonk A
AD  - Department of Microbiology, Brigham and Women's Hospital, Boston, MA.
LA  - eng
GR  - K23 DK073713/DK/NIDDK NIH HHS/United States
GR  - R03 DK089146/DK/NIDDK NIH HHS/United States
GR  - R03DK089146/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20150204
PL  - United States
TA  - J Pediatr
JT  - The Journal of pediatrics
JID - 0375410
RN  - 0 (DNA, Bacterial)
RN  - 0 (Proton Pump Inhibitors)
SB  - IM
MH  - Adolescent
MH  - Bacteria/*drug effects/genetics
MH  - Bronchoalveolar Lavage Fluid/microbiology
MH  - Bronchoscopy
MH  - Child
MH  - Child, Preschool
MH  - Cross-Sectional Studies
MH  - DNA, Bacterial/analysis
MH  - Electric Impedance
MH  - Endoscopy, Gastrointestinal
MH  - Esophageal pH Monitoring
MH  - Female
MH  - Follow-Up Studies
MH  - Gastroesophageal Reflux/*drug therapy/physiopathology
MH  - Humans
MH  - Infant
MH  - Laryngoscopy
MH  - Lung/*microbiology
MH  - Male
MH  - Oropharynx/*microbiology
MH  - Prospective Studies
MH  - Proton Pump Inhibitors/*pharmacology
MH  - Stomach/*microbiology
PMC - PMC4380592
MID - NIHMS652069
EDAT- 2015/02/11 06:00
MHDA- 2015/07/03 06:00
PMCR- 2016/04/01
CRDT- 2015/02/10 06:00
PHST- 2014/07/31 00:00 [received]
PHST- 2014/11/25 00:00 [revised]
PHST- 2014/12/22 00:00 [accepted]
PHST- 2015/02/10 06:00 [entrez]
PHST- 2015/02/11 06:00 [pubmed]
PHST- 2015/07/03 06:00 [medline]
PHST- 2016/04/01 00:00 [pmc-release]
AID - S0022-3476(14)01236-0 [pii]
AID - 10.1016/j.jpeds.2014.12.067 [doi]
PST - ppublish
SO  - J Pediatr. 2015 Apr;166(4):917-23. doi: 10.1016/j.jpeds.2014.12.067. Epub 2015 
      Feb 4.