Nature子刊：肠菌及其代谢物或与新冠呼吸衰竭死亡率有关

Nature Communications[IF:17.694]

① 招募71例COVID-19相关危重疾病患者，进入重症监护室3天内收集粪便样本，进行宏基因组测序和菌群衍生代谢物定量；

② 71例患者中39例存活，32例死亡，两组在抗生素使用及特异性疗法（如类固醇、瑞德西韦）间无显著差异；

③ 死亡率与粪便菌群中变形菌门丰度增加、粪便次级胆汁酸和去氨酪氨酸浓度（其浓度与机械通气的呼吸衰竭进展相关）降低有关；

④ 基于粪便菌群及其代谢物浓度可较好地预测新冠感染患者的呼吸功能和死亡率（AUC=0.74）。

Immunomodulatory fecal metabolites are associated with mortality in COVID-19 patients with respiratory failure
11-03, doi: 10.1038/s41467-022-34260-2

【主编评语】COVID-19的呼吸衰竭和死亡是由病毒和炎症引起的肺组织损伤造成的，肠道菌群及衍生的代谢物与呼吸道病毒感染的免疫反应有关，但它们对病情严重的新冠患者的影响尚不清楚。近日，美国芝加哥大学医学院研究人员在Nature Communications发表最新研究，纳入71例COVID-19（最终39例存活，32例死亡）危重症患者，基于粪便菌群及代谢物检测，发现粪便菌群中变形菌门丰度增加、粪便次级胆汁酸和去氨酪氨酸浓度降低与死亡率增加有关，并利用模型进一步验证。总之，该研究为未来靶向肠道菌群联合药物干预危重新冠患者提供了新思路。

Immunomodulatory fecal metabolites are associated with mortality in COVID-19 patients with respiratory failure

免疫调节性粪便代谢物与新冠肺炎呼吸衰竭患者的死亡率相关

10.1038/s41467-022-34260-2

11-03, Article

Abstract:
Respiratory failure and mortality from COVID-19 result from virus- and inflammation-induced lung tissue damage. The intestinal microbiome and associated metabolites are implicated in immune responses to respiratory viral infections, however their impact on progression of severe COVID-19 remains unclear. We prospectively enrolled 71 patients with COVID-19 associated critical illness, collected fecal specimens within 3 days of medical intensive care unit admission, defined microbiome compositions by shotgun metagenomic sequencing, and quantified microbiota-derived metabolites (NCT #04552834). Of the 71 patients, 39 survived and 32 died. Mortality was associated with increased representation of Proteobacteria in the fecal microbiota and decreased concentrations of fecal secondary bile acids and desaminotyrosine (DAT). A microbiome metabolic profile (MMP) that accounts for fecal secondary bile acids and desaminotyrosine concentrations was independently associated with progression of respiratory failure leading to mechanical ventilation. Our findings demonstrate that fecal microbiota composition and microbiota-derived metabolite concentrations can predict the trajectory of respiratory function and death in patients with severe SARS-Cov-2 infection and suggest that the gut-lung axis plays an important role in the recovery from COVID-19.

First Authors:
Matthew R Stutz

Correspondence Authors:
Eric G Pamer,Bhakti K Patel

All Authors:
Matthew R Stutz,Nicholas P Dylla,Steven D Pearson,Paola Lecompte-Osorio,Ravi Nayak,Maryam Khalid,Emerald Adler,Jaye Boissiere,Huaiying Lin,William Leiter,Jessica Little,Amber Rose,David Moran,Michael W Mullowney,Krysta S Wolfe,Christopher Lehmann,Matthew Odenwald,Mark De La Cruz,Mihai Giurcanu,Anne S Pohlman,Jesse B Hall,Jean-Luc Chaubard,Anitha Sundararajan,Ashley Sidebottom,John P Kress,Eric G Pamer,Bhakti K Patel