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Oral Presentation - 25
Are airway microbiota and inflammation in children with esophageal atresia related to reflux aspiration?
R Dissanayake*, H Yuan*, M Coffey**, I Traini*, SY Chin*, J Menzies***, J Hughes****, I McKay*, J van Dorst*, C Hodgkins*****, S Leach*, C Ooi**, U Krishnan**
*School of Clinical Medicine, Discipline of Paediatrics and Child Health, UNSW Medicine and Health, University of New South Wales, Randwick, Australia
**Department of Gastroenterology, Sydney Children’s Hospital, Randwick, Australia
***Department of Nutrition and Dietetics, Sydney Children’s Hospital, Randwick, NSW Australia
****Department of Speech Pathology, Sydney Children’s Hospital, Randwick, NSW, Australia
*****NSW Health Pathology, SEALS Pathology, Prince of Wales Hospital Laboratory
Purpose
Respiratory complications are a common extra-intestinal manifestation of esophageal atresia (EA). This study aims to assess the degree of airway dysbiosis and inflammation present in children with EA compared to healthy controls (HC) and explore its association with reflux and respiratory outcomes.
Method
The sub-study within the Evaluating the Alimentary and Respiratory Tracts in Health and Disease program collected clinical data and oropharyngeal swabs from EA and HC aged 0 to 17 years. 16S rRNA sequencing (V4 region) was performed. S100A12 and pepsin were measured using enzyme linked immunosorbent assays. Targeted liquid chromatography mass spectrometry was utilized to measure bile acids. Associations between airway microbiota, inflammation, reflux markers and respiratory outcomes were analyzed.
Results
Forty-five EA participants (mean age 6.7, standard deviation (SD) 4.96) were age and sex matched with 45 HC participants (mean age 7.7, SD 4.84). Richness and Shannon diversity were significantly lower in oropharyngeal samples of children with EA compared to age matched HC (p<0.0001 and p=0.001, respectively). Beta diversity analysis indicated differences in oropharyngeal bacterial composition between HC and EA cohorts. Median oropharyngeal S100A12 levels were higher in patients with EA compared to HC, 54.7 ng/ml vs 14.7 ng/ml, respectively (p=0.02). Pepsin was detected in all EA samples, median value (interquartile range) of 10.3 ng/ml (7.4 – 15.8). Pepsin was positively correlated with S100A12 levels in the EA cohort (r=0.38 p=0.04). Concentration of bile acids, were higher in patients with EA compared to HC.
Conclusions
Children with EA have an altered oropharyngeal microbiota and higher levels of inflammation compared to HC. Positive correlations of pepsin and S100A12 levels suggest a potential role of reflux in the development of airway inflammation in EA.