Azithromycin therapy during respiratory syncytial virus bronchiolitis: Upper airway microbiome alterations and subsequent recurrent wheeze Yanjiao Zhou,

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Presentation transcript:

Azithromycin therapy during respiratory syncytial virus bronchiolitis: Upper airway microbiome alterations and subsequent recurrent wheeze Yanjiao Zhou, PhD, Leonard B. Bacharier, MD, Megan Isaacson-Schmid, BSc, Jack Baty, BA, Kenneth B. Schechtman, PhD, Geneline Sajol, BSc, Kristine Wylie, PhD, Gregory A. Storch, MD, Mario Castro, MD, MPH, Avraham Beigelman, MD, MSCI Journal of Allergy and Clinical Immunology Volume 138, Issue 4, Pages 1215-1219.e5 (October 2016) DOI: 10.1016/j.jaci.2016.03.054 Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 1 Bacterial community structure in the AZM and placebo groups before and after the study treatment (A and B), and the dynamics of bacterial community structure changes in the 2 groups over the treatment period (C and D). In this nonmetric multidimensional scaling plot, each dot represents the microbiome composition of 1 sample. Dots that are closer to each other have more similar microbiome composition than do dots that are farther to each other. A, No difference in microbiome composition between AZM and placebo groups at randomization. B, Clear separation between the 2 groups at the end of study treatments. C and D, The microbiota shifted considerably, but in different trajectories, between randomization and day 14 in both the AZM (A) and the placebo (B) groups. Journal of Allergy and Clinical Immunology 2016 138, 1215-1219.e5DOI: (10.1016/j.jaci.2016.03.054) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig 2 Changes in the relative abundance of bacterial genera at the end of study treatments compared with randomization. After 14 days of treatment, Moraxella (q value = 0.03) significantly decreased in the AZM group. Dolosigranulum (q value = 0.03) and Corynebacterium (q value = 0.03) increased significantly in the placebo group, and Streptococcus (q value = 0.01) decreased significantly in the placebo group. *q value < 0.05. Journal of Allergy and Clinical Immunology 2016 138, 1215-1219.e5DOI: (10.1016/j.jaci.2016.03.054) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E1 Relative abundance of the dominant bacteria (>1%) before and after the study treatment, as illustrated by heat map. The colors describe the different abundance of each bacterial genus. Each column corresponds to 1 sample, while each row represents the bacterial genus. Journal of Allergy and Clinical Immunology 2016 138, 1215-1219.e5DOI: (10.1016/j.jaci.2016.03.054) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E2 Relative abundance of Moraxella in the AZM and placebo groups at the end of study treatments (day 14). Moraxella abundance is significantly lower in the AZM group than in the placebo group (q value = 0.009). Journal of Allergy and Clinical Immunology 2016 138, 1215-1219.e5DOI: (10.1016/j.jaci.2016.03.054) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions

Fig E3 A schematic model of the possible mechanism through which AZM decreases the occurrence of post-RSV RW. Journal of Allergy and Clinical Immunology 2016 138, 1215-1219.e5DOI: (10.1016/j.jaci.2016.03.054) Copyright © 2016 American Academy of Allergy, Asthma & Immunology Terms and Conditions