INVESTIGATION OF PARASITIC AND FUNGAL FLORA IN PATIENTS WITH ASTHMA USING CONVENTIONAL AND MOLECULAR METHODS
Project no. 21022 · Status: Kapanmış · 2019
Summary
Asthma is a disease that causes airway limitation and significantly decreases the quality of life, with high morbidity and mortality. Today, it is known that viral infection, allergens, exposure of cigarette smoke, air pollution and genetics play a role in the onset and worsening of asthma. However, bacteria, fungi and parasites also play an important role in the etiology of asthma. Although there have been studies to determine the bacterial-fungal-parasitic flora of asthmatic patients in the world, there has not been performed such a study in our country. In addition, no research has yet been carried out in the world on the skin flora that reflects the close environment where asthmatic patients live in the best way. Several studies have been conducted to investigate Pneumocystis jiroveci, suggesting to cause asthma attacks and found in the respiratory tract samples of asthmatic patients; however, there is no study on Cryptosporidium spp. and Microsporidium spp. which can cause colonization and infection in the respiratory tract by inhalation and bacteremia. In the project, it was aimed to determine the bacterial, fungal and parasitic factors that play a role in the etiology of asthma patients and to evaluate their effects on the severity and attacks of asthma. In this context, although it was planned to include 100 patients with different severity of asthma clinics, samples were collected from 40 asthma patients and 40 healthy volunteers due to the process in which only emergency patients were admitted to clinics due to the SARS-CoV-2 pandemic and outpatient services were carried out by telephone. Scoring of these patients according to the severity of asthma was based on the GINA 2020 guideline. Fungi from sputum and skin swab samples and parasites from fecal samples were investigated by using conventional methods. After DNA extraction from stool and sputum samples, Cryptosporidium spp. and Microsporidium spp. DNA were searched in stool and P. jiroveci, Microsporidium spp. and Cryptosporidium spp. DNA in sputum. In this study, Aspergillus fumigatus, Microsporidium spp., Cryptosporidium spp., and P.jiroveci were detected only in sputum samples of asthmatic patients (p=0.120, 0.125, 0.029 ve 0.029, respectively) . Candida spp. levels were found to be significantly higher in sputum samples of asthmatic patients compared to healthy volunteers (p=0.001) . While the rates of Cryptosporidium spp. in the stools of asthmatic patients and the control group were similar, Microsporidium spp. (p=0.24) was found in the stools of only two asthmatic patients. Also, Blastocystis spp. was detected in two groups, but it was higher in asthmatic patients than control group (p=0.35). By metagenomic analysis, it has been determined that the diversity of microbiota is higher in the sputum of asthmatic patients, but the species dominant in the microbiota are less. Consistent with previous studies, Proteobacteria phylum was detected at a higher rate in sptum microbiota of asthmatics compared to the control group. However, the most detected microorganism phylum is Firmicutes in accordance with the control group. This is the first study investigating Cryptosporidium spp., Microsporidium spp. and intestinal protozoa in samples of asthmatic patients. The higher rate of these factors in asthmatic patients compared to healthy volunteers and the changes they cause in the FEV1 value, which indicates asthma severity, have shown that these opportunistic factors should be kept in mind for asthmatic people. Special procedures must be applied in case of doubt for these factors that cannot be detected by routine laboratory factors. By increasing the number of studies to be conducted on microbiota, it will be possible to benefit from microbiota in diagnosis and treatment, and we think that our study is a pioneering study on this subject.