A new study has identified significant differences in airway fungal composition between pulmonary hypertension patients and healthy individuals, providing the first comprehensive analysis of airway mycobiome in this condition.
Published in BMC Medicine, researchers analyzed pharyngeal swabs from 244 PH patients and 120 controls across three independent medical centers. They found increased levels of Purpureocillium, Issatchenkia, and Cyberlindnera in PH patients, while Peroneutypa, Simplicillium, and Metarhizium were notably reduced. These differences remained consistent across PH classifications (Groups 1, 3, and 4), WHO functional classes (I-IV), disease severities, and importantly, were not influenced by antibiotic or corticosteroid use.
Alpha-diversity analysis showed significantly lower fungal diversity (Shannon index) in PH patients, while beta-diversity analysis revealed distinct fungal profiles between PH patients and controls. Receiver operating characteristic (ROC) analysis showed that the enriched fungal genera provided an area under the curve (AUC) of 0.76 for identifying PH patients, while the reduced fungal genera set yielded an AUC of 0.83 in distinguishing controls.
Correlation analysis found that Ascomycota abundance was negatively associated with pulmonary vascular resistance (rho = -0.437, p < 0.001) and mPAP (rho = -0.293, p < 0.001) but positively correlated with cardiac output (rho = 0.330, p < 0.001). Researchers also observed increased connections among the top fungal phyla or genera in PH patients compared to controls.
"These data provide compelling evidence and a fundamental resource for the future elucidation of the potential causal relationship between altered lung/airway mycobiomes and disease development in PH," noted the research team led by Chenting Zhang, Bihua Zhong, Qian Jiang, Wenju Lu, and Hongkai Wu, with corresponding authors Chunli Liu, Jian Wang, and Kai Yang.
Future research should examine interactions among airway bacteria, mycobiomes, and viromes to develop a more comprehensive understanding of microbiome signatures in PH.
No conflicts of interest were disclosed.
