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The lower-airway microbiome and metabolome in preterm infants: Identifying potential predictive biomarkers of bronchopulmonary dysplasia

The lower-airway microbiome may influence the pathogenesis of lung disease. Bronchopulmonary dysplasia (BPD) is a serious morbidity associated with preterm birth that may be influenced by lower-airway microbial or metabolic alterations. This study used16S rRNA gene sequencing, metabolomic analyses, and the Kyoto Encyclopedia of Genes and Genomes (KEGG) database to investigate the lower-airway microbiome and metabolome in a cohort of preterm infants with mild, moderate, or severe BPD or no BPD. Differences in the diversity and composition of the infants' lower airway microbiota, as well as metabolic status, were initially observed, but became less pronounced at 7 days of life. Decreased diversity of the lower-airway microbiome, increased abundance of Stenotrophomonas, and increased level of sn-glycerol 3-phosphoethanolamine were associated with increased BPD severity, and have potential as predictive biomarkers for BPD. Stenotrophomonas may contribute to the development of BPD and influence the composition of the lower-airway microbiome through its metabolite, sn-glycerol 3-phosphoethanolamine. These findings provide novel insights into the lower-airway microbiome and its role in BPD.