Small airways function: a gut issue?

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Introduction: While gut microbiome has been linked to respiratory diseases, its relation to lung function is poorly studied. Objectives: To assess the associations between gut microbiota and impulse oscillometry (IOS), a technique sensitive in detecting early changes in small airways function. Methods: This cross-sectional analysis included 8521 adults from the population-based SCAPIS study. Associations between microbiota and IOS z-scores for resistance (R5) and reactance (X5) at 5 Hz were assessed in linear regression models, adjusted for sex, age, plate, country of birth (basic), smoking, education, physical activity, fibre intake, use of antibiotics, proton-pump inhibitors and systemic steroids past 6 months, diabetes, asthma and BMI (full), accounted for multiple testing. Results: In the basic and full model, 590 and 143 associations between species and IOS were observed. Representing the highest estimates (full model), a change in prevalence from 5th to 95th percentile in Intestimonas butyriciproducens was associated (ß (95% CI)) with lower (better) R5 (-0.12 (-0.17, -0.07)) and higher (better) X5 (0.18 (0.09, 0.28)), while Scardovia Wiggsiae was associated with higher (worse) R5 (0.11 (0.06, 0.16)). Higher microbial diversity (5th to 95th percentile) was linked to lower (better) R5; ß (95% CI) -0.15 (-0.21, -0.09) for richness and -0.10 (-0.16, -0.04) for Shannon’s index, and higher (better) X5; 0.10 (0.01, 0.19) for inverse Simpson and 0.19 (0.10, 0.28) for richness. When excluding respiratory diseases (n=7761), 208 species correlated to IOS (full model). Conclusions: Irrespective of respiratory disease, gut microbiota related to IOS, suggesting specific microbiome compositions and microbial diversity may play a role in small airways function.

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