{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T20:31:06Z","timestamp":1793046666286,"version":"4.5.0"},"reference-count":53,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100012166","name":"National Key Research and Development Program of China","doi-asserted-by":"publisher","award":["2022YFA1304302"],"award-info":[{"award-number":["2022YFA1304302"]}],"id":[{"id":"10.13039\/501100012166","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MedComm"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Acute severe lower respiratory tract infections (asLRTIs) pose a significant clinical challenge, especially in critically ill patients, but the role of the lower respiratory tract microbiome (LRTM) remains unclear. This study aimed to characterize LRTM composition and host immune factors to identify prognostic features of clinical outcomes. The study included 53 asLRTI patients and 35 controls. Metagenomics, metabolomics, proteomics, and RNA sequencing were conducted, while analysis of similarities (ANOSIM) and Cox regression were performed for statistics. Clinical data, including pneumonia severity scores, were collected on BALF sampling, with a 100\u2010day follow\u2010up. LRTM samples were grouped into five clusters (C1\u2013C5). Cluster C5 resembled controls, while others showed significantly lower diversity. LRTM composition correlated with prognosis, with higher pathogenic bacteria abundance linked to poorer outcomes. Cluster C3 was associated with poor prognosis and reduced survival. Metabolite analysis revealed elevated \u03b1\u2010ketoisocaproic acid in asLRTIs and higher 10\u2010nitrolinoleate in poor\u2010prognosis patients. Immune responses varied across clusters, with distinct gene and cytokine expression patterns. Cluster C1, associated with\n                    <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                    , exhibited heightened IL17 pathway activation. LRTM composition in asLRTIs is linked to clinical outcomes, with no single gradient of difference but distinct community states characterized by varying pathogens, metabolites, and immune responses.\n                  <\/jats:p>","DOI":"10.1002\/mco2.70907","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T05:22:33Z","timestamp":1786339353000},"source":"Crossref","is-referenced-by-count":1,"title":["Lower Respiratory Microbiome Dysbiosis Is Associated With Poor Prognosis in Acute Severe Lower Respiratory Tract Infection"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1535-8222","authenticated-orcid":false,"given":"Minghua","family":"Zhan","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory Peking University People's Hospital  Beijing China"},{"name":"Hebei Key Laboratory of Pathogenic Mechanisms and Diagnosis &amp; Treatment Technologies for Lung Microbiome, Department of Clinical Laboratory First Affiliated Hospital of Hebei North University  Zhangjiakou Hebei China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongbin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Peking University People's Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyao","family":"Li","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Microbiology and Infectious Diseases, Department of Pulmonary and Critical Care Medicine, Center of Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, National Center for Respiratory Medicine, Institute of Respiratory Medicine China\u2013Japan Friendship Hospital  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Si","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Peking University People's Hospital  Beijing 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