Project Summary/Abstract
Acute respiratory distress syndrome (ARDS), the most severe form of acute lung injury (ALI), is common in
COVID-19 and was a major driver of the now >1 million deaths in the USA since March 2020. Rigorous work
has emphasized the key role the immune system and the microbiome plays in lung diseases like ALI. This
includes an important role for pro-inflammatory T helper 17 (Th17) cells, which expand and increase their
activation in lung tissue during ALI and lead to pulmonary fluid accumulation. While select gut bacteria can induce
Th17 cells, the causal role of the microbiome in ALI and ARDS remains a major knowledge gap.
Bifidobacterium adolescentis is a gut isolate with the highest Th17 inducing capacity of any human gut
bacterium. My own preliminary data show that colonization of germ-free (GF) mice with B. adolescentis is
sufficient to markedly alter the expression of many genes in lung tissue, including hundreds of genes implicated
in ARDS. My data also indicates that B. adolescentis and other bifidobacteria secrete small molecules that
activate Th17 cells, providing a plausible mechanism by which bifidobacteria could contribute to lung injury. My
K08 application will build on a set of tools based on our laboratory’s recent discovery that the host ketone body,
β-hydroxybuytrate (βHB), uniquely suppresses the growth of Bifidobacterium species.
I hypothesize that Bifidobacterium, which are suppressed by gut epithelial βHB, secrete small molecules
that reach lung tissue and activate Th17 cells during ALI. The proposed research plan will provide multiple
training opportunities leading to a unique and sustainable research program. As a clinical fellow in the Turnbaugh
lab (UCSF), I have learned microbiome data analysis, anaerobic microbiology, and gnotobiotic mouse
husbandry. This project, coupled to in-depth support by lung experts Drs. Sheppard and Matthay (UCSF), will
help me develop an independent research area that builds upon my past training. I will develop skills quantifying
ALI severity in two ALI models and pair these ALI models with state-of-the-art tools in microbiome research.
This proposal is both technologically and conceptually innovative. We will leverage resources available
in our laboratory to selectively manipulate Bifidobacterium colonization levels in conventionally raised mice using
βHB. My proposed experiments will help elucidate the metabolites produced by gut Bifidobacterium that induce
pulmonary Th17 phenotypes, emphasizing the importance of considering bacterial metabolism for immune
function and lung physiologic impairment. Our proposed studies will shift the focus to remote communication
between prevalent human gut bacteria and lung tissues, mediated by secreted bacterial metabolites. For patients
with ALI, this work will define putative mechanisms by which gut microorganisms contribute to devastating
physiologic impairment and provide a conceptual basis to understand the scope and molecular impact of the gut
microbiome on lung function in both health and disease.