ObjectiveTo investigate the heterogeneity of gut microbiota between patients with solitary pulmonary nodules (SPN) and multiple pulmonary nodules (MPN), and to explore the intrinsic relationship between Traditional Chinese Medicine (TCM) constitution types and the intestinal microecology. MethodsA prospective study was conducted on 280 patients with pulmonary nodules enrolled between April 2022 and December 2024 from Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan Cancer Hospital, Chengdu Integrated Traditional Chinese Medicine & Western Medicine Hospital. Among them, 118 (42.1%) were male and 162 (57.9%) were female, with a median age of 50 (42, 57) years. Based on imaging findings, patients were divided into a SPN group (n=65) and an MPN group (n=215). TCM constitution types were identified using a Constitution in Chinese Medicine Questionnaire. Fecal samples were collected for 16S rRNA sequencing. Bioinformatics analysis was employed to analyze inter-group differences in microbial community structure. The correlation between TCM constitutions and gut microbiota was examined using Procrustes analysis and Spearman correlation analysis. ResultsThe distribution of TCM constitution types between the two groups showed a statistically significant difference (P<0.05). The SPN group was predominantly characterized by the Qi-depression constitution, while the MPN group was more commonly associated with Yang-deficiency and Phlegm-dampness constitutions. Microbiota analysis revealed that the gut microbiota health index was significantly higher in the SPN group than in the MPN group (P<0.05), whereas the microbiota dysbiosis index showed the opposite pattern. Taxonomic analysis identified higher abundances of Ruminococcus_torques_group, Haemophilus, and Fusobacterium in the SPN group. The abundance of Leuconostoc was significantly increased in the MPN group. Procrustes analysis and Spearman correlation analysis indicated that in the SPN group, the Qi-depression constitution was positively correlated with Ruminococcus_torques_group and Bacteroides. In the MPN group, the Yang-deficiency constitution was negatively correlated with Faecalibacterium, while no statistically significant correlations were found between specific bacterial genera and the Phlegm-dampness or Qi-deficiency constitutions. ConclusionSPN and MPN exhibit significant heterogeneity in TCM constitutional tendencies and microecological characteristics. The abundance of specific bacterial genera may serve as potential biomarkers for distinguishing between SPN and MPN. The interaction between TCM constitutions and specific gut microbiota provides a theoretical basis for the precise TCM syndrome differentiation and microecological intervention in pulmonary nodules.
Objective To analyze the differences in distribution of traditional Chinese medicine (TCM) syndrome elements and salivary microbiota between the individuals with pulmonary nodules and those without, and to explore the potential correlation between the distribution of TCM syndrome elements and salivary microbiota in patients with pulmonary nodules. Methods We retrospectively recruited 173 patients with pulmonary nodules (PN) and 40 healthy controls (HC). The four diagnostic information was collected from all participants, and syndrome differentiation method was used to analyze the distribution of TCM syndrome elements in both groups. Saliva samples were obtained from the subjects for 16S rRNA high-throughput sequencing to obtain differential microbiota and to explore the correlation between TCM syndrome elements and salivary microbiota in the evolution of the pulmonary nodule disease. Results The study found that in the PN group, the primary TCM syndrome elements related to disease location were the lung and liver, and the primary TCM syndrome elements related to disease nature were yin deficiency and phlegm. In the HC group, the primary TCM syndrome elements related to disease location were the lung and spleen, and the primary TCM syndrome elements related to disease nature were dampness and qi deficiency. There were differences between the two groups in the distribution of TCM syndrome elements related to disease location (lung, liver, kidney, exterior, heart) and disease nature (yin deficiency, phlegm, qi stagnation, qi deficiency, dampness, blood deficiency, heat, blood stasis) (P<0.05). The species abundance of the salivary microbiota was higher in the PN group than that in the HC group (P<0.05), and there was significant difference in community composition between the two groups (P<0.05). Correlation analysis using multiple methods, including Mantel test network heatmap analysis and Spearman correlation analysis and so on, the results showed that in the PN group, Prevotella and Porphyromonas were positively correlated with disease location in the lung, and Porphyromonas and Granulicatella were positively correlated with disease nature in yin deficiency (P<0.05). ConclusionThe study concludes that there are notable differences in the distribution of TCM syndrome elements and the species abundance and composition of salivary microbiota between the patients with pulmonary nodules and the healthy individuals. The distinct external syndrome manifestations in patients with pulmonary nodules, compared to healthy individuals, may be a cascade event triggered by changes in the salivary microbiota. The dual correlation of Porphyromonas with both disease location and nature suggests that changes in its abundance may serve as an objective indicator for the improvement of symptoms in patients with yin deficiency-type pulmonary nodules.