Recently, the classic journal of circulation and peripheral vascular disease, Hypertension (IF: 7.713) published an editorial titled “Hypertension Editors’ Picks: Pulmonary Hypertension”, which included 20 excellent papers in the field of pulmonary hypertension published in the journal between 2018 and 2020. The research paper on the composition of pharyngeal microbiota flora in patients with pulmonary hypertension published in November 2020 by the pulmonary vascular disease group of the SKLRD, “Altered Airway Microbiota Composition in Patients with Pulmonary Hypertension”, was selected, which was the first time for a paper of the pulmonary vascular disease group to be selected into the Editors’ Picks of the journal. Professor Wang Jian and associate professor Yang Kai of the SKLRD are the corresponding authors of the paper, and Dr. Zhang Chenting, Dr. Zhang Tingting and Professor Lu Wenju are the first authors.

There are many kinds and a huge number of microbial groups on the body surface and inside the body of humans, which are affected by complex internal and external factors. The human micro ecosystem is a very complex system. The normal flora plays a vital role in the life activities of the host. The pharynx is a physiological part connecting the mouth, nasopharynx, the lower respiratory tract, esophagus and so on. Connected with the external environment, it is an important channel for many bacteria to invade the lower respiratory tract and cause pulmonary infection. The dynamic balance of pharyngeal microbiota environment plays an important role in the occurrence and development of many human diseases. Therefore, the systematic study of the composition and distribution of pharyngeal microbiota in the state of pulmonary hypertension is of great importance to the further understanding of the phenotype and mechanism of pulmonary hypertension.

The pharyngeal swabs of a total of 118 patients with pulmonary hypertension and 79 healthy controls were collected. Through the 16S ribosomal RNA gene sequencing, the study first systematically reported the difference of the composition of pharyngeal flora between the patients with pulmonary hypertension and healthy control group. Compared with the healthy control group, the patients with pulmonary hypertension have a higher abundance of pharyngeal flora and a lower diversity. The patients were obviously higher than the healthy control group in the abundance of three kinds of bacteria, namely Streptococcus, Lautropiamirabilis and Ralstonia. And significant analysis of inter-group differences and LDFSe multilevel species difference analysis suggest that the differential expression of the three kinds of bacteria in the pharynx is expected to be a new and potential bio-marker for the noninvasive diagnosis of pulmonary hypertension. Further functional predictive analysis suggests that the pharyngeal flora enriched in patients with pulmonary hypertension is closely related to the activation of signaling pathways such as bacterial invasion of epithelial cells and bacterial endotoxin.