RT Journal Article
SR Electronic
T1 Longitudinal profiling of the lung microbiome in the AERIS study demonstrates repeatability of bacterial and eosinophilic COPD exacerbations
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP thoraxjnl-2017-210408
DO 10.1136/thoraxjnl-2017-210408
A1 David Mayhew
A1 Nathalie Devos
A1 Christophe Lambert
A1 James R Brown
A1 Stuart C Clarke
A1 Viktoriya L Kim
A1 Michal Magid-Slav
A1 Bruce E Miller
A1 Kristoffer K Ostridge
A1 Ruchi Patel
A1 Ganesh Sathe
A1 Daniel F Simola
A1 Karl J Staples
A1 Ruby Sung
A1 Ruth Tal-Singer
A1 Andrew C Tuck
A1 Stephanie Van Horn
A1 Vincent Weynants
A1 Nicholas P Williams
A1 Jeanne-Marie Devaster
A1 Tom M A Wilkinson
A1 ,
YR 2018
UL http://thorax.bmj.com/content/early/2018/01/31/thoraxjnl-2017-210408.abstract
AB Background Alterations in the composition of the lung microbiome associated with adverse clinical outcomes, known as dysbiosis, have been implicated with disease severity and exacerbations in COPD.Objective To characterise longitudinal changes in the lung microbiome in the AERIS study (Acute Exacerbation and Respiratory InfectionS in COPD) and their relationship with associated COPD outcomes.Methods We surveyed 584 sputum samples from 101 patients with COPD to analyse the lung microbiome at both stable and exacerbation time points over 1 year using high-throughput sequencing of the 16S ribosomal RNA gene. We incorporated additional lung microbiology, blood markers and in-depth clinical assessments to classify COPD phenotypes.Results The stability of the lung microbiome over time was more likely to be decreased in exacerbations and within individuals with higher exacerbation frequencies. Analysis of exacerbation phenotypes using a Markov chain model revealed that bacterial and eosinophilic exacerbations were more likely to be repeated in subsequent exacerbations within a subject, whereas viral exacerbations were not more likely to be repeated. We also confirmed the association of bacterial genera, including Haemophilus and Moraxella, with disease severity, exacerbation events and bronchiectasis.Conclusions Subtypes of COPD have distinct bacterial compositions and stabilities over time. Some exacerbation subtypes have non-random probabilities of repeating those subtypes in the future. This study provides insights pertaining to the identification of bacterial targets in the lung and biomarkers to classify COPD subtypes and to determine appropriate treatments for the patient.Trial registration number Results, NCT01360398.