RT Journal Article
SR Electronic
T1 Sputum microbiome temporal variability and dysbiosis in chronic obstructive pulmonary disease exacerbations: an analysis of the COPDMAP study
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 331
OP 338
DO 10.1136/thoraxjnl-2017-210741
VO 73
IS 4
A1 Zhang Wang
A1 Richa Singh
A1 Bruce E Miller
A1 Ruth Tal-Singer
A1 Stephanie Van Horn
A1 Lynn Tomsho
A1 Alexander Mackay
A1 James P Allinson
A1 Adam J Webb
A1 Anthony J Brookes
A1 Leena M George
A1 Bethan Barker
A1 Umme Kolsum
A1 Louise E Donnelly
A1 Kylie Belchamber
A1 Peter J Barnes
A1 Dave Singh
A1 Christopher E Brightling
A1 Gavin C Donaldson
A1 Jadwiga A Wedzicha
A1 James R Brown
A1 ,
YR 2018
UL http://thorax.bmj.com/content/73/4/331.abstract
AB Background Recent studies suggest that lung microbiome dysbiosis, the disease associated disruption of the lung microbial community, might play a key role in chronic obstructive pulmonary disease (COPD) exacerbations. However, characterising temporal variability of the microbiome from large longitudinal COPD cohorts is needed to better understand this phenomenon.Methods We performed a 16S ribosomal RNA survey of microbiome on 716 sputum samples collected longitudinally at baseline and exacerbations from 281 subjects with COPD at three UK clinical centres as part of the COPDMAP consortium.Results The microbiome composition was similar among centres and between stable and exacerbations except for a small significant decrease of Veillonella at exacerbations. The abundance of Moraxella was negatively associated with bacterial alpha diversity. Microbiomes were distinct between exacerbations associated with bacteria versus eosinophilic airway inflammation. Dysbiosis at exacerbations, measured as significant within subject deviation of microbial composition relative to baseline, was present in 41% of exacerbations. Dysbiosis was associated with increased exacerbation severity indicated by a greater fall in forced expiratory volume in one second, forced vital capacity and a greater increase in CAT score, particularly in exacerbations with concurrent eosinophilic inflammation. There was a significant difference of temporal variability of microbial alpha and beta diversity among centres. The variation of beta diversity significantly decreased in those subjects with frequent historical exacerbations.Conclusions Microbial dysbiosis is a feature of some exacerbations and its presence, especially in concert with eosinophilic inflammation, is associated with more severe exacerbations indicated by a greater fall in lung function.Trial registration number Results, NCT01620645.