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 Wang, Zhang
A1 Singh, Richa
A1 Miller, Bruce E
A1 Tal-Singer, Ruth
A1 Van Horn, Stephanie
A1 Tomsho, Lynn
A1 Mackay, Alexander
A1 Allinson, James P
A1 Webb, Adam J
A1 Brookes, Anthony J
A1 George, Leena M
A1 Barker, Bethan
A1 Kolsum, Umme
A1 Donnelly, Louise E
A1 Belchamber, Kylie
A1 Barnes, Peter J
A1 Singh, Dave
A1 Brightling, Christopher E
A1 Donaldson, Gavin C
A1 Wedzicha, Jadwiga A
A1 Brown, James R
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.