Abstract
Increasing evidence suggests that the lung microbiome plays an important role in chronic obstructive pulmonary disease (COPD) severity. However, the dynamics of the lung microbiome during COPD exacerbations and its potential role in disease aetiology remain poorly understood.
We completed a longitudinal 16S ribosomal RNA survey of the lung microbiome on 476 sputum samples collected from 87 subjects with COPD at four visits defined as stable state, exacerbation, 2 weeks post-therapy and 6 weeks recovery.
Our analysis revealed a dynamic lung microbiota where changes appeared to be associated with exacerbation events and indicative of specific exacerbation phenotypes. Antibiotic and steroid treatments appear to have differential effects on the lung microbiome. We depict a microbial interaction network for the lung microbiome and suggest that perturbation of a few bacterial operational taxonomic units, in particular Haemophilus spp., could greatly impact the overall microbial community structure. Furthermore, several serum and sputum biomarkers, in particular sputum interleukin-8, appear to be highly correlated with the structure and diversity of the microbiome.
Our study furthers the understanding of lung microbiome dynamics in COPD patients and highlights its potential as a biomarker, and possibly a target, for future respiratory therapeutics.
Abstract
Lung microbiome changes are associated with COPD exacerbation events and implicated in host inflammatory responses http://ow.ly/Wamjx
Footnotes
This article has supplementary material available from erj.ersjournals.com
Support statement: The study was sponsored by University Hospitals of Leicester National Health Service (NHS) Trust. Study cohort BEAT-COPD (Biomarkers to Target Antibiotic and Systemic Corticosteroid Therapy in COPD Exacerbations) was co-funded by the Medical Research Council (UK) and AstraZeneca, with microbiome analysis funded by GlaxoSmithKline (GSK). C.E. Brightling and M. Bafadhel were funded by the National Institute for Health Research (NIHR) with additional support from the Leicester NIHR Respiratory Biomedical Research Unit. Z. Wang is supported by the GSK Early Talent Postdoctoral Fellowship Program. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Clinical trial: This study is registered at www.isrctn.com with identifier number 92422949.
Conflict of interest: Disclosures can be found alongside the online version of this article at erj.ersjournals.com
- Received August 24, 2015.
- Accepted December 6, 2015.
- Copyright ©ERS 2016