PT - JOURNAL ARTICLE AU - Micheál Mac Aogáin AU - Ravishankar Chandrasekaran AU - Albert Lim Yick Hou AU - Low Teck Boon AU - Gan Liang Tan AU - Tidi Hassan AU - Ong Thun How AU - Amanda Hui Qi Ng AU - Denis Bertrand AU - Jia Yu Koh AU - Sze Lei Pang AU - Zi Yang Lee AU - Xiao Wei Gwee AU - Christopher Martinus AU - Yang Yie Sio AU - Sri Anusha Matta AU - Fook Tim Chew AU - Holly R. Keir AU - John E. Connolly AU - John Arputhan Abisheganaden AU - Mariko Siyue Koh AU - Niranjan Nagarajan AU - James D. Chalmers AU - Sanjay H. Chotirmall TI - IMMUNOLOGICAL COROLLARY OF THE PULMONARY MYCOBIOME IN BRONCHIECTASIS: THE CAMEB STUDY AID - 10.1183/13993003.00766-2018 DP - 2018 Jan 01 TA - European Respiratory Journal PG - 1800766 4099 - http://erj.ersjournals.com/content/early/2018/05/31/13993003.00766-2018.short 4100 - http://erj.ersjournals.com/content/early/2018/05/31/13993003.00766-2018.full AB - Introduction: Understanding the composition and clinical importance of the fungal mycobiome was recently identified as a key topic in a “research priorities” consensus statement for bronchiectasis Methods: Patients were recruited as part of the CAMEB study: an international multicentre cross-sectional Cohort of Asian and Matched European Bronchiectasis patients. The mycobiome was determined in 238 patients by targeted amplicon shotgun sequencing of the 18S-28S rRNA internally transcribed spacer regions ITS1 and ITS2. Specific qPCR for detection of and conidial quantification for a range of airway Aspergillus species was performed. Sputum galactomannan, Aspergillus-specific IgE, IgG and Thymus and Activation Regulated Chemokine levels were measured systemically and associated to clinical outcomes. Results: The bronchiectasis mycobiome is distinct, and characterised by specific fungal genera including Aspergillus, Cryptococcus, and Clavispora. A. fumigatus (in Singapore/Kuala Lumpur) and A. terreus (in Dundee) dominated profiles, the latter associating with exacerbations. High frequencies of Aspergillus-associated disease including sensitization and allergic bronchopulmonary aspergillosis were detected. Each revealed distinct mycobiome profiles and associated with more severe disease, poorer pulmonary function and increased exacerbations. Conclusion: The pulmonary mycobiome is of clinical relevance in bronchiectasis. Screening for Aspergillus-associated disease should be considered even in apparently stable patients.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Lim has nothing to disclose.Conflict of interest: Dr. Ng has nothing to disclose.Conflict of interest: Dr. Martinus has nothing to disclose.Conflict of interest: Dr. Bertrand has nothing to disclose.Conflict of interest: Dr. Chew reports personal fees from Sime Darby Technology Center, personal fees from Olam International and First Resources Ltd., outside the submitted work.Conflict of interest: Dr. Tan has nothing to disclose.Conflict of interest: Dr. Keir has nothing to disclose.Conflict of interest: Dr. Chalmers reports grants and personal fees from Glaxosmithkline, grants and personal fees from Boehringer-Ingelheim, grants from Astrazeneca, grants and personal fees from Pfizer, grants and personal fees from Bayer Healthcare, grants and personal fees from Grifols, personal fees from Napp, outside the submitted work.Conflict of interest: Dr. Koh has nothing to disclose.Conflict of interest: Dr. Abisheganaden has nothing to disclose.Conflict of interest: Dr. Connolly has nothing to disclose.Conflict of interest: Dr. Koh has nothing to disclose.Conflict of interest: Dr. Mac Aogáin has nothing to disclose.Conflict of interest: Dr. Nagarajan has nothing to disclose.Conflict of interest: Dr. Chandrasekaran has nothing to disclose.Conflict of interest: Dr. Chotirmall has nothing to disclose.Conflict of interest: Dr. Matta has nothing to disclose.Conflict of interest: Dr. Pang has nothing to disclose.Conflict of interest: Dr. Low has nothing to disclose.Conflict of interest: Dr. Ong has nothing to disclose.Conflict of interest: Dr. Hassan has nothing to disclose.Conflict of interest: Dr. Gwee has nothing to disclose.Conflict of interest: Dr. Sio has nothing to disclose.Conflict of interest: Dr. Lee has nothing to disclose.