RT Journal Article
SR Electronic
T1 IMMUNOLOGICAL COROLLARY OF THE PULMONARY MYCOBIOME IN BRONCHIECTASIS: THE CAMEB STUDY
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1800766
DO 10.1183/13993003.00766-2018
A1 Micheál Mac Aogáin
A1 Ravishankar Chandrasekaran
A1 Albert Lim Yick Hou
A1 Low Teck Boon
A1 Gan Liang Tan
A1 Tidi Hassan
A1 Ong Thun How
A1 Amanda Hui Qi Ng
A1 Denis Bertrand
A1 Jia Yu Koh
A1 Sze Lei Pang
A1 Zi Yang Lee
A1 Xiao Wei Gwee
A1 Christopher Martinus
A1 Yang Yie Sio
A1 Sri Anusha Matta
A1 Fook Tim Chew
A1 Holly R. Keir
A1 John E. Connolly
A1 John Arputhan Abisheganaden
A1 Mariko Siyue Koh
A1 Niranjan Nagarajan
A1 James D. Chalmers
A1 Sanjay H. Chotirmall
YR 2018
UL http://erj.ersjournals.com/content/early/2018/05/31/13993003.00766-2018.abstract
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.