PT  - JOURNAL ARTICLE
AU  - Ashley Sullivan
AU  - Chris Ward
AU  - Deborah Casey
AU  - Deirdre Flynn
AU  - Eoin B. Hunt
AU  - Joseph A. Eustace
AU  - Paul M. O' Byrne
AU  - Barry J. Plant
AU  - John A. Macsharry
AU  - Desmond M. Murphy
TI  - The impact of anti-IgE treatment on the airway microbiome in asthma
AID  - 10.1183/13993003.congress-2020.5284
DP  - 2020 Sep 07
TA  - European Respiratory Journal
PG  - 5284
VI  - 56
IP  - suppl 64
4099  - http://erj.ersjournals.com/content/56/suppl_64/5284.short
4100  - http://erj.ersjournals.com/content/56/suppl_64/5284.full
SO  - Eur Respir J2020 Sep 07; 56
AB  - Introduction: Severe asthma accounts for 5-10% of asthmatics. Omalizumab is an effective add on therapy for the treatment of severe allergic IgE mediated asthma. Little is known as to its effect on the lung microbiome.Aims and Objectives: Our aim was to elucidate potential differences in microbial diversity in a cohort of well-defined severe asthmatics after treatment with omalizumab.Methods: 9 severe asthmatics underwent bronchoscopy with bronchoalveolar lavage (BAL) pre- and post-omalizumab treatment. Cell differentials and cytokine levels were determined and DNA extraction performed. BAL cell pellet (CP, phagocytosed bacteria) and bacteria pellet (BP, free bacteria) derived DNA underwent qPCR to determine the presence and identity of microbes pre- and post- omalizumabResults: Microbes such as Prevotella, Veillonella, N. bacilliformis and M. catharralis remained at consistent levels within the patient cohort irrespective of treatment. Following omalizumab therapy there was an increased detection of Bordetella (CP) (0% to 89%), C. pneumoniae (CP) (11% to 89%) and (BP) (22% to 67%), N. meningitidis (CP) (22% to 100%) and (BP) (11% to 78%), S. pneumoniae (CP) (33% to 89%), H. influenzae (CP) (44% to 100%) and S. aureus (BP) (0% to78%). A decrease in the detection of microbes such as Bordetella (BP) (56% to 22%), M. pneumonaie (BP) (44% to 22%) and H. influenzae (BP) (78% to 55%) was observed.Conclusions: These findings suggest monoclonal asthma treatments such as omalizumab may affect lung microbial diversity.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 5284.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).