Frequent exacerbators of chronic obstructive pulmonary disease have distinguishable sputum microbiome signatures during clinical stability

Abstract

IntroductionFrequent exacerbation phenotype of chronic obstructive pulmonary disease (COPD) represents a more concerning disease subgroup requiring better prevention and intervention, of which airway microbiome provides new perspective for further exploration.MethodsTo investigate whether frequent exacerbators of COPD have distinguishable sputum microbiome during clinical stability, COPD patients at high disease grades with or without frequent exacerbation were recruited for sputum microbiome analysis. Sputum samples were collected during clinical stability and underwent 16S rRNA sequencing, which was then subjected for amplicon sequence variants (ASVs)-based microbiome analysis.ResultsOur results revealed that compared with healthy controls and infrequent exacerbators, frequent COPD exacerbators have distinguishably dysbiotic sputum microbiome, as featured by fewer ASVs features, lower alpha diversity, distinct beta diversity patterns. Further taxonomic compositional analysis illustrated the structural distinctions between frequent COPD exacerbators and infrequent exacerbators at differential taxa levels and highlighted Stenotrephomonas due to its prominent elevation in frequent COPD exacerbators, providing a promising candidate for further exploration of microbiome biomarker. Moreover, we also demonstrated that frequent exacerbation phenotype is distinguishable from infrequent exacerbation phenotype with respect of functional implications.ConclusionOur study demonstrated the first positive correlation between the frequent exacerbation phenotype of COPD and the sputum microbiome during clinical stability in a single-center Chinese COPD cohort and provide potential diagnostic and therapeutic targets for further investigation.

Respiratory culture growth and 3‐years lung health outcomes in children with bronchopulmonary dysplasia and tracheostomies

“…The lack of association between presence of respiratory bacteria, including P. aeruginosa , and continued use of respiratory support at 36 months posttracheostomy placement suggests that identification of pathogenic bacteria, whether during ARI or during surveillance testing, may not directly cause or propagate respiratory dysfunction. This is in contrast to what is known among other populations (i.e., cystic fibrosis, chronic obstructive pulmonary disease), in which such pathogenic respiratory bacteria has been demonstrated to decrease lung function over time, as directly measured by pulmonary function testing and indirectly measured by disease exacerbation risk 14–18,25–30 . This lack of association with ongoing respiratory support among children with tracheostomies is particularly important because it was identified in spite of the fact that children with pathogen identification had far more cultures obtained than their peers without pathogen identification.…”

“…Our findings suggest that respiratory tract P. aeruginosa, when identified risk. [14][15][16][17][18][25][26][27][28][29][30] This lack of association with ongoing respiratory support among children with tracheostomies is particularly important because it was identified in spite of the fact that children with pathogen identification had far more cultures obtained than their peers without pathogen identification. In additional analysis of what factors do drive untimely respiratory support weaning, not surprisingly, a child's number of complex chronic conditions was associated with continued need for respiratory support in this cohort.…”

Controlling Nutritional Status Score as a Predictor for Chronic Obstructive Pulmonary Disease Exacerbation Risk in Elderly Patients

“…The increased experience of AECOPD with age is probably due to biological and environmental factors [21]. The higher CAT scores and lower FEV1 values in the frequent exacerbator group, when compared to the infrequent exacerbator group, confirm the greater likelihood of frequent exacerbators to experience a less favourable clinical course, marked by a more rapid decline in lung function and poorer clinical outcomes [22]. Also, the inflammatory status plays a significant role in the evolution of COPD, and there is strong associative evidence that the inflammatory processes in COPD increase the risk of poor clinical outcomes, such as cardiovascular disease (CVD) and lung cancer [23,24].…”

Respiratory Culture Growth and 3-Year Lung Health Outcomes in Children with BPD and Tracheostomies

“…This is in contrast to what is known among other populations (i.e., cystic fibrosis, COPD), in which such pathogenic respiratory bacteria has been demonstrated to decrease lung function over time, as directly measured by pulmonary function testing and indirectly measured by disease exacerbation risk. [14][15][16][17][18][25][26][27][28][29][30] This lack of association with ongoing respiratory support among children with tracheostomies is particularly important because it was identified in spite of the fact that children with pathogen identification had far more cultures obtained than their peers without pathogen identification. In additional analysis of what factors do drive untimely respiratory support weaning, not surprisingly, a child's number of complex chronic conditions was associated with continued need for respiratory support in this cohort.…”