The Role of Lung Colonization in Connective Tissue Disease-Associated Interstitial Lung Disease

Rícci, Alberto; Pagliuca, Alessandra; Vermi, Morgana; Pizzirusso, Dario; Innammorato, Marta; Sglavo, Raffaele; Scarso, Francesco; Salemi, Simonetta; Laganà, Bruno; Rosa, Roberta; D’Ascanio, Michela

doi:10.3390/microorganisms9050932

Cited by 9 publications

(7 citation statements)

References 51 publications

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“…In addition, in our study, elevated pulmonary FDG uptake was associated with pulmonary bacterial/fungal infection and elevated IIM disease activity. These findings reflect the focal immune abnormality of both IIM and an infectious background, consistent with previous reports that CTD-related immune alterations and infectious triggers played important roles in the progressive phenotype of CTD-ILD [38,39].…”

Section: Discussionsupporting

confidence: 92%

The lungs were on fire: a pilot study of 18F-FDG PET/CT in idiopathic-inflammatory-myopathy-related interstitial lung disease

Liang

Liu

et al. 2021

Arthritis Res Ther

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Background Interstitial lung disease (ILD) and its rapid progression (RP) are the main contributors to unfavourable outcomes of patients with idiopathic inflammatory myopathy (IIM). This study aimed to identify the clinical value of PET/CT scans in IIM-ILD patients and to construct a predictive model for RP-ILD. Methods Adult IIM-ILD patients who were hospitalized at four divisions of the First Affiliated Hospital, Zhejiang University School of Medicine (FAHZJU), from 1 January 2017 to 31 December 2020 were reviewed. PET/CT scans and other characteristics of patients who met the inclusion and exclusion criteria were collected and analysed. Results A total of 61 IIM-ILD patients were enrolled in this study. Twenty-one patients (34.4%) developed RP-ILD, and 24 patients (39.3%) died during follow-up. After false discovery rate (FDR) correction, the percent-predicted diffusing capacity of the lung for carbon monoxide (DLCO%, P = 0.014), bilateral lung mean standard uptake value (SUVmean, P = 0.014) and abnormal mediastinal lymph node (P = 0.045) were significantly different between the RP-ILD and non-RP-ILD groups. The subsequent univariate and multivariate logistic regression analyses verified our findings. A “DLM” model was established by including the above three values to predict RP-ILD with a cut-off value of ≥ 2 and an area under the curve (AUC) of 0.905. Higher bilateral lung SUVmean (P = 0.019) and spleen SUVmean (P = 0.011) were observed in IIM-ILD patients who died within 3 months, and a moderate correlation was recognized between the two values. Conclusions Elevated bilateral lung SUVmean, abnormal mediastinal lymph nodes and decreased DLCO% were significantly associated with RP-ILD in IIM-ILD patients. The “DLM” model was valuable in predicting RP-ILD and requires further validation.

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Section: Discussionsupporting

confidence: 92%

The lungs were on fire: a pilot study of 18F-FDG PET/CT in idiopathic-inflammatory-myopathy-related interstitial lung disease

Liang

Liu

et al. 2021

Arthritis Res Ther

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“…The presence of respiratory bacteria such as H. influenzae and S. pneumoniae has been associated with a poorer prognosis [ 20 , 22 ]. In COPD and ILD, H. influenzae and P. aeruginosa are frequently isolated, and their colonization has been associated with exacerbations or progression [ 8 , 23 ]. Similarly, the isolation of P. aeruginosa has been associated with impaired lung function and increased mortality in bronchiectasis [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Respiratory Bacterial Findings on Patients with Chronic Pulmonary Aspergillosis

Cho,

Moon,

Kim

et al. 2024

International Journal of Microbiology

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Background. Distinct bacterial strains may affect the prognosis of patients with chronic respiratory diseases. However, little is known about the clinical significance of respiratory bacteria in patients with chronic pulmonary aspergillosis (CPA), a progressive and debilitating disease caused by Aspergillus spp. Objectives. This study aimed to analyze data obtained from CPA patients and their sputum or bronchial washing samples and investigate the prevalence and composition of respiratory bacteria and clinical implications. Patients and Methods. We retrospectively reviewed the data of patients diagnosed with CPA between March 2019 and February 2023 in a tertiary referral hospital. We assessed the clinical characteristics and overall and pneumonia-specific survival rates of patients with CPA based on the presence of bacteria. Results and Conclusions. We included 142 patients with CPA. The most commonly identified bacteria were Klebsiella pneumoniae (22.5%), followed by Pseudomonas aeruginosa (21.8%) and Escherichia coli (4.2%). Patients with isolated bacteria had a higher prevalence of older age, female sex, diabetes, and a history of extrathoracic malignancy than those without isolated bacteria (P=0.024,0.013,0.021,and 0.034, respectively). Furthermore, over a median follow-up of 11 (4–21) months, the pneumonia-specific mortality rate was 13.4% (19/142), which was higher in patients with isolated bacteria than in those without (P=0.045, log-rank test). Particularly, patients with the presence of P. aeruginosa had a significantly higher mortality rate from pneumonia than those without the presence of P. aeruginosa (adjusted hazard ratio, 3.34; P=0.015). In conclusion, CPA patients with isolated bacteria, especially P. aeruginosa, showed higher mortality rates due to pneumonia. Performing tests to identify bacteria in the lower respiratory tract of patients with CPA may be helpful in predicting future prognosis. Further studies are required to validate these findings in diverse ethnic groups.

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“…An abundance of microbiota lives both inside and outside the human body. Investigation of the microbiota has contributed dramatically to our understanding of their critical role in multiple human diseases, such as cancers, infectious diseases, and lung diseases (1)(2)(3)(4). The "Human Microbiome Project" was launched in 2007 to understand the complexity of the human microbiome, which has also contributed to the understanding of pathogenesis in a wide range of human diseases (5).…”

Section: Introductionmentioning

confidence: 99%

Potential Association Between Changes in Microbiota Level and Lung Diseases: A Meta-Analysis

Chai

Wang

et al. 2022

Front. Med.

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Objective:Lung microbiota is increasingly implicated in multiple types of respiratory diseases. However, no study has drawn a consistent conclusion regarding the relationship between changes in the microbial community and lung diseases. This study verifies the association between microbiota level and lung diseases by performing a meta-analysis.Methods:Literature databases, including PubMed, ISI Web of Science, Embase, Google Scholar, PMC, and CNKI, were used to collect related articles published before March 20, 2021. The standard mean deviation (SMD) and related 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup, sensitivity, and publication bias analyses were also conducted.Results:Six studies, comprising 695 patients with lung diseases and 176 healthy individuals, were included in this meta-analysis. The results indicated that the microbiota level was higher in patients with lung diseases than in healthy individuals (SMD = 0.39, 95% CI = 0.22–0.55, I2 = 91.5%, P < 0.01). Subgroup analysis based on country demonstrated that the microbiota level was significantly higher in Chinese (SMD = 1.90, 95% CI = 0.87–2.93, I2 = 62.3%, P < 0.01) and Korean (SMD = 0.24, 95% CI = 0.13–0.35, I2 = 78.7%, P < 0.01) patients with lung diseases. The microbiota level of patients with idiopathic pulmonary fibrosis (IPF) (SMD = 1.40, 95% CI = 0.42–2.38, I2 = 97.3%, P = 0.005), chronic obstructive pulmonary disease (COPD) (SMD = 0.30, 95% CI = 0.09–0.50, I2 = 83.9%, P = 0.004), and asthma (SMD = 0.19, 95% CI = 0.06–0.32, I2 = 69.4%, P = 0.004) were significantly higher than those of the healthy group, whereas a lower microbiota level was found in patients with chronic hypersensitivity pneumonitis (CHP). The microbiota level significantly increased when the disease sample size was >50. Subgroup analysis based on different microbiota genera, indicated that Acinetobacter baumannii and Pseudomonas aeruginosa were significantly increased in COPD and asthma diseases.Conclusion:We observed that patients with IPF, COPD, and asthma had a higher microbiota level, whereas patients with CHP had a lower microbiota level compared to the healthy individuals. The level of A. baumannii and P. aeruginosa were significantly higher in patients with COPD and asthma, and thus represented as potential microbiota markers in the diagnosis and treatment of lung diseases.

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The Role of Lung Colonization in Connective Tissue Disease-Associated Interstitial Lung Disease

Cited by 9 publications

References 51 publications

The lungs were on fire: a pilot study of 18F-FDG PET/CT in idiopathic-inflammatory-myopathy-related interstitial lung disease

The lungs were on fire: a pilot study of 18F-FDG PET/CT in idiopathic-inflammatory-myopathy-related interstitial lung disease

Impact of Respiratory Bacterial Findings on Patients with Chronic Pulmonary Aspergillosis

Potential Association Between Changes in Microbiota Level and Lung Diseases: A Meta-Analysis

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