國家衛生研究院 NHRI:Item 3990099045/15269
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    题名: Lung microbiota and neutrophilic inflammation associated with clinical outcomes in bronchiectasis and chronic obstructive pulmonary disease overlap
    作者: Chen, Y;Hou, H;Chien, N;Lu, K;Cheng, S;Chien, J;Lin, C;Liao, Y;Chen, C;Wang, H;Hsueh, P;Yu, C
    贡献者: Institute of Population Health Sciences
    摘要: 9Rationale: Bronchiectasis and COPD overlap (BCO) or “COPD-bronchiectasis association” has been reported with higher degree of airway inflammation, more clinical symptoms, greater disease severity, and worse prognosis than individual disease. The association of lung microbiota and inflammatory status in BCO is a poorly researched area. We assess the lung microbiota, airway inflammation and clinical outcomes in patients with BCO compared with individuals with COPD or bronchiectasis without overlap in East Asian population. Methods: Patients with a clinical diagnosis of COPD or bronchiectasis were prospectively recruited between November 2018 and February2022. Bronchoalveolar lavage (BAL) samples were collected for the assessment of conventional culture, 16S ribosomal RNA (16S rRNA) sequencing and inflammatory markers. Negative control samples for background contamination were performed by using prevalence and frequency methods in dcontanm. Quantification high-resolution computed tomography was used to evaluate the severity of emphysema and the radiological severity of bronchiectasis. Results: In total, 195consecutively stable patients with COPD and/or bronchiectasis were enrolled and 181 patients were included in the final analysis (including 86 patients with COPD, 46 patients with bronchiectasis, and 49 patients with BCO). Patients with BCO and bronchiectasis shared highly similar microbiome communities, which exhibited lower alpha diversity and are predominant of Proteobacteria when compared with COPD. Expectedly, patients in BCO group displayed more disease severity, greater neutrophilic inflammation as well as higher risk of future exacerbation when compared with individual disease without overlap. Interestingly, two entities of BCO group (COPD and bronchiectasis as primary diagnosis), present with distinct clinical features and inflammatory profiles as well as small difference of microbiome communities. Further analysis revealed that Pseudomonas genera correlated with neutrophilic inflammation which could be a dominant trait in BCO linked to exacerbation. In contrast, patients with predominance of Firmicutesa long with higher microbial diversity and commensal taxa could be another trait in COPD dominant cohort. Nevertheless, we did not identify any specific taxon that was associated with eosinophilic inflammation. Another novel finding is that two oral taxa (Treponema socranskii and Dialister invisus) in BCO group were associated with airway neutrophilic inflammation and exacerbation. Conclusions: Our study is among the first to investigate the lung microbiome and airway inflammation associated with BCO in an East Asian cohort by using both COPD and bronchiectasis as comparators. The lung microbiota in BCO is very closer to bronchiectasis, Proteobacteria and neutrophilic inflammation are characterized in BCO associated with future exacerbation.
    日期: 2023-05-21
    關聯: American Journal of Respiratory and Critical Care Medicine. 2023 May 21;207:Meeting Abstract A2655.
    Link to: http://dx.doi.org/10.1164/ajrccm-conference.2023.207.1_MeetingAbstracts.A2655
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1073-449X&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000995814702308
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