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Observational Study
. 2019 Jun 24;19(1):112.
doi: 10.1186/s12890-019-0867-x.

Relationship between the respiratory microbiome and the severity of airflow limitation, history of exacerbations and circulating eosinophils in COPD patients

Laura Millares  1   2   3 , Sergi Pascual  4 , Concepción Montón  3   5   6   7 , Marian García-Núñez  1   2   3 , Cristina Lalmolda  1   2 , Rosa Faner  2   7 , Carme Casadevall  2   4   8 , Laia Setó  1   2 , Silvia Capilla  9 , Amàlia Moreno  5 , Ady Angélica Castro-Acosta  2   10 , Carlos José Alvarez-Martinez  2   10 , Oriol Sibila  7   11 , Germán Peces-Barba  2   12 , Borja G Cosio  2   13 , Alvar Agustí  2   7   14 , Joaquim Gea  2   4   7   8 , Eduard Monsó  15   16   17   18
Affiliations
Observational Study

Relationship between the respiratory microbiome and the severity of airflow limitation, history of exacerbations and circulating eosinophils in COPD patients

Laura Millares et al. BMC Pulm Med. .

Abstract

Background: The respiratory microbiome is altered in COPD patients but its relationship with core components of the disease, such as the severity of airflow limitation, the frequency of exacerbations or the circulating levels of eosinophils, is unclear.

Methods: Cross-sectional study comprising 72 clinically stable COPD patients (mean age 68 [SD 7.9] years; FEV1 48.7 [SD 20.1]% of reference) who provided spontaneous sputum samples for 16S rRNA gene amplification and sequencing. The microbiome composition was analysed with QIIME.

Results: We observed that: (1) more severe airflow limitation was associated with reduced relative abundance (RA) of Treponema and an increase in Pseudomonas; (2) patients with ≥2 exacerbations the previous year showed a significantly different bacterial community with respect to non-exacerbators (p = 0.014), with changes in 13 genera, including an increase of Pseudomonas, and finally, (3) peripheral eosinophils levels ≥2% were associated with more diverse microbiome [Chao1 224.51 (74.88) vs 277.39 (78.92) p = 0.006; Shannon 3.94 (1.05) vs 4.54 (1.06) p = 0.020], and a significant increase in the RAs of 20 genera.

Conclusion: The respiratory microbiome in clinically stable COPD patients varies significantly according to the severity of airflow limitation, previous history of exacerbations and circulating eosinophils levels.

Keywords: Bacterial community; Diversity; Eosinophils; Exacerbations; Sputum; Stable COPD.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Genera showing significant differences in their relative abundance according to GOLD severity level, with higher figures for Treponema in GOLD 1 (b) and for Pseudomonas in GOLD 4 (a) (dotted line = median)
Fig. 2
Fig. 2
The RA of three genera significantly increased (a) and 10 genera decreased (b) in patients with ≥2 exacerbations the previous year compared with non-exacerbators (dotted line = median)
Fig. 3
Fig. 3
Genera with significantly higher (n = 20) (b) and lower (a) RAs (n = 1) in patients with circulating eosinophils ≥2% (dotted line = median)
Fig. 4
Fig. 4
α-diversity parameters, Chao1 (a) and Shannon (b), in patients classified according to circulating eosinophils ≥2%
See this image and copyright information in PMC

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