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. 2021 Apr 27;9(5):932.
doi: 10.3390/microorganisms9050932.

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

Alberto Ricci  1 , Alessandra Pagliuca  1 , Morgana Vermi  1 , Dario Pizzirusso  1 , Marta Innammorato  1 , Raffaele Sglavo  1 , Francesco Scarso  1 , Simonetta Salemi  2 , Bruno Laganà  2 , Roberta Di Rosa  2 , Michela D'Ascanio  1
Affiliations

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

Alberto Ricci et al. Microorganisms. .

Abstract

Connective tissue diseases (CTDs) may frequently manifest with interstitial lung disease (ILD), which may severely impair quality and expectation of life. CTD-ILD generally has a chronic clinical course, with possible acute exacerbations. Although several lines of evidence indicate a relevant role of infections in the acute exacerbations of CTD-ILD, little information is available regarding the prevalence of infections in chronic CTD-ILD and their possible role in the clinical course. The aim of the present retrospective study was the identification of lung microbial colonization in broncho-alveolar lavage from patients affected by stable CTD-ILD with radiologically defined lung involvement. We demonstrated that 22.7% of patients with CTD-ILD display microbial colonization by Pseudomonas aeruginosa, Haemophilus influenzae, and non-tuberculous mycobacteria. Moreover, these patients display a major radiologic lung involvement, with higher impairment in lung function tests confirmed in a multivariate logistic regression analysis. Overall, the present study provides new information on lung colonization during CTD-ILD and its possible relationship with lung disease progression and severity.

Keywords: autoimmune disease; connective tissue diseases; high-resolution computed tomography; interstitial lung diseases; lung function tests; microbiota; pulmonary fibrosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Representative CT scan imaging demonstrating the fibrotic lung involvement in patients belonging to Group 1 (representing patients in absence of true pathogen in broncho-alveolar lavage) or Group 2 (representing patients in the presence of pathogens in broncho-alveolar lavage). Note the different fibrotic involvement. Note the ground glass and reticular opacities. Moreover, a relationship between traction bronchiectasis and bacterial colonization was not observed.
Figure 2
Figure 2
Pulmonary function test findings in patients with CTD-ILD. Group 1 (patients without bacterial colonization in broncho-alveolar lavage) or Group 2 (patients with bacterial colonization in broncho-alveolar lavage). * p < 0.05.
See this image and copyright information in PMC

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