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Multicenter Study
. 2024 Mar;23(2):252-261.
doi: 10.1016/j.jcf.2023.11.010. Epub 2023 Dec 28.

Longitudinal changes in the cystic fibrosis airway microbiota with time and treatment

Gisli G Einarsson  1 , Laura J Sherrard  2 , Joseph E Hatch  3 , Bryan Zorn  3 , Elinor Johnston  2 , Clodagh McGettigan  2 , Katherine O'Neill  2 , Deirdre F Gilpin  2 , Damian G Downey  2 , Michelle Murray  4 , Gillian Lavelle  4 , Gerry McElvaney  4 , Matthew C Wolfgang  3 , Richard Boucher  3 , Marianne S Muhlebach  3 , Ian Bradbury  5 , J Stuart Elborn  2 , Michael M Tunney  2
Affiliations
Free article
Multicenter Study

Longitudinal changes in the cystic fibrosis airway microbiota with time and treatment

Gisli G Einarsson et al. J Cyst Fibros. 2024 Mar.
Free article

Abstract

Background: Whether there is any benefit in integrating culture-independent molecular analysis of the lower airway microbiota of people with cystic fibrosis into clinical care is unclear. This study determined the longitudinal trajectory of the microbiota and if there were microbiota characteristics that corresponded with response to treatment or predicted a future pulmonary exacerbation.

Methods: At least one sputum sample was collected from 149 participants enrolled in this prospective longitudinal multi-centre study and total bacterial density and microbiota community measurements were determined and compared with clinical parameters.

Results: In 114 participants with paired samples when clinically stable, ∼8 months apart, the microbiota remained conserved between timepoints, regardless of whether participants received acute intravenous antibiotic treatment or not. In 62 participants, who presented with an acute exacerbation, a decrease in community richness correlated best with patient response to antibiotic treatment. Analysis of baseline samples from 30 participants who exacerbated within 4 months of their stable sample being collected and 72 participants who remained stable throughout the study showed that community characteristics such as lower richness at baseline may be predictive of an exacerbation in addition to several clinical parameters. However, lasso regression analysis indicated that only lung function (p = 0.014) was associated with a future exacerbation.

Conclusions: The airway microbiota remains stable over periods <1 year with modest shifts related to treatment apparent which might provide some additional insights to patient-level measurements.

Keywords: Exacerbations; Microbiota; Pseudomonas aeruginosa; Respiratory infections.

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Conflict of interest statement

Declaration of Competing Interest MMT and JSE report grants from Northern Ireland Health and Social Care Research and Development Office and MSM reports grants from National Institutes of Health HL084934, during the conduct of the study. NGMcE reports grants from US-Ireland partnership/Science Foundation Ireland/Health Research Board, during the conduct of the study. JSE and MMT also reports grants from the EU Innovative Medicines Initiative, outside the submitted work. MMT reports grants from Novartis, Basilea Pharmaceutica, Alaxia SAS, and Polyphor outside the submitted work. JSE reports grants, personal fees and clinical trial involvement with Vertex and clinical trial involvement with Celtaxsys and Corbus Pharmaceuticals, outside the submitted work. RCB reports personal fees from and has a patent pending with Parion Sciences, outside the submitted work. All other authors report no conflicts of interest.

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