Division of Pulmonary/Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA.
Research Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
NPJ Biofilms Microbiomes. 2021 Feb 5;7(1):14. doi: 10.1038/s41522-021-00185-9.
Chronic obstructive pulmonary disease (COPD) is heterogeneous in development, progression, and phenotypes. Little is known about the lung microbiome, sampled by bronchoscopy, in milder COPD and its relationships to clinical features that reflect disease heterogeneity (lung function, symptom burden, and functional impairment). Using bronchoalveolar lavage fluid collected from 181 never-smokers and ever-smokers with or without COPD (GOLD 0-2) enrolled in the SubPopulations and InteRmediate Outcome Measures In COPD Study (SPIROMICS), we find that lung bacterial composition associates with several clinical features, in particular bronchodilator responsiveness, peak expiratory flow rate, and forced expiratory flow rate between 25 and 75% of FVC (FEF). Measures of symptom burden (COPD Assessment Test) and functional impairment (six-minute walk distance) also associate with disparate lung microbiota composition. Drivers of these relationships include members of the Streptococcus, Prevotella, Veillonella, Staphylococcus, and Pseudomonas genera. Thus, lung microbiota differences may contribute to airway dysfunction and airway disease in milder COPD.
慢性阻塞性肺疾病（COPD）在发展、进展和表型上具有异质性。对于通过支气管镜取样的轻度 COPD 中的肺部微生物组及其与反映疾病异质性的临床特征（肺功能、症状负担和功能障碍）之间的关系，我们知之甚少。使用来自从未吸烟者和有或没有 COPD（GOLD 0-2）的吸烟者的支气管肺泡灌洗液，这些人参与了 COPD 亚人群和中间结局测量研究（SPIROMICS），我们发现肺部细菌组成与几个临床特征相关，特别是支气管扩张剂反应性、呼气峰流速和用力呼气流量率在 FVC 的 25%至 75%之间（FEF）。症状负担（COPD 评估测试）和功能障碍（六分钟步行距离）的测量也与不同的肺部微生物群落组成相关。这些关系的驱动因素包括链球菌、普雷沃菌、韦荣球菌、葡萄球菌和假单胞菌属的成员。因此，肺部微生物组的差异可能导致轻度 COPD 中的气道功能障碍和气道疾病。
