Effects of Inhaled Corticosteroids/Long-Acting Beta-Agonists (ICS/LABA) on Airway Microbial Diversity and IL-8/IL-10 Cytokine Levels in Stable COPD.

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a severe respiratory system disorder. In recent years, the combined therapy of inhaled corticosteroids/long-acting beta-agonists (ICS/LABA) has become the primary treatment for stable COPD patients. This study aimed to investigate the effects of ICS/LABA treatment on the airway microbiota and inflammatory profiles in COPD patients.

Materials and methods: Respiratory samples were collected from 18 individuals, including 2 healthy controls, 4 COPD patients, and 12 COPD patients receiving ICS/LABA treatment. Microbial diversity sequencing was employed to analyze the respiratory microbiota, with both diversity and functional predictions performed. Inflammatory factor levels were assessed using enzyme-linked immunosorbent assay (ELISA).

Results: The COPD group exhibited a dysregulated respiratory microbiota compared to the control group. Compared to the COPD group, patients in the ICS/LABA treatment group showed a trend toward decreased α-diversity of bacterial communities in the respiratory tract, while the α- diversity of fungi significantly increased. Post-treatment, the abundance of Streptococcus and Fusicolla decreased, whereas the abundance of Moraxella and Candida increased in the respiratory tract. These findings suggest that ICS/LABA treatment may help maintain a balanced respiratory microbiota. Furthermore, patients in the treatment group exhibited a significant decrease in IL-8 levels and a notable increase in IL-10 levels, indicating that ICS/LABA therapy may modulate cytokine levels by suppressing inflammatory responses and promoting anti-inflammatory reactions.

Conclusion: The combined therapy of inhaled corticosteroids/long-acting beta-agonists (ICS/LABA) appears to regulate the gene functions of respiratory tract microbiota and IL-8/IL- 10 levels in stable COPD patients. These findings offer new insights into personalized COPD treatment and microbial interventions.