Hayoung Choi,Hollian Richardson,Chandani Hennayake,Morven Shuttleworth,Erin Cant,Mathieu Bottier,Arietta Spinou,Kara Robertson,Merete Long,Anthony De Soyza,Felix C Ringshausen,Pieter Goeminne,Natalie Lorent,Charles Haworth,Josje Altenburg,Michael R Loebinger,Daniela Alferes de Lima Headley,Alison J Dicker,Francesco Blasi,Michal Shteinberg,Stefano Aliberti,Eva Polverino,Oriol Sibila,Amelia Shoemark,James D Chalmers
{"title":"支气管扩张的上呼吸道微生物组,纤毛粘膜功能和临床结果:来自EMBARC-BRIDGE研究的数据。","authors":"Hayoung Choi,Hollian Richardson,Chandani Hennayake,Morven Shuttleworth,Erin Cant,Mathieu Bottier,Arietta Spinou,Kara Robertson,Merete Long,Anthony De Soyza,Felix C Ringshausen,Pieter Goeminne,Natalie Lorent,Charles Haworth,Josje Altenburg,Michael R Loebinger,Daniela Alferes de Lima Headley,Alison J Dicker,Francesco Blasi,Michal Shteinberg,Stefano Aliberti,Eva Polverino,Oriol Sibila,Amelia Shoemark,James D Chalmers","doi":"10.1164/rccm.202504-0875oc","DOIUrl":null,"url":null,"abstract":"RATIONALE\r\nInfection is a key disease driver in bronchiectasis, and the upper airway microbiome has been known to shape the lower airway microbiome.\r\n\r\nOBJECTIVES\r\nTo evaluate the relationship between the upper airway microbiome, mucociliary function, and clinical outcomes in bronchiectasis.\r\n\r\nMETHODS\r\nNasopharyngeal swabs were collected from 344 bronchiectasis patients enrolled across five European centers. A total of 104 patients had nasopharyngeal samples obtained at the 1-year follow-up. Microbiome composition was assessed according to BSI and severe exacerbations. The α- and β-diversity were measured using the Chao1 and Bray-Curtis indices, respectively. Random forest analysis was performed. Dysbiosis was defined as >10% relative abundance of pathogenic taxa comprising Pseudomonas, Haemophilus, and Staphylococcus.\r\n\r\nMEASUREMENTS AND MAIN RESULTS\r\nOf the 344 patients, 200 (58.1%) were female (median age, 68 years; interquartile range, 59-75 years). α-diversity significantly differed according to disease severity (P=0.002), and β-diversity analysis revealed distinct microbiome profiles associated with disease severity and severe exacerbation (PERMANOVA, P=0.021 and 0.001, respectively). Random forest analysis identified Pseudomonas as being associated with severe bronchiectasis (BSI≥9) and severe exacerbations. The genus-level relative taxon abundance of Pseudomonas was well correlated with Pseudomonas aeruginosa growth in the sputum culture. Patients with nasopharyngeal dysbiosis had more severe respiratory symptoms, showed epithelial disruption on nasal epithelial biopsy, and experienced more severe exacerbation over a 1-year follow-up period than those in the non-dysbiosis group. The microbiome profiles were relatively stable between baseline and 1-year follow-up (P=0.95).\r\n\r\nCONCLUSION\r\nThe upper airway microbiome is associated with disease severity and severe exacerbation of bronchiectasis.","PeriodicalId":7664,"journal":{"name":"American journal of respiratory and critical care medicine","volume":"36 1","pages":""},"PeriodicalIF":19.4000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Upper Airway Microbiome, Mucociliary Function, and Clinical Outcomes in Bronchiectasis: Data from the EMBARC-BRIDGE Study.\",\"authors\":\"Hayoung Choi,Hollian Richardson,Chandani Hennayake,Morven Shuttleworth,Erin Cant,Mathieu Bottier,Arietta Spinou,Kara Robertson,Merete Long,Anthony De Soyza,Felix C Ringshausen,Pieter Goeminne,Natalie Lorent,Charles Haworth,Josje Altenburg,Michael R Loebinger,Daniela Alferes de Lima Headley,Alison J Dicker,Francesco Blasi,Michal Shteinberg,Stefano Aliberti,Eva Polverino,Oriol Sibila,Amelia Shoemark,James D Chalmers\",\"doi\":\"10.1164/rccm.202504-0875oc\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"RATIONALE\\r\\nInfection is a key disease driver in bronchiectasis, and the upper airway microbiome has been known to shape the lower airway microbiome.\\r\\n\\r\\nOBJECTIVES\\r\\nTo evaluate the relationship between the upper airway microbiome, mucociliary function, and clinical outcomes in bronchiectasis.\\r\\n\\r\\nMETHODS\\r\\nNasopharyngeal swabs were collected from 344 bronchiectasis patients enrolled across five European centers. A total of 104 patients had nasopharyngeal samples obtained at the 1-year follow-up. Microbiome composition was assessed according to BSI and severe exacerbations. The α- and β-diversity were measured using the Chao1 and Bray-Curtis indices, respectively. Random forest analysis was performed. Dysbiosis was defined as >10% relative abundance of pathogenic taxa comprising Pseudomonas, Haemophilus, and Staphylococcus.\\r\\n\\r\\nMEASUREMENTS AND MAIN RESULTS\\r\\nOf the 344 patients, 200 (58.1%) were female (median age, 68 years; interquartile range, 59-75 years). α-diversity significantly differed according to disease severity (P=0.002), and β-diversity analysis revealed distinct microbiome profiles associated with disease severity and severe exacerbation (PERMANOVA, P=0.021 and 0.001, respectively). Random forest analysis identified Pseudomonas as being associated with severe bronchiectasis (BSI≥9) and severe exacerbations. The genus-level relative taxon abundance of Pseudomonas was well correlated with Pseudomonas aeruginosa growth in the sputum culture. Patients with nasopharyngeal dysbiosis had more severe respiratory symptoms, showed epithelial disruption on nasal epithelial biopsy, and experienced more severe exacerbation over a 1-year follow-up period than those in the non-dysbiosis group. The microbiome profiles were relatively stable between baseline and 1-year follow-up (P=0.95).\\r\\n\\r\\nCONCLUSION\\r\\nThe upper airway microbiome is associated with disease severity and severe exacerbation of bronchiectasis.\",\"PeriodicalId\":7664,\"journal\":{\"name\":\"American journal of respiratory and critical care medicine\",\"volume\":\"36 1\",\"pages\":\"\"},\"PeriodicalIF\":19.4000,\"publicationDate\":\"2025-09-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of respiratory and critical care medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1164/rccm.202504-0875oc\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of respiratory and critical care medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1164/rccm.202504-0875oc","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Upper Airway Microbiome, Mucociliary Function, and Clinical Outcomes in Bronchiectasis: Data from the EMBARC-BRIDGE Study.
RATIONALE
Infection is a key disease driver in bronchiectasis, and the upper airway microbiome has been known to shape the lower airway microbiome.
OBJECTIVES
To evaluate the relationship between the upper airway microbiome, mucociliary function, and clinical outcomes in bronchiectasis.
METHODS
Nasopharyngeal swabs were collected from 344 bronchiectasis patients enrolled across five European centers. A total of 104 patients had nasopharyngeal samples obtained at the 1-year follow-up. Microbiome composition was assessed according to BSI and severe exacerbations. The α- and β-diversity were measured using the Chao1 and Bray-Curtis indices, respectively. Random forest analysis was performed. Dysbiosis was defined as >10% relative abundance of pathogenic taxa comprising Pseudomonas, Haemophilus, and Staphylococcus.
MEASUREMENTS AND MAIN RESULTS
Of the 344 patients, 200 (58.1%) were female (median age, 68 years; interquartile range, 59-75 years). α-diversity significantly differed according to disease severity (P=0.002), and β-diversity analysis revealed distinct microbiome profiles associated with disease severity and severe exacerbation (PERMANOVA, P=0.021 and 0.001, respectively). Random forest analysis identified Pseudomonas as being associated with severe bronchiectasis (BSI≥9) and severe exacerbations. The genus-level relative taxon abundance of Pseudomonas was well correlated with Pseudomonas aeruginosa growth in the sputum culture. Patients with nasopharyngeal dysbiosis had more severe respiratory symptoms, showed epithelial disruption on nasal epithelial biopsy, and experienced more severe exacerbation over a 1-year follow-up period than those in the non-dysbiosis group. The microbiome profiles were relatively stable between baseline and 1-year follow-up (P=0.95).
CONCLUSION
The upper airway microbiome is associated with disease severity and severe exacerbation of bronchiectasis.
期刊介绍:
The American Journal of Respiratory and Critical Care Medicine focuses on human biology and disease, as well as animal studies that contribute to the understanding of pathophysiology and treatment of diseases that affect the respiratory system and critically ill patients. Papers that are solely or predominantly based in cell and molecular biology are published in the companion journal, the American Journal of Respiratory Cell and Molecular Biology. The Journal also seeks to publish clinical trials and outstanding review articles on areas of interest in several forms. The State-of-the-Art review is a treatise usually covering a broad field that brings bench research to the bedside. Shorter reviews are published as Critical Care Perspectives or Pulmonary Perspectives. These are generally focused on a more limited area and advance a concerted opinion about care for a specific process. Concise Clinical Reviews provide an evidence-based synthesis of the literature pertaining to topics of fundamental importance to the practice of pulmonary, critical care, and sleep medicine. Images providing advances or unusual contributions to the field are published as Images in Pulmonary, Critical Care, Sleep Medicine and the Sciences.
A recent trend and future direction of the Journal has been to include debates of a topical nature on issues of importance in pulmonary and critical care medicine and to the membership of the American Thoracic Society. Other recent changes have included encompassing works from the field of critical care medicine and the extension of the editorial governing of journal policy to colleagues outside of the United States of America. The focus and direction of the Journal is to establish an international forum for state-of-the-art respiratory and critical care medicine.