Inhaled Corticosteroids Selectively Alter the Microbiome and Host Transcriptome in the Small Airways of Patients with Chronic Obstructive Pulmonary Disease

BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are commonly treated with inhaled corticosteroid/long-acting ß2-agonist combination therapy. While previous studies have investigated the host-microbiome interactions in COPD, the effects of specific steroid formulations on this complex cross-talk remain obscure.

METHODS: We collected and evaluated data from the Study to Investigate the Differential Effects of Inhaled Symbicort and Advair on Lung Microbiota (DISARM), a randomized controlled trial. Bronchoscopy was performed on COPD patients before and after treatment with salmeterol/fluticasone, formoterol/budesonide or formoterol-only. Bronchial brush samples were processed for microbial 16S rRNA gene sequencing and host mRNA sequencing. Longitudinal changes in the microbiome at a community, phylum and genus level were correlated with changes in host gene expression using a Spearman's rank correlation test.

FINDINGS: In COPD patients treated with salmeterol/fluticasone, the expression levels of 676 host genes were significantly correlated to changes in the alpha diversity of the small airways. At a genus level, the expression levels of 122 host genes were significantly related to changes in the relative abundance of Haemophilus. Gene enrichment analyses revealed the enrichment of pathways and biological processes related to innate and adaptive immunity and inflammation. None of these changes were evident in patients treated with formoterol/budesonide or formoterol alone.

INTERPRETATION: Changes in the microbiome following salmeterol/fluticasone treatment are related to alterations in the host transcriptome in the small airways of patients with COPD. These data may provide insights into why some COPD patients treated with inhaled corticosteroids may be at an increased risk for airway infection, including pneumonia.

FUNDING: The Canadian Institute of Health Research, the British Columbia Lung Association, and an investigator-initiated grant from AstraZeneca.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:10

Enthalten in:

Biomedicines - 10(2022), 5 vom: 11. Mai

Sprache:

Englisch

Beteiligte Personen:

Yip, William [VerfasserIn]
Li, Xuan [VerfasserIn]
Koelwyn, Graeme J [VerfasserIn]
Milne, Stephen [VerfasserIn]
Leitao Filho, Fernando Sergio [VerfasserIn]
Yang, Chen Xi [VerfasserIn]
Hernández Cordero, Ana I [VerfasserIn]
Yang, Julia [VerfasserIn]
Yang, Cheng Wei Tony [VerfasserIn]
Shaipanich, Tawimas [VerfasserIn]
van Eeden, Stephan F [VerfasserIn]
Leung, Janice M [VerfasserIn]
Lam, Stephen [VerfasserIn]
McNagny, Kelly M [VerfasserIn]
Sin, Don D [VerfasserIn]

Links:

Volltext

Themen:

16S rRNA gene sequencing
Bronchoscopy
Budesonide
COPD
Fluticasone
Inflammation
Inhaled corticosteroids
Journal Article
MRNA-sequencing
Microbiome
Transcriptomics

Anmerkungen:

Date Revised 16.07.2022

published: Electronic

Citation Status PubMed-not-MEDLINE

doi:

10.3390/biomedicines10051110

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM341481289