Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi · 2026
Comparative analysis of clinical outcomes and short-term treatment response of sputum microbiome between eosinophilic and non-eosinophilic COPD acute exacerbation.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
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Liu Tsunglin, Lai Ching-Han, Wu Yu-Wei, Lee Cheng-Hung, Chen Po-Lin, Wang Jiu-Yao, Hsieh Miao-Hsi, Hu Po-Hsiang, Jeng Shuen-Lin, Chuang Yu-Ching, Chuang Chiao-Hsiung, Wang Jiun-Ling, Kuo Chin-Wei
Аннотация
BACKGROUND: Eosinophilic AECOPD is a specific phenotype; however, the clinical outcomes and the short-term changes in sputum microbiome remain unclear.
METHODS: We retrospectively included AECOPD patients admitted to National Cheng Kung Universal Hospital from January 2013 to December 2022. The primary outcome was respiratory failure rate. In addition, self-expectorated sputum was prospectively collected on days 1 and 5 of hospitalization between June 2020 and May 2021, and 16S rRNA gene segments (V3-V4) were amplified for sputum microbiome identification. Eosinophilic AECOPD were defined as blood eosinophils (bEOS) exceeding 2 % at admission.
RESULTS: From the analysis of 202 AECOPD hospitalizations, patients with bEOS ≥2 % had shorter hospital stays and respiratory failure days (β-coefficient: 2.98 and -3.86, P < 0.001 and = 0.049, respectively), a lower risk of respiratory failure and intensive care unit admission (odds ratio: 0.29 and 0.35, P = 0.007 and = 0.029, respectively). In a sub-cohort of 30 AECOPD patients undergoing sputum microbiome analysis, 12 had bEOS ≥2 %, a significant decrease in Shannon diversity at the phylum level after 5 days of treatment was observed only in the bEOS <2 % group. Moreover, the relative abundance of Proteobacteria increased after treatment in the patients with bEOS ≥ 2 % while a trend of decrease was observed in those with bEOS<2 %.
CONCLUSIONS: Patients with eosinophilic AECOPD demonstrate better short-term clinical outcomes. The sputum microbiota in the eosinophilic and non-eosinophilic patients also respond differently to the treatment for AECOPD.
METHODS: We retrospectively included AECOPD patients admitted to National Cheng Kung Universal Hospital from January 2013 to December 2022. The primary outcome was respiratory failure rate. In addition, self-expectorated sputum was prospectively collected on days 1 and 5 of hospitalization between June 2020 and May 2021, and 16S rRNA gene segments (V3-V4) were amplified for sputum microbiome identification. Eosinophilic AECOPD were defined as blood eosinophils (bEOS) exceeding 2 % at admission.
RESULTS: From the analysis of 202 AECOPD hospitalizations, patients with bEOS ≥2 % had shorter hospital stays and respiratory failure days (β-coefficient: 2.98 and -3.86, P < 0.001 and = 0.049, respectively), a lower risk of respiratory failure and intensive care unit admission (odds ratio: 0.29 and 0.35, P = 0.007 and = 0.029, respectively). In a sub-cohort of 30 AECOPD patients undergoing sputum microbiome analysis, 12 had bEOS ≥2 %, a significant decrease in Shannon diversity at the phylum level after 5 days of treatment was observed only in the bEOS <2 % group. Moreover, the relative abundance of Proteobacteria increased after treatment in the patients with bEOS ≥ 2 % while a trend of decrease was observed in those with bEOS<2 %.
CONCLUSIONS: Patients with eosinophilic AECOPD demonstrate better short-term clinical outcomes. The sputum microbiota in the eosinophilic and non-eosinophilic patients also respond differently to the treatment for AECOPD.