The impact of COPD with frequent acute exacerbation and respiratory failure on micro-biology in the respiratory tract_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

CHEN Wen ¹ , ZHANG Xiangyan ^1,2,3 , YE Xianwei ^1,2,3 , DONG Han ² ,  ZHANG Cheng ^1,2

1. Guizhou Medical University, Guiyang, Guizhou 550025, P. R. China;
2. Department of Respiratory and Critical Care Medicine, Guizhou Provincial Peoples’s Hospital, Guiyang, Guizhou 550002, P. R. China;
3. Key Laboratory of Diagnosis and Treatment of Pulmonary Immune Diseases, National Health and Construction Commission, Guiyang, Guizhou 550002, P. R. China;

Corresponding author：

ZHANG Cheng, Email: 315861985@qq.com

Keywords：

Chronic obstructive pulmonary disease; respiratory failure; frequency of acute exacerbation; microbiome; high-throughout-sequencing

DOI：

10.7507/1671-6205.202208065

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Objective To investigate the characteristics of micro-biology in the respiratory tract in the patients who were suffering acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with/without their respiratory failures as well as with the high/low frequency of exacerbation. Methods Sixty confirmed subjects in the Department of Respiratory and Critical Care in Guizhou Provincial Hospital from Nov. 2021 to Mar. 2022 were chosen and then divided them into two pairs of sub-groups randomly. Sub-group pairs one were based on the frequency of AECOPD: higher frequency and lower frequency. Sub-group pairs two were based on whether the patients were once with respiratory failure or not. 16S rRNA high-throughput sequencing method was used to detect sputum microecology. The Alpha and Beta diversity of each subgroup, and the differences in bacterial composition and relative abundance, were compared. Results For the AECOPD group with low-frequent of exacerbation, its diversity and abundance of microbiology were higher than those group with high-frequent of exacerbation. The group of AECOPD with respiratory failure had lower bacteria micro diversity but abundancy was higher than those group without respiratory failure. Conclusion The frequency of AECOPD and whether it is with respiratory failure is related to the change of micro-biology in respiratory tract, so such change plays a great role in this disease.

Citation： CHEN Wen, ZHANG Xiangyan, YE Xianwei, DONG Han, ZHANG Cheng. The impact of COPD with frequent acute exacerbation and respiratory failure on micro-biology in the respiratory tract. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(5): 305-310. doi: 10.7507/1671-6205.202208065 Copy

1.	Liang LR, Li CW, Shen Y, et al. Long-term trends in hospitalization and outcomes in adult patients with exacerbation of chronic obstructive pulmonary disease in Beijing, China, from 2008 to 2017. Int J Chron Obstruct Pulmon Dis, 2020, 15: 1155-1164.
2.	Collard HR, Ryerson CJ, Corte TJ, et a1. Acute exacerbation of idiopathic pulmonary fibrosis. An International Working Group report. Am J Respir Crit Care Med, 2016, 194(3): 265-275.
3.	Sethi S, Murphy TF. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med, 2008 , 359(22): 2355-2365.
4.	Papi A, Bellettato CM, Braccioni F, et a1. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med, 2006, 173(10): 1114-1121.
5.	Delhaes L, Monchy S, Fréalle E, et a1. The airway microbiota in cystic fibrosis: a complex fungal and bacterial community - implications for therapeutic management. PLoS One, 2012, 7(4): e36313.
6.	Edwards MR, Bartlett NW, Hussell T, et a1. The microbiology of asthma. Nat Rev Microbiol, 2012, 10(7): 459-471.
7.	Busse WW, Lemanske RF Jr, Gern JE. Role of viral respiratory infections in asthma and asthma exacerbations. Lancet, 2010, 376(9743): 826-834.
8.	Djukanović R, Gadola SD. Virus infection, asthma, and chronic obstructive pulmonary disease. N Engl J Med, 2008, 359(19): 2062-2064.
9.	Dicker AJ, Huang JTJ, Lonergan M, et al. The sputum microbiome, airway inflammation, and mortality in chronic obstructive pulmonary disease. J Allergy Clin Immunol, 2021, 147(1): 158-167.
10.	陈军, 彭亚, 毛锦娟, 等. 慢性阻塞性肺疾病患者继发呼吸衰竭的危险因素的系统评价. 华西医学, 2021, 36(11): 1563-1569.
11.	曹林发. 慢性阻塞性肺疾病并发呼吸衰竭相关危险因素分析. 江西医药, 2010, 45(2): 129-131.
12.	蒋旭宏, 王原, 华军益, 等. 急诊科C、D类慢性阻塞性肺疾病急性发作患者细菌分布及耐药性分析. 中华急诊医学杂志, 2013, 22(6): 626-629.
13.	Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease 2021 report[EB/OL]. (2020-11-17)[2020-12-15]. https://goldcopd.org/gold-reports/.
14.	陈亚红, 郑丹蕾. 对慢性阻塞性肺疾病急性加重定义相关问题的几点思考. 中华医学杂志, 2019, 99 (32): 2481-2484.
15.	Pothirat C, Chaiwong W, Limsukon A, et al. Detection of acute deterioration in health status visit among COPD patients by monitoring COPD assessment test score. Int J Chron Obstruct Pulmon Dis, 2015, 10(1): 277-282.
16.	Jones PW, Chen WH, Wilcox TK, et al. Characterizing and quantifying the symptomatic features of COPD exacerbations. Chest, 2011, 139(6): 1388-1394.
17.	Leidy NK, Wilcox TK, Jones PW, et al. Standardizing measurement of chronic obstructive pulmonary disease exacerbations: reliability and validity of a patient-reported diary. Am J Respir Crit Care Med, 2011, 183(3): 323–329.
18.	慢性阻塞性肺疾病急性加重 (AECOPD) 诊治专家组. 慢性阻塞性肺疾病急性加重 (AECOPD) 诊治中国专家共识 (2017 年更新版). 国际呼吸杂志, 2017, 37(14): 1041-1057.
19.	Tett A, Pasolli E, Masetti G, et al. Prevotella diversity, niches and interactions with the human host. Nat Rev Microbiol, 2021, 19(9): 585-599.
20.	Garcia-Clemente M, de la Rosa D, Máiz L, et al. Impact of Pseudomonas aeruginosa infection on patients with chronic inflammatory airway diseases. J Clin Med, 2020, 9(12): 3800.
21.	Budden KF, Gellatly SL, Wood DLA, et al. Emerging pathogenic links between microbiota and the gut-lung axis. Nat Rev Microbiol, 2017, 15(1): 55-63.
22.	Dang AT, Marsland BJ. Microbes, metabolites, and the gut-lung axis. Mucosal Immunol, 2019, 12(4): 843-850.
23.	Huang YJ, Sethi S, Murphy T, et al. Airway microbiome dynamics in exacerbations of chronic obstructive pulmonary disease. J Clin Microbiol, 2014, 52(8): 2813-2823.
24.	Hilty M, Burke C, Pedro H, et al. Disordered microbial communities in asthmatic airways. PLoS One, 2010, 5(1): e8578.
25.	Rodrigo-Troyano A, Melo V, Marcos PJ, et a1. Pseudomonas aeruginosa in chronic obstructive pulmonary disease patients with frequent hospitalized exacerbations: a prospective multicentre study. Respiration, 2018, 96(5): 417-424.
26.	曹彬, 蔡柏蔷. 关注细菌感染在慢性阻塞性肺疾病急性加重时的作用. 中华内科杂志, 2006, 45(12): 969-970.
27.	Juneau RA, Pang B, Armbruster CE, et al. Peroxiredoxin-glutaredoxin and catalase promote resistance of nontypeable Haemophilus influenzae 86-028NP to oxidants and survival within neutrophil extracellular traps. Infect Immun, 2015, 83(1): 239-246.
28.	Morrow JD, Chase RP, Parker MM, et al. RNA-sequencing across three matched tissues reveals shared and tissue-specific gene expression and pathway signatures of COPD. Respir Res, 2019, 20(1): 65.
29.	Galiana A, Aguirr E, Rodridguez JC, et al. Sputum microbiota in moderate versus severe patients with COPD. Eur Respir J, 2014, 43(6): 1787-1790.
30.	Mayhew D, Devos N, Lambert C, et al. Longitudinal profiling of the lung microbiome in the AERIS study demonstrates repeatability of bacterial and eosinophilic COPD exacerbations. Thorax, 2018, 73(5): 422-430.
31.	徐圣葆. 慢性阻塞性肺疾病并发呼吸衰竭相关危险因素分析. 中国医师进修杂志, 2010, 33(10): 4-6.
32.	Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004, 350(10): 1005-1012.
33.	陈红. 慢性阻塞性肺疾病致急性呼吸衰竭的危险因素分析. 中国实用医药, 2017, 12(30): 61-62.
34.	Millares L, Ferrari R, Gallego M, et al. Bronchial microbiome of severe COPD patients colonised by Pseudomonas aeruginosa. Eur J Clin Microbiol Infect Dis, 2014, 33(7): 1101-1111.

1. Liang LR, Li CW, Shen Y, et al. Long-term trends in hospitalization and outcomes in adult patients with exacerbation of chronic obstructive pulmonary disease in Beijing, China, from 2008 to 2017. Int J Chron Obstruct Pulmon Dis, 2020, 15: 1155-1164.
2. Collard HR, Ryerson CJ, Corte TJ, et a1. Acute exacerbation of idiopathic pulmonary fibrosis. An International Working Group report. Am J Respir Crit Care Med, 2016, 194(3): 265-275.
3. Sethi S, Murphy TF. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med, 2008 , 359(22): 2355-2365.
4. Papi A, Bellettato CM, Braccioni F, et a1. Infections and airway inflammation in chronic obstructive pulmonary disease severe exacerbations. Am J Respir Crit Care Med, 2006, 173(10): 1114-1121.
5. Delhaes L, Monchy S, Fréalle E, et a1. The airway microbiota in cystic fibrosis: a complex fungal and bacterial community - implications for therapeutic management. PLoS One, 2012, 7(4): e36313.
6. Edwards MR, Bartlett NW, Hussell T, et a1. The microbiology of asthma. Nat Rev Microbiol, 2012, 10(7): 459-471.
7. Busse WW, Lemanske RF Jr, Gern JE. Role of viral respiratory infections in asthma and asthma exacerbations. Lancet, 2010, 376(9743): 826-834.
8. Djukanović R, Gadola SD. Virus infection, asthma, and chronic obstructive pulmonary disease. N Engl J Med, 2008, 359(19): 2062-2064.
9. Dicker AJ, Huang JTJ, Lonergan M, et al. The sputum microbiome, airway inflammation, and mortality in chronic obstructive pulmonary disease. J Allergy Clin Immunol, 2021, 147(1): 158-167.
10. 陈军, 彭亚, 毛锦娟, 等. 慢性阻塞性肺疾病患者继发呼吸衰竭的危险因素的系统评价. 华西医学, 2021, 36(11): 1563-1569.
11. 曹林发. 慢性阻塞性肺疾病并发呼吸衰竭相关危险因素分析. 江西医药, 2010, 45(2): 129-131.
12. 蒋旭宏, 王原, 华军益, 等. 急诊科C、D类慢性阻塞性肺疾病急性发作患者细菌分布及耐药性分析. 中华急诊医学杂志, 2013, 22(6): 626-629.
13. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease 2021 report[EB/OL]. (2020-11-17)[2020-12-15]. https://goldcopd.org/gold-reports/.
14. 陈亚红, 郑丹蕾. 对慢性阻塞性肺疾病急性加重定义相关问题的几点思考. 中华医学杂志, 2019, 99 (32): 2481-2484.
15. Pothirat C, Chaiwong W, Limsukon A, et al. Detection of acute deterioration in health status visit among COPD patients by monitoring COPD assessment test score. Int J Chron Obstruct Pulmon Dis, 2015, 10(1): 277-282.
16. Jones PW, Chen WH, Wilcox TK, et al. Characterizing and quantifying the symptomatic features of COPD exacerbations. Chest, 2011, 139(6): 1388-1394.
17. Leidy NK, Wilcox TK, Jones PW, et al. Standardizing measurement of chronic obstructive pulmonary disease exacerbations: reliability and validity of a patient-reported diary. Am J Respir Crit Care Med, 2011, 183(3): 323–329.
18. 慢性阻塞性肺疾病急性加重 (AECOPD) 诊治专家组. 慢性阻塞性肺疾病急性加重 (AECOPD) 诊治中国专家共识 (2017 年更新版). 国际呼吸杂志, 2017, 37(14): 1041-1057.
19. Tett A, Pasolli E, Masetti G, et al. Prevotella diversity, niches and interactions with the human host. Nat Rev Microbiol, 2021, 19(9): 585-599.
20. Garcia-Clemente M, de la Rosa D, Máiz L, et al. Impact of Pseudomonas aeruginosa infection on patients with chronic inflammatory airway diseases. J Clin Med, 2020, 9(12): 3800.
21. Budden KF, Gellatly SL, Wood DLA, et al. Emerging pathogenic links between microbiota and the gut-lung axis. Nat Rev Microbiol, 2017, 15(1): 55-63.
22. Dang AT, Marsland BJ. Microbes, metabolites, and the gut-lung axis. Mucosal Immunol, 2019, 12(4): 843-850.
23. Huang YJ, Sethi S, Murphy T, et al. Airway microbiome dynamics in exacerbations of chronic obstructive pulmonary disease. J Clin Microbiol, 2014, 52(8): 2813-2823.
24. Hilty M, Burke C, Pedro H, et al. Disordered microbial communities in asthmatic airways. PLoS One, 2010, 5(1): e8578.
25. Rodrigo-Troyano A, Melo V, Marcos PJ, et a1. Pseudomonas aeruginosa in chronic obstructive pulmonary disease patients with frequent hospitalized exacerbations: a prospective multicentre study. Respiration, 2018, 96(5): 417-424.
26. 曹彬, 蔡柏蔷. 关注细菌感染在慢性阻塞性肺疾病急性加重时的作用. 中华内科杂志, 2006, 45(12): 969-970.
27. Juneau RA, Pang B, Armbruster CE, et al. Peroxiredoxin-glutaredoxin and catalase promote resistance of nontypeable Haemophilus influenzae 86-028NP to oxidants and survival within neutrophil extracellular traps. Infect Immun, 2015, 83(1): 239-246.
28. Morrow JD, Chase RP, Parker MM, et al. RNA-sequencing across three matched tissues reveals shared and tissue-specific gene expression and pathway signatures of COPD. Respir Res, 2019, 20(1): 65.
29. Galiana A, Aguirr E, Rodridguez JC, et al. Sputum microbiota in moderate versus severe patients with COPD. Eur Respir J, 2014, 43(6): 1787-1790.
30. Mayhew D, Devos N, Lambert C, et al. Longitudinal profiling of the lung microbiome in the AERIS study demonstrates repeatability of bacterial and eosinophilic COPD exacerbations. Thorax, 2018, 73(5): 422-430.
31. 徐圣葆. 慢性阻塞性肺疾病并发呼吸衰竭相关危险因素分析. 中国医师进修杂志, 2010, 33(10): 4-6.
32. Celli BR, Cote CG, Marin JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004, 350(10): 1005-1012.
33. 陈红. 慢性阻塞性肺疾病致急性呼吸衰竭的危险因素分析. 中国实用医药, 2017, 12(30): 61-62.
34. Millares L, Ferrari R, Gallego M, et al. Bronchial microbiome of severe COPD patients colonised by Pseudomonas aeruginosa. Eur J Clin Microbiol Infect Dis, 2014, 33(7): 1101-1111.

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