Prospective study on changes in the microbiome after bronchoscopic therapies in COPD

<bold>Background:</bold> Different bronchoscopic therapy options are available for patients with chronic obstructive pulmonary disease (COPD) that suffer from dyspnea, hypersecretion and exacerbations. Microbiome analyses have shown a relevant proportion of airway colonisation in COPD patients and an increase in pathogenic germs after endoscopic lung volume reduction (ELVR). Prospective data on microbiome changes after bronchoscopic interventions are lacking. <bold>Methods:</bold> This is a prospective study collecting bronchial secretion of bacterial colonization and microbiome in advanced COPD patients undergoing different bronchoscopic therapies (mainly ELVR with valves). In addition, clinical symptoms, dietary behaviour, exacerbations, mucus scoring on computed tomography, metabolic parameters (lipid and glucose metabolism) as well as metabolome analyses will be assessed before and up to 6 months after the endoscopic procedure. <bold>Results:</bold> A total of 60 patients (mean FEV1 33.5 ± 10.9 %, mean BMI 24.8 ± 4.2 kg/m²) were included in the study with collection of bronchial secretion, of whom 21 were already seen a second time (bronchoscopic procedures: 1x foam, 1x implantable artificial bronchus, 3x bronchial rheoplasty, 16x endobronchial valves). At baseline, 60% of all patients were colonized with at least one pathogen. Nine patients (42.9%) showed new pathogens after intervention (mainly <italic>Rothia mucilaginosa</italic>) and one patient had a new colonization with <italic>Pseudomonas aeruginosa</italic> after endobronchial valve implantation. <bold>Conclusion:</bold> The microbiome composition showed a specific bacterial genotype signature after bronchoscopic procedures. Further follow-up data will allow definitive conclusions.