Airway fungal and bacterial microbiota in allergic bronchopulmonary aspergillosis

<bold>Introduction:</bold> Fungal and bacterial microbiota play an important role in the development of allergic bronchopulmonary aspergillosis (ABPA). We aim to characterize airway microbiome in ABPA patients and controls. <bold>Methods:</bold> Bronchoalveolar lavage fluid (BALF) was collected from 32 ABPA subjects, 18 eosinophilic granulomatosis with polyangiitis (EGPA) subjects and 15 non-cystic fibrosis bronchiectasis subjects. 16S rRNA and internal transcribed space (ITS) sequencing were performed to evaluate the microbiota profile with different airway inflammatory conditions. <bold>Results:</bold> 1. Mycobiome: Compared with EGPA patients, ABPA and bronchiectasis patients exhibited significantly increased fungal alpha diversities in the airway (p<0.001, Chao1 index). Mycobiome community compositions differed among the three groups (β-diversity, Adonis p=0.001). Linear discriminant analysis Effect Size (LEfSe) found that <italic>Aspergillaceae</italic>, <italic>Xeromyces</italic>, <italic>Albonectria</italic>, <italic>Colletotrichum</italic>, <italic>Vanrija</italic>, <italic>Idriella</italic>, <italic>Engyodontium</italic> were enriched in ABPA patients. While the abundances of <italic>Sarocladium</italic> and <italic>Talaromyces</italic> were higher in EGPA patients. 2. Bacteriome: lower lung bacteriobiota α-diversity was observed in ABPA and bronchiectasis patients than in EGPA patients (p=0.0013 and p=0.011 for Simpson index). β-diversity was dissimilar between ABPA and both EGPA and bronchiectasis patients (Adonis p=0.001 and p=0.031, respectively). <italic>Ralstonia</italic>, <italic>Neisseria</italic> and <italic>Delftia</italic> were more abundant in the ABPA airways, while <italic>Haemophilus</italic>, <italic>Actinomyces</italic>, <italic>Rothia</italic> and <italic>Cutibacterium</italic> were increased in bronchiectasis patients. <bold>Conclusions:</bold> Lung microbiota profile changes among differential airway phenotypes. Patients with ABPA contain distinct biodiversity and microbiome composition.