The airways fungal microbiota and risk for coronary heart disease in COPD patients and healthy controls

<bold>Background:</bold> The role of the upper and lower airways mycobiome in health and disease is yet unexplored. We aimed to characterize the mycobiome in COPD patients and healthy controls, stratified by risk of coronary heart disease. <bold>Methods:</bold> 81 COPD patients and 90 healthy controls who had concurrent coronary computed tomography angiography (CCTA) scans from the MicroCOPD Study in Bergen, Norway, were included. The ITS1 gene was sequenced from oral wash (OW) and broncheoalveolar lavage (BAL) samples with an Illumina HiSeq. Calcium score was estimated from the CT scans and dichotomized as < and ≥ 100 as a marker of coronary heart disease risk. <bold>Results:</bold> The mean relative frequency of the most abundant classes and genera in COPD and controls were stratified by calcium score (Figure 1). Analysis of compositions of microbiomes with bias correction (ANCOM-BC2) revealed that Sordiamycetes, Eurotiomycetes and Agaricomycetes were significantly (p<0.02 all) less abundant in BAL in healthy controls, whereas Tremellomycetes were less abundant in BAL in COPD patients with high calcium score (p=0.007), after adjustment for sex, age and smoking. For OW there were 6/17 classes of fungi who differed between those with low and high calcium score among controls, and 4/17 among COPD patients. <bold>Conclusion:</bold> The oral and lower airways mycobiome differed by risk of coronary heart disease in both COPD patients and healthy controls. <fig><object-id>erj;64/suppl_68/OA4572/F1</object-id><object-id>F1</object-id><object-id>F1</object-id><graphic></graphic></fig>