Upper-Airway Microbiome, Mucociliary Function, and Clinical Outcomes in Bronchiectasis: Data from the EMBARC-BRIDGE Study

<b>Rationale:</b> Infection is a key disease driver in bronchiectasis, and the upper-airway microbiome has been known to shape the lower-airway microbiome. <b>Objective:</b> To evaluate the relationship between the upper-airway microbiome, mucociliary function, and clinical outcomes in bronchiectasis. <b>Methods:</b> Nasopharyngeal swabs were collected from 344 patients with bronchiectasis enrolled across five European centers. A total of 104 patients had nasopharyngeal samples obtained at the 1-year follow-up. Microbiome composition was assessed according to Bronchiectasis Severity Index and severe exacerbations. The α- and β-diversity were measured using the Chao1 and Bray-Curtis indices, respectively. Random forest analysis was performed. Dysbiosis was defined as >10% relative abundance of pathogenic taxa comprising <i>Pseudomonas</i>, <i>Haemophilus,</i> and <i>Staphylococcus</i>. <b>Measurements and Main Results:</b> Of the 344 patients, 200 (58.1%) were female (median age, 68 yr; IQR, 59-75 yr). α-Diversity significantly differed according to disease severity (<i>P</i> = 0.002), and β-diversity analysis revealed distinct microbiome profiles associated with disease severity and severe exacerbation (permutational multivariate ANOVA, <i>P</i> = 0.021 and <i>P</i> = 0.001, respectively). Random forest analysis identified <i>Pseudomonas</i> as being associated with severe bronchiectasis (Bronchiectasis Severity Index ⩾9) and severe exacerbations. The genus-level relative taxon abundance of <i>Pseudomonas</i> was well correlated with <i>Pseudomonas aeruginosa</i> growth in the sputum culture. Patients with nasopharyngeal dysbiosis had more severe respiratory symptoms, showed epithelial disruption on nasal epithelial biopsy, and experienced more severe exacerbation over a 1-year follow-up period than those in the nondysbiosis group. The microbiome profiles were relatively stable between baseline and 1-year follow-up (<i>P</i> = 0.95). <b>Conclusions:</b> The upper-airway microbiome is associated with disease severity and severe exacerbation of bronchiectasis.

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Journal
American Journal of Respiratory and Critical Care Medicine
Published
2025-09-12
DOI
https://doi.org/10.1164/rccm.202504-0875oc
Citations
1
Primary Topic
Cystic Fibrosis Research Advances
Type
article
Field-Weighted Citation Impact
1.52
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article

Upper-Airway Microbiome, Mucociliary Function, and Clinical Outcomes in Bronchiectasis: Data from the EMBARC-BRIDGE Study

Mathieu Bottier, Arietta Spinou, Chandani Hennayake, Josje Altenburg et al.
1 citations
American Journal of Respiratory and Critical Care Medicine
Cystic Fibrosis Research Advances
1.52
article

Upper-Airway Microbiome, Mucociliary Function, and Clinical Outcomes in Bronchiectasis: Data from the EMBARC-BRIDGE Study

Mathieu Bottier, Arietta Spinou, Chandani Hennayake, Josje Altenburg, Michal Shteinberg, Keith Robertson, Oriol Sibila, Michael R. Loebinger, Charles Haworth, Felix C. Ringshausen, Eva Polverino, Daniela Alferes, Pieter Goeminne, Erin Cant, Natalie Lorent, Amelia Shoemark, Anthony De Soyza, Alison Dicker, Hayoung Choi, Morven Shuttleworth, Francesco Blasi, James D. Chalmers, Hollian Richardson, Merete Bridget Long, Stefano Aliberti
article en
1 citations

Abstract

<b>Rationale:</b> Infection is a key disease driver in bronchiectasis, and the upper-airway microbiome has been known to shape the lower-airway microbiome. <b>Objective:</b> To evaluate the relationship between the upper-airway microbiome, mucociliary function, and clinical outcomes in bronchiectasis. <b>Methods:</b> Nasopharyngeal swabs were collected from 344 patients with bronchiectasis enrolled across five European centers. A total of 104 patients had nasopharyngeal samples obtained at the 1-year follow-up. Microbiome composition was assessed according to Bronchiectasis Severity Index and severe exacerbations. The α- and β-diversity were measured using the Chao1 and Bray-Curtis indices, respectively. Random forest analysis was performed. Dysbiosis was defined as >10% relative abundance of pathogenic taxa comprising <i>Pseudomonas</i>, <i>Haemophilus,</i> and <i>Staphylococcus</i>. <b>Measurements and Main Results:</b> Of the 344 patients, 200 (58.1%) were female (median age, 68 yr; IQR, 59-75 yr). α-Diversity significantly differed according to disease severity (<i>P</i> = 0.002), and β-diversity analysis revealed distinct microbiome profiles associated with disease severity and severe exacerbation (permutational multivariate ANOVA, <i>P</i> = 0.021 and <i>P</i> = 0.001, respectively). Random forest analysis identified <i>Pseudomonas</i> as being associated with severe bronchiectasis (Bronchiectasis Severity Index ⩾9) and severe exacerbations. The genus-level relative taxon abundance of <i>Pseudomonas</i> was well correlated with <i>Pseudomonas aeruginosa</i> growth in the sputum culture. Patients with nasopharyngeal dysbiosis had more severe respiratory symptoms, showed epithelial disruption on nasal epithelial biopsy, and experienced more severe exacerbation over a 1-year follow-up period than those in the nondysbiosis group. The microbiome profiles were relatively stable between baseline and 1-year follow-up (<i>P</i> = 0.95). <b>Conclusions:</b> The upper-airway microbiome is associated with disease severity and severe exacerbation of bronchiectasis.

American Journal of Respiratory and Critical Care MedicineVol. 211(12)
Humanitas University (IT), University of Ulster (GB), Technion – Israel Institute of Technology (IL), University of Dundee (GB), King's College London (GB), University of Milan (IT), Royal Papworth Hospital (GB), Royal Brompton & Harefield NHS Foundation Trust (GB), Universitair Ziekenhuis Leuven (BE), Sacred Heart Hospital (IE), Hospital de Sant Pau (ES), Freeman Hospital (GB), Ninewells Hospital (GB), Harefield Hospital (GB), Amsterdam UMC Location University of Amsterdam (NL), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT), Medizinische Hochschule Hannover (DE), National Institute for Health and Care Research (GB), Ospedale Maggiore (IT), Hallym University Kangnam Sacred Heart Hospital (KR), Royal Brompton Hospital (GB), Vall d'Hebron Institut de Recerca (ES), Carmel Medical Center (IL), Centro de Investigación Biomédica en Red (ES), Rappaport Family Institute for Research in the Medical Sciences (IL), Vlaamse Vereniging voor Obstetrie en Gynaecolo (BE), Vall d'Hebron Hospital Universitari (ES), German Center for Lung Research (DE), Royal Victoria Hospital (GB), Amsterdam University Medical Centers (NL), Istituti di Ricovero e Cura a Carattere Scientifico (IT), Fundació Clínic per a la Recerca Biomèdica (ES), IRCCS Humanitas Research Hospital (IT), Imperial College London (GB), University of Amsterdam (NL), University of Sheffield (GB), KU Leuven (BE)
Openalex Percentile: Top 14%
Cystic Fibrosis Research Advances
1.52
DOISourceOpenAlex
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