Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis.

Gijs, Pieter-Jan; Daccord, Cécile; Bernasconi, Eric; Brutsche, Martin; Clarenbach, Christian F; Hostettler, Katrin; Guler, Sabina A.; Mercier, Louis; Ubags, Niki; Funke-Chambour, Manuela; von Garnier, Christophe (2023). Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis. ERJ Open Research, 9(3) European Respiratory Society 10.1183/23120541.00720-2022

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BACKGROUND

High bacterial burden in the lung microbiota predicts progression of idiopathic pulmonary fibrosis (IPF). Azithromycin (AZT) is a macrolide antibiotic known to alter the lung microbiota in several chronic pulmonary diseases, and observational studies have shown a positive effect of AZT on mortality and hospitalisation rate in IPF. However, the effect of AZT on the lung microbiota in IPF remains unknown.

METHODS

We sought to determine the impact of a 3-month course of AZT on the lung microbiota in IPF. We assessed sputum and oropharyngeal swab specimens from 24 adults with IPF included in a randomised controlled crossover trial of oral AZT 500 mg 3 times per week. 16S rRNA gene amplicon sequencing and quantitative PCR (qPCR) were performed to assess bacterial communities. Antibiotic resistance genes (ARGs) were assessed using real-time qPCR.

RESULTS

AZT significantly decreased community diversity with a stronger and more persistent effect in the lower airways (sputum). AZT treatment altered the temporal kinetics of the upper (oropharyngeal swab) and lower airway microbiota, increasing community similarity between the two sites for 1 month after macrolide cessation. Patients with an increase in ARG carriage had lower bacterial density and enrichment of the genus Streptococcus. In contrast, patients with more stable ARG carriage had higher bacterial density and enrichment in Prevotella.

CONCLUSIONS

AZT caused sustained changes in the diversity and composition of the upper and lower airway microbiota in IPF, with effects on the temporal and spatial dynamics between the two sites.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Rheumatology and Immunology
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Pneumology

UniBE Contributor:

Guler, Sabina Anna, Funke-Chambour, Manuela

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2312-0541

Publisher:

European Respiratory Society

Language:

English

Submitter:

Pubmed Import

Date Deposited:

26 May 2023 16:01

Last Modified:

26 May 2023 16:11

Publisher DOI:

10.1183/23120541.00720-2022

PubMed ID:

37228285

BORIS DOI:

10.48350/182930

URI:

https://boris.unibe.ch/id/eprint/182930

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