1. Bacterial load and inflammatory response in sputum of alpha-1 antitrypsin deficiency patients with COPD.
- Author
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Balbi B, Sangiorgi C, Gnemmi I, Ferrarotti I, Vallese D, Paracchini E, Delle Donne L, Corda L, Baderna P, Corsico A, Carone M, Brun P, Cappello F, Ricciardolo FL, Ruggeri P, Mumby S, Adcock IM, Caramori G, and Di Stefano A
- Subjects
- Aged, Bacteria genetics, Bacteria pathogenicity, Bacterial Load, Case-Control Studies, Female, Host-Pathogen Interactions, Humans, Male, Middle Aged, Pulmonary Disease, Chronic Obstructive diagnosis, Pulmonary Disease, Chronic Obstructive immunology, Pulmonary Disease, Chronic Obstructive microbiology, Risk Factors, Sputum immunology, Sputum microbiology, alpha 1-Antitrypsin Deficiency diagnosis, alpha 1-Antitrypsin Deficiency immunology, alpha 1-Antitrypsin Deficiency microbiology, Bacteria isolation & purification, Inflammation Mediators analysis, Lung immunology, Lung microbiology, Pulmonary Disease, Chronic Obstructive etiology, Smoking adverse effects, alpha 1-Antitrypsin Deficiency complications
- Abstract
Background: Airway inflammation may drive the progression of chronic obstructive pulmonary disease (COPD) associated with alpha-1 antitrypsin deficiency (AATD), but the relationship between airway microbiota and inflammation has not been investigated., Methods: We studied 21 non-treated AATD (AATD-noT) patients, 20 AATD-COPD patients under augmentation therapy (AATD-AT), 20 cigarette smoke-associated COPD patients, 20 control healthy smokers (CS) and 21 non-smokers (CON) with normal lung function. We quantified sputum inflammatory cells and inflammatory markers (IL-27, CCL3, CCL5, CXCL8, LTB
4 , MPO) by ELISA, total bacterial load (16S) and pathogenic bacteria by qRT-PCR., Results: AATD-AT patients were younger but had similar spirometric and DLCO values compared to cigarette smoke-associated COPD, despite a lower burden of smoking history. Compared to cigarette smoke-associated COPD, AATD-noT and AATD-AT patients had lower sputum neutrophil levels ( p =0.0446, p =0.0135), total bacterial load (16S) ( p =0.0081, p =0.0223), M. catarrhalis ( p =0.0115, p =0.0127) and S. pneumoniae ( p =0.0013, p =0.0001). Sputum IL-27 was significantly elevated in CS and cigarette smoke-associated COPD. AATD-AT, but not AATD-noT patients, had IL-27 sputum levels (pg/ml) significantly lower than COPD ( p =0.0297) and these positively correlated with FEV1 % predicted values ( r =0.578, p =0.0307)., Conclusions: Compared to cigarette smoke-associated COPD, AATD-AT (COPD) patients have a distinct airway inflammatory and microbiological profile. The decreased sputum bacterial load and IL-27 levels in AATD-AT patients suggests that augmentation therapy play a role in these changes., Competing Interests: This study was funded by Istituti Clinici Scientifici Maugeri, IRCCS and by Grifols Inc. Grifols Inc. with a two-year grant. Grifols funding included laboratory supplies, travel expenses for collecting samples around the Country and a fellowship for a Ph.D. The authors report no other conflicts of interest in this work., (© 2019 Balbi et al.)- Published
- 2019
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