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Sputum microbiome profiles identify severe asthma phenotypes of relative stability at 12 to 18 months
- Source :
- Journal of Allergy and Clinical Immunology, 147(1), 123. Mosby Inc., Journal of allergy and clinical immunology, 147(1), 123-134. Mosby Inc.
- Publication Year :
- 2021
-
Abstract
- Background: Asthma is a heterogeneous disease characterized by distinct phenotypes with associated microbial dysbiosis. Objectives: Our aim was to identify severe asthma phenotypes based on sputum microbiome profiles and assess their stability after 12 to 18 months. A further aim was to evaluate clusters’ robustness after inclusion of an independent cohort of patients with mild-to-moderate asthma. Methods: In this longitudinal multicenter cohort study, sputum samples were collected for microbiome profiling from a subset of the Unbiased Biomarkers in Prediction of Respiratory Disease Outcomes adult patient cohort at baseline and after 12 to 18 months of follow-up. Unsupervised hierarchical clustering was performed by using the Bray-Curtis β-diversity measure of microbial profiles. For internal validation, partitioning around medoids, consensus cluster distribution, bootstrapping, and topological data analysis were applied. Follow-up samples were studied to evaluate within-patient clustering stability in patients with severe asthma. Cluster robustness was evaluated by using an independent cohort of patients with mild-to-moderate asthma. Results: Data were available for 100 subjects with severe asthma (median age 55 years; 42% males). Two microbiome-driven clusters were identified; they were characterized by differences in asthma onset, smoking status, residential locations, percentage of blood and/or sputum neutrophils and macrophages, lung spirometry results, and concurrent asthma medications (all P values < .05). The cluster 2 patients displayed a commensal-deficient bacterial profile that was associated with worse asthma outcomes than those of the cluster 1 patients. Longitudinal clusters revealed high relative stability after 12 to 18 months in those with severe asthma. Further inclusion of an independent cohort of 24 patients with mild-to-moderate asthma was consistent with the clustering assignments. Conclusion: Unbiased microbiome-driven clustering revealed 2 distinct robust phenotypes of severe asthma that exhibited relative overtime stability. This suggests that the sputum microbiome may serve as a biomarker for better characterizing asthma phenotypes.
- Subjects :
- Spirometry
Male
medicine.medical_specialty
Allergy
Time Factors
Immunology
asthma phenotypes
Severity of Illness Index
Specimen Handling
03 medical and health sciences
0302 clinical medicine
neutrophils
Internal medicine
medicine
follow-up
unbiased clusters
Humans
Immunology and Allergy
030212 general & internal medicine
Microbiome
Asthma
U-BIOPRED Study Group
metagenomics
medicine.diagnostic_test
business.industry
Microbiota
Sputum
lung function
Middle Aged
medicine.disease
respiratory tract diseases
macrophages
030228 respiratory system
1107 Immunology
Cohort
Biomarker (medicine)
Sputum microbiome
Female
medicine.symptom
business
Cohort study
Follow-Up Studies
Subjects
Details
- Language :
- English
- ISSN :
- 00916749
- Database :
- OpenAIRE
- Journal :
- Journal of Allergy and Clinical Immunology, 147(1), 123. Mosby Inc., Journal of allergy and clinical immunology, 147(1), 123-134. Mosby Inc.
- Accession number :
- edsair.doi.dedup.....589156fca2532178264942d62ac5fc16