Long-Term Risk of Mortality Associated with Isolation of Pseudomonas aeruginosa in COPD: A Systematic Review and Meta-Analysis

Martínez-García, Miguel Ángel; Rigau, David; Barrecheguren, Miriam; García-Ortega, Alberto; Núñez, Alexa; Oscullo, Grace; Miravitlles, Marc

doi:10.2147/copd.s346294

Cited by 17 publications

(18 citation statements)

References 42 publications

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“…During the early stages of COPD, airways are predominantly colonized with H. influenzae, M. catarrhalis, and S. pneumoniae. These bacterial species drive inflammation and tissue damage as previously described ( 111 , 115 – 117 , 119 – 121 ). Mechanisms of tissue damage induced by these bacteria are discussed further in the following sections.…”

Section: Airway Bacterial Colonizationmentioning

confidence: 88%

“…These effects are mediated via the release of bacterial outer membrane vesicles harboring extracellular products, such as LPS, a potent inflammatory stimulus demonstrated by earlier studies to induce lung emphysema in hamsters ( 118 ). Several COPD human studies have supported this hypothesis, showing that bacterial colonization of the airways induces inflammation ( 111 , 115 – 117 , 119 – 121 ) and impairs lung function (FEV 1 ) ( 122 ).…”

Section: Introductionmentioning

confidence: 90%

“…Following the publication of early reports in 2010 describing the lung microbiome ( 112 – 115 ), authors revised the vicious circle to suggest that insults such as tobacco smoke exposure, which impair airway mucosal defenses mediate dysbiosis, leading to dysregulated immune response, further impairment of mucosal defense and ensuing dysbiosis, inducing inflammation and further dysbiosis ( 99 ). In distal airways, this inflammation contributes to tissue damage and progressive obstruction, as is the case for P. aeruginosa and N. subflava ( 9 , 116 , 117 ). These effects are mediated via the release of bacterial outer membrane vesicles harboring extracellular products, such as LPS, a potent inflammatory stimulus demonstrated by earlier studies to induce lung emphysema in hamsters ( 118 ).…”

Section: Introductionmentioning

confidence: 99%

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Airway microbiome-immune crosstalk in chronic obstructive pulmonary disease

et al. 2023

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Chronic Obstructive Pulmonary Disease (COPD) has significantly contributed to global mortality, with three million deaths reported annually. This impact is expected to increase over the next 40 years, with approximately 5 million people predicted to succumb to COPD-related deaths annually. Immune mechanisms driving disease progression have not been fully elucidated. Airway microbiota have been implicated. However, it is still unclear how changes in the airway microbiome drive persistent immune activation and consequent lung damage. Mechanisms mediating microbiome-immune crosstalk in the airways remain unclear. In this review, we examine how dysbiosis mediates airway inflammation in COPD. We give a detailed account of how airway commensal bacteria interact with the mucosal innate and adaptive immune system to regulate immune responses in healthy or diseased airways. Immune-phenotyping airway microbiota could advance COPD immunotherapeutics and identify key open questions that future research must address to further such translation.

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Section: Airway Bacterial Colonizationmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Airway microbiome-immune crosstalk in chronic obstructive pulmonary disease

et al. 2023

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“…The meta-analysis also revealed that individuals with COPD had an adjusted higher death risk when PA separated from sputum. 78 …”

Section: Discussionmentioning

confidence: 99%

Global Research Trends on the Link Between the Microbiome and COPD: A Bibliometric Analysis

Chen¹,

Zeng²,

Liu³

et al. 2023

COPD

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Background The pathogenesis of chronic obstructive pulmonary disease (COPD) has been studied in relation to the microbiome, providing space for more targeted interventions and new treatments. Numerous papers on the COPD microbiome have been reported in the last 10 years, yet few publications have used bibliometric methods to evaluate this area. Methods We searched the Web of Science Core Collection for all original research articles in the field of COPD microbiome from January 2011 to August 2022 and used CiteSpace for visual analysis. Results A total of 505 relevant publications were obtained, and the number of global publications in this field is steadily increasing every year, with China and the USA occupying the first two spots in international publications. Imperial College London and the University of Leicester produced the most publications. Brightling C from the UK was the most prolific writer, while Huang Y and Sze M from the USA were first and second among the authors cited. The American Journal of Respiratory and Critical Care Medicine had the highest frequency of citations. The top 10 institutions, cited authors and journals are mostly from the UK and the US. In the ranking of citations, the first article was a paper published by Sze M on changes in the lung tissue’s microbiota in COPD patients. The keywords “exacerbation”, “gut microbiota”, “lung microbiome”, “airway microbiome”, “bacterial colonization”, and “inflammation” were identified as cutting-edge research projects for 2011–2022. Conclusion Based on the visualization results, in the future, we can use the gut–lung axis as the starting point to explore the immunoinflammatory mechanism of COPD, and study how to predict the effects of different treatments of COPD by identifying the microbiota, and how to achieve the optimal enrichment of beneficial bacteria and the optimal consumption of harmful bacteria to improve COPD.

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“…The isolation of PA in sputum in COPD deserves special attention. Old studies have shown that PA has a role in exacerbations, particularly in more severe COPD patients, 45 and new evidence suggest that PA may be associated with increased mortality in COPD; 46 , 47 all these studies support a role of PA in the progression of the disease. Murphy et al 48 observed that acquisition of PA was frequently followed by the development of an exacerbation and that approximately one third of PA strains demonstrated persistence, irrespective of the development of an immunological response mediated by antibodies.…”

Section: Introductionmentioning

confidence: 98%

The Impact of Chronic Bronchial Infection in COPD: A Proposal for Management

Martínez-García¹,

Miravitlles²

2022

COPD

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Up to 50% of patients with chronic obstructive pulmonary disease (COPD) in stable state may carry potentially pathogenic microorganisms (PPMs) in their airways. The presence of PPMs has been associated with increased symptoms, increased risk and severity of exacerbations, a faster decline in lung function and impairment in quality of life. Although some clinical trials have demonstrated a reduction in exacerbations in patients chronically treated with systemic antibiotics, particularly macrolides, the selection of patients was based on the previous frequency of exacerbations and not on the presence of PPMs in their airways. Therefore, unlike in bronchiectasis, there is a lack of evidence-based recommendations for assessment and treatment of the presence of PPMs in either single or repeated isolations in COPD. In this article, we propose that chronic bronchial infection (CBI) in COPD be defined as the isolation of the same PPM in at least three sputum samples separated by more than one month; we review the impact of CBI on the natural course of COPD and suggest a course of action in patients with a single isolation of a PPM or suspected CBI. Antibiotic treatment in stable COPD should be recommended based on four main criteria: a) the presence of comorbid bronchiectasis, b) the demonstration of a single or multiple isolation of the same PPM, c) the clinical impact of CBI on the patients, and d) the type of PPM, either Pseudomonas aeruginosa or non-pseudomonal PPM. These recommendations are derived from evidence generated in patients with bronchiectasis and, until new evidence specifically obtained in COPD is available, they may help in the management of these challenging patients with COPD. Existing evidence suggests that inhaled therapy is insufficient to manage patients with moderate-to-severe COPD, frequent exacerbations, and CBI. New studies must be conducted in this particularly demanding population.

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Long-Term Risk of Mortality Associated with Isolation of Pseudomonas aeruginosa in COPD: A Systematic Review and Meta-Analysis

Cited by 17 publications

References 42 publications

Airway microbiome-immune crosstalk in chronic obstructive pulmonary disease

Airway microbiome-immune crosstalk in chronic obstructive pulmonary disease

Global Research Trends on the Link Between the Microbiome and COPD: A Bibliometric Analysis

The Impact of Chronic Bronchial Infection in COPD: A Proposal for Management

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