&lt;p&gt;Prevention of Acute Exacerbation in Subjects with Moderate-to-very Severe COPD by Modulating Lower Respiratory Microbiome: Protocol of a Prospective, Multicenter, Randomized Controlled Trial&lt;/p&gt;

Hua, Jenna; Hu, Weiping; Zuo, Yi-Hui; Zhang, Jing

doi:10.2147/copd.s274005

Cited by 9 publications

(10 citation statements)

References 18 publications

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“…COPD exacerbations are acute events characterized by the worsening of respiratory symptoms [ 55 ]. A patient with COPD experiences 0.5 to 3.5 exacerbations yearly [ 3 ]. The primary cause of acute exacerbations of COPD (AECOPD) are respiratory infections (70–80%) caused predominantly by bacteria and viruses, and rarely by fungi.…”

Section: The Relation Between Microbiomes and Copd Exacerbationsmentioning

confidence: 99%

“…A difficult aspect in the follow-up and treatment of patients with COPD is that COPD exacerbations are associated with a decrease in the patients’ quality of life, health status, and the progression of the disease by increasing the rate of decline of lung function. Exacerbations are responsible for frequent medical visits, hospital admissions, and changes in medication, and are the leading cause of death in patients with COPD [ 3 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Lung and Gut Microbiome in COPD

Karakasidis

Kotsiou

Gourgoulianis

2023

JPM

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Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. The association between lung and gut microbiomes in the pathogenesis of COPD has been recently uncovered. The goal of this study was to discuss the role of the lung and gut microbiomes in COPD pathophysiology. A systematic search of the PubMed database for relevant articles submitted up to June 2022 was performed. We examined the association between the lung and gut microbiome dysbiosis, reflected in bronchoalveolar lavage (BAL), lung tissue, sputum, and feces samples, and the pathogenesis and progression of COPD. It is evident that the lung and gut microbiomes affect each other and both play a vital role in the pathogenesis of COPD. However, more research needs to be carried out to find the exact associations between microbiome diversity and COPD pathophysiology and exacerbation genesis. Another field that research should focus on is the impact of treatment interventions targeting the human microbiome in preventing COPD genesis and progression.

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Section: The Relation Between Microbiomes and Copd Exacerbationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Lung and Gut Microbiome in COPD

Karakasidis

Kotsiou

Gourgoulianis

2023

JPM

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“…Decrease in the number of exacerbations, hospital admissions, and hospitalization days NCT03449459 Completed: 2021 [30] 144 (est. *There is not an agreement between principal investigators (Pls) and the sponsor (or its agents), which restricts the PIs' rights to discuss or publish trial results after the trial is completed.…”

Section: Inhaled Antibiotics and Airway Bacterial Decolonization For ...mentioning

confidence: 99%

“…A pilot multicentric randomized controlled trial (RCT) is ongoing to evaluate the efficacy and safety of long-term intermittent inhaled amikacin in patients with moderate-to-very severe COPD (NCT03449459) ( Table 1 ). [ 30 ] The primary outcome of the study is time to the first moderate-to-severe exacerbation. Lung function, COPD assessment test (CAT) scores, modified Medical Research Council (mMRC) scale, LRT bacterial load, and adverse events are also planned to be assessed.…”

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confidence: 99%

Inhaled antibiotics and airway bacterial decolonization for patients with chronic obstructive pulmonary disease: The rationale and future

Han

Hua

et al. 2022

Journal of Translational Internal Medicine

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“…Such a downward spiral is the so-called "vicious circle hypothesis". Therefore, it has been hypothesized that regulating the lower respiratory microbiome may be helpful to prevent the acute exacerbations of COPD, slow down the disease progression, and improve the quality of life in patients with COPD [9]. At present, a large number of studies have found that inhaled or oral medications can directly/indirectly regulate respiratory microbiome, such as corticosteroids [10][11][12], antibiotics [13], and probiotics [14,15], but whether such regulation can bene t patients remains unknown [16].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary rehabilitation can alter the respiratory microbiome in patients with COPD

Zhang

et al. 2023

Preprint

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Background As one of the main causes ofchronic obstructive pulmonary disease (COPD), respiratory microbiome is of great significance to the disease progression. Meanwhile, pulmonary rehabilitation (PR), as an effective nonpharmacologicintervention for COPD, evaluation of the efficacy is limited to the improvement of symptoms and lung function, which is one-sided to a certain extent. Therefore, an individualized 2-week intensive PR programme was established in the present study for patients with COPD to investigate whether this short course of PR can have impact on respiratory microbiome in patients. Methods The patients with stable COPD who participated in this study underwent short-term, high-intensity and center-based PR programme, which included two major components: respiratory muscle training and vibration expectoration. Sputum samples were collected before and after the PR to detect alterations of respiratory microbiome by metagenomic sequencing. The main purpose was to observe changes of composition, function and resistance genes in respiratory microbiomebefore and after PR, and explore the relationship of respiratory microbiome with lung function and symptoms. Results After the 2-week intensive PR, the abundance of Firmicutes, Actinobacteria and Bacteroidetesdecreased, while that of Proteobacteria increased at the phylum level; the abundance of Streptococcus and Prevotella decreased, while that of Neisseria increased at the genus level. Concomitantly, it was found that Firmicutes, Actinobacteria, Streptococcus and Prevotella were negatively correlated with lung function and positively correlated with CAT score, while Neisseria was positively correlated with lung function and negatively correlated with CAT score. Based on the Kyoto Encyclopedia of Genes and Genomes (KEGG) database, the functional abundance of most respiratory microbiome decreased after 2-week PR. Simultaneously, the species function abundance was negatively correlated with the lung function of COPD. In addition, the resistance gene fluctuated with the attribution of the species, and the macrolide resistance genes of COPD were significantly reduced after 2-week PR. Conclusions The short course of intensive PR can alter the composition, function and antibiotic resistance genes of respiratory microbiome in patients with COPD, which plays a role by promoting the self-regulation ability of patients. This study provides a novel, gentle and non-pharmacologic intervention for the regulation of microbiome in the future.

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<p>Prevention of Acute Exacerbation in Subjects with Moderate-to-very Severe COPD by Modulating Lower Respiratory Microbiome: Protocol of a Prospective, Multicenter, Randomized Controlled Trial</p>

Cited by 9 publications

References 18 publications

Lung and Gut Microbiome in COPD

Lung and Gut Microbiome in COPD

Inhaled antibiotics and airway bacterial decolonization for patients with chronic obstructive pulmonary disease: The rationale and future

Pulmonary rehabilitation can alter the respiratory microbiome in patients with COPD

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