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Association between pathogens detected using quantitative polymerase chain reaction with airway inflammation in COPD at stable state and exacerbations.
Chest 2015; 147(1):46-55Chest

Abstract

BACKGROUND

Relationships between airway inflammation and respiratory potentially pathogenic microorganisms (PPMs) quantified using quantitative polymerase chain reaction (qPCR) in subjects with COPD are unclear. Our aim was to evaluate mediators of airway inflammation and their association with PPMs in subjects with COPD at stable state and during exacerbations.

METHODS

Sputum from 120 stable subjects with COPD was analyzed for bacteriology (colony-forming units; total 16S; and qPCR targeting Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae), differential cell counts, and inflammatory mediators using the Meso-Scale Discovery Platform. Subjects were classified as colonized if any PPM was identified above the threshold of detection by qPCR. Symptoms were quantified using the visual analog scale.

RESULTS

At stable state, 60% of subjects were qPCR positive for H influenzae, 48% for M catarrhalis, and 28% for S pneumoniae. Elevated sputum concentrations of IL-1β, IL-10, and tumor necrosis factor (TNF)-α were detected in samples qPCR positive for either H influenzae or M catarrhalis. Bacterial loads of H influenzae positively correlated with IL-1β, IL-8, IL-10, TNF-α, and symptoms; and M catarrhalis correlated with IL-10 and TNF-α. H influenzae qPCR bacterial load was an independent predictor of sputum TNF-α and IL-1β. In 55 subjects with paired exacerbation data, qPCR bacterial load fold change at exacerbation in M catarrhalis but not H influenzae correlated to changes in sputum TNF-α and IL-1β concentrations.

CONCLUSIONS

At stable state, H influenzae is associated with increased airway inflammation in COPD. The relationship between bacterial load changes of specific pathogens and airway inflammation at exacerbation and recovery warrants further investigation.

Authors+Show Affiliations

Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, and the Department of Infection, Immunity, and Inflammation, University of Leicester, Leicester.Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, and the Department of Infection, Immunity, and Inflammation, University of Leicester, Leicester.Department of Clinical Microbiology, University Hospitals of Leicester National Health Service Trust, Leicester.Respiratory Medicine Unit, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus, Oxford, England.Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, and the Department of Infection, Immunity, and Inflammation, University of Leicester, Leicester; Department of Clinical Microbiology, University Hospitals of Leicester National Health Service Trust, Leicester.Institute for Lung Health, National Institute for Health Research Respiratory Biomedical Research Unit, and the Department of Infection, Immunity, and Inflammation, University of Leicester, Leicester.Respiratory Medicine Unit, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus, Oxford, England. Electronic address: mona.bafadhel@ndm.ox.ac.uk.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25103335

Citation

Barker, Bethan L., et al. "Association Between Pathogens Detected Using Quantitative Polymerase Chain Reaction With Airway Inflammation in COPD at Stable State and Exacerbations." Chest, vol. 147, no. 1, 2015, pp. 46-55.
Barker BL, Haldar K, Patel H, et al. Association between pathogens detected using quantitative polymerase chain reaction with airway inflammation in COPD at stable state and exacerbations. Chest. 2015;147(1):46-55.
Barker, B. L., Haldar, K., Patel, H., Pavord, I. D., Barer, M. R., Brightling, C. E., & Bafadhel, M. (2015). Association between pathogens detected using quantitative polymerase chain reaction with airway inflammation in COPD at stable state and exacerbations. Chest, 147(1), pp. 46-55. doi:10.1378/chest.14-0764.
Barker BL, et al. Association Between Pathogens Detected Using Quantitative Polymerase Chain Reaction With Airway Inflammation in COPD at Stable State and Exacerbations. Chest. 2015;147(1):46-55. PubMed PMID: 25103335.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between pathogens detected using quantitative polymerase chain reaction with airway inflammation in COPD at stable state and exacerbations. AU - Barker,Bethan L, AU - Haldar,Koirobi, AU - Patel,Hemu, AU - Pavord,Ian D, AU - Barer,Michael R, AU - Brightling,Christopher E, AU - Bafadhel,Mona, PY - 2014/8/9/entrez PY - 2014/8/12/pubmed PY - 2015/3/11/medline SP - 46 EP - 55 JF - Chest JO - Chest VL - 147 IS - 1 N2 - BACKGROUND: Relationships between airway inflammation and respiratory potentially pathogenic microorganisms (PPMs) quantified using quantitative polymerase chain reaction (qPCR) in subjects with COPD are unclear. Our aim was to evaluate mediators of airway inflammation and their association with PPMs in subjects with COPD at stable state and during exacerbations. METHODS: Sputum from 120 stable subjects with COPD was analyzed for bacteriology (colony-forming units; total 16S; and qPCR targeting Haemophilus influenzae, Moraxella catarrhalis, and Streptococcus pneumoniae), differential cell counts, and inflammatory mediators using the Meso-Scale Discovery Platform. Subjects were classified as colonized if any PPM was identified above the threshold of detection by qPCR. Symptoms were quantified using the visual analog scale. RESULTS: At stable state, 60% of subjects were qPCR positive for H influenzae, 48% for M catarrhalis, and 28% for S pneumoniae. Elevated sputum concentrations of IL-1β, IL-10, and tumor necrosis factor (TNF)-α were detected in samples qPCR positive for either H influenzae or M catarrhalis. Bacterial loads of H influenzae positively correlated with IL-1β, IL-8, IL-10, TNF-α, and symptoms; and M catarrhalis correlated with IL-10 and TNF-α. H influenzae qPCR bacterial load was an independent predictor of sputum TNF-α and IL-1β. In 55 subjects with paired exacerbation data, qPCR bacterial load fold change at exacerbation in M catarrhalis but not H influenzae correlated to changes in sputum TNF-α and IL-1β concentrations. CONCLUSIONS: At stable state, H influenzae is associated with increased airway inflammation in COPD. The relationship between bacterial load changes of specific pathogens and airway inflammation at exacerbation and recovery warrants further investigation. SN - 1931-3543 UR - https://www.unboundmedicine.com/medline/citation/25103335/Association_between_pathogens_detected_using_quantitative_polymerase_chain_reaction_with_airway_inflammation_in_COPD_at_stable_state_and_exacerbations_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0012-3692(15)30234-8 DB - PRIME DP - Unbound Medicine ER -