Airway Bacteria Quantification Using Polymerase Chain Reaction Combined with Neutrophil and Eosinophil Counts Identifies Distinct COPD Endotypes

oleh: Augusta Beech, Simon Lea, Jian Li, Natalie Jackson, Alex Mulvanny, Dave Singh

Format: Article
Diterbitkan: MDPI AG 2021-09-01

Deskripsi

Background: Chronic obstructive pulmonary disease (COPD) inflammatory endotypes are associated with different airway microbiomes. We used quantitative polymerase chain reaction (qPCR) analysis of sputum samples to establish the bacterial load upper limit in healthy controls; these values determined the bacterial colonisation prevalence in a longitudinal COPD cohort. Bacteriology combined with sputum inflammatory cells counts were used to investigate COPD endotypes. Methods: Sixty COPD patients and 15 healthy non-smoking controls were recruited. Sputum was analysed by qPCR (for <i>Haemophilus influenzae, Moraxella catarrhalis, Streptococcus pneumoniae</i> and <i>Psuedomonas aeruginosa</i>) and sputum differential cell counts at baseline and 6 months. Results: At baseline and 6 months, 23.1% and 25.6% of COPD patients were colonised with <i>H. influenzae</i>, while colonisation with other bacterial species was less common, e.g., <i>S. pneumoniae</i>—1.9% and 5.1%, respectively. <i>H. influenzae</i> + ve patients had higher neutrophil counts at baseline (90.1% vs. 67.3%, <i>p</i> < 0.01), with similar results at 6 months. COPD patients with sputum eosinophil counts ≥3% at ≥1 visit rarely showed bacterial colonisation. Conclusions: The prevalence of <i>H. influenzae</i> colonisation was approximately 25%, with low colonisation for other bacterial species. <i>H. influenzae</i> colonisation was associated with sputum neutrophilia, while eosinophilic inflammation and <i>H. influenzae</i> colonisation rarely coexisted.