The respiratory virome and exacerbations in patients with chronic obstructive pulmonary disease.

INTRODUCTION:Exacerbations are major contributors to morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD), and respiratory bacterial and viral infections are an important trigger. However, using conventional diagnostic techniques, a causative agent is not always foun...

Full description

Bibliographic Details
Main Authors: Anneloes L van Rijn, Sander van Boheemen, Igor Sidorov, Ellen C Carbo, Nikos Pappas, Hailiang Mei, Mariet Feltkamp, Marianne Aanerud, Per Bakke, Eric C J Claas, Tomas M Eagan, Pieter S Hiemstra, Aloys C M Kroes, Jutte J C de Vries
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2019-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0223952
_version_ 1819110885806833664
author Anneloes L van Rijn
Sander van Boheemen
Igor Sidorov
Ellen C Carbo
Nikos Pappas
Hailiang Mei
Mariet Feltkamp
Marianne Aanerud
Per Bakke
Eric C J Claas
Tomas M Eagan
Pieter S Hiemstra
Aloys C M Kroes
Jutte J C de Vries
author_facet Anneloes L van Rijn
Sander van Boheemen
Igor Sidorov
Ellen C Carbo
Nikos Pappas
Hailiang Mei
Mariet Feltkamp
Marianne Aanerud
Per Bakke
Eric C J Claas
Tomas M Eagan
Pieter S Hiemstra
Aloys C M Kroes
Jutte J C de Vries
author_sort Anneloes L van Rijn
collection DOAJ
description INTRODUCTION:Exacerbations are major contributors to morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD), and respiratory bacterial and viral infections are an important trigger. However, using conventional diagnostic techniques, a causative agent is not always found. Metagenomic next-generation sequencing (mNGS) allows analysis of the complete virome, but has not yet been applied in COPD exacerbations. OBJECTIVES:To study the respiratory virome in nasopharyngeal samples during COPD exacerbations using mNGS. STUDY DESIGN:88 nasopharyngeal swabs from 63 patients from the Bergen COPD Exacerbation Study (2006-2010) were analysed by mNGS and in-house qPCR for respiratory viruses. Both DNA and RNA were sequenced simultaneously using an Illumina library preparation protocol with in-house adaptations. RESULTS:By mNGS, 24/88 samples tested positive. Sensitivity and specificity, as compared with PCR, were 96% and 98% for diagnostic targets (23/24 and 1093/1120, respectively). Additional viral pathogens detected by mNGS were herpes simplex virus type 1 and coronavirus OC43. A positive correlation was found between Cq value and mNGS viral normalized species reads (log value) (p = 0.002). Patients with viral pathogens had lower percentages of bacteriophages (p<0.001). No correlation was found between viral reads and clinical markers. CONCLUSIONS:The mNGS protocol used was highly sensitive and specific for semi-quantitative detection of respiratory viruses. Excellent negative predictive value implicates the power of mNGS to exclude any pathogenic respiratory viral infectious cause in one test, with consequences for clinical decision making. Reduced abundance of bacteriophages in COPD patients with viral pathogens implicates skewing of the virome during infection, with potential consequences for the bacterial populations, during infection.
first_indexed 2024-12-22T03:48:50Z
format Article
id doaj.art-74a773c530fe45e992dade27e7214948
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-22T03:48:50Z
publishDate 2019-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-74a773c530fe45e992dade27e72149482022-12-21T18:40:04ZengPublic Library of Science (PLoS)PLoS ONE1932-62032019-01-011410e022395210.1371/journal.pone.0223952The respiratory virome and exacerbations in patients with chronic obstructive pulmonary disease.Anneloes L van RijnSander van BoheemenIgor SidorovEllen C CarboNikos PappasHailiang MeiMariet FeltkampMarianne AanerudPer BakkeEric C J ClaasTomas M EaganPieter S HiemstraAloys C M KroesJutte J C de VriesINTRODUCTION:Exacerbations are major contributors to morbidity and mortality in patients with chronic obstructive pulmonary disease (COPD), and respiratory bacterial and viral infections are an important trigger. However, using conventional diagnostic techniques, a causative agent is not always found. Metagenomic next-generation sequencing (mNGS) allows analysis of the complete virome, but has not yet been applied in COPD exacerbations. OBJECTIVES:To study the respiratory virome in nasopharyngeal samples during COPD exacerbations using mNGS. STUDY DESIGN:88 nasopharyngeal swabs from 63 patients from the Bergen COPD Exacerbation Study (2006-2010) were analysed by mNGS and in-house qPCR for respiratory viruses. Both DNA and RNA were sequenced simultaneously using an Illumina library preparation protocol with in-house adaptations. RESULTS:By mNGS, 24/88 samples tested positive. Sensitivity and specificity, as compared with PCR, were 96% and 98% for diagnostic targets (23/24 and 1093/1120, respectively). Additional viral pathogens detected by mNGS were herpes simplex virus type 1 and coronavirus OC43. A positive correlation was found between Cq value and mNGS viral normalized species reads (log value) (p = 0.002). Patients with viral pathogens had lower percentages of bacteriophages (p<0.001). No correlation was found between viral reads and clinical markers. CONCLUSIONS:The mNGS protocol used was highly sensitive and specific for semi-quantitative detection of respiratory viruses. Excellent negative predictive value implicates the power of mNGS to exclude any pathogenic respiratory viral infectious cause in one test, with consequences for clinical decision making. Reduced abundance of bacteriophages in COPD patients with viral pathogens implicates skewing of the virome during infection, with potential consequences for the bacterial populations, during infection.https://doi.org/10.1371/journal.pone.0223952
spellingShingle Anneloes L van Rijn
Sander van Boheemen
Igor Sidorov
Ellen C Carbo
Nikos Pappas
Hailiang Mei
Mariet Feltkamp
Marianne Aanerud
Per Bakke
Eric C J Claas
Tomas M Eagan
Pieter S Hiemstra
Aloys C M Kroes
Jutte J C de Vries
The respiratory virome and exacerbations in patients with chronic obstructive pulmonary disease.
PLoS ONE
title The respiratory virome and exacerbations in patients with chronic obstructive pulmonary disease.
title_full The respiratory virome and exacerbations in patients with chronic obstructive pulmonary disease.
title_fullStr The respiratory virome and exacerbations in patients with chronic obstructive pulmonary disease.
title_full_unstemmed The respiratory virome and exacerbations in patients with chronic obstructive pulmonary disease.
title_short The respiratory virome and exacerbations in patients with chronic obstructive pulmonary disease.
title_sort respiratory virome and exacerbations in patients with chronic obstructive pulmonary disease
url https://doi.org/10.1371/journal.pone.0223952
work_keys_str_mv AT anneloeslvanrijn therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT sandervanboheemen therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT igorsidorov therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT ellenccarbo therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT nikospappas therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT hailiangmei therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT marietfeltkamp therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT marianneaanerud therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT perbakke therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT ericcjclaas therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT tomasmeagan therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT pietershiemstra therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT aloyscmkroes therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT juttejcdevries therespiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT anneloeslvanrijn respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT sandervanboheemen respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT igorsidorov respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT ellenccarbo respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT nikospappas respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT hailiangmei respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT marietfeltkamp respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT marianneaanerud respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT perbakke respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT ericcjclaas respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT tomasmeagan respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT pietershiemstra respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT aloyscmkroes respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease
AT juttejcdevries respiratoryviromeandexacerbationsinpatientswithchronicobstructivepulmonarydisease