Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis
Background High bacterial burden in the lung microbiota predicts progression of idiopathic pulmonary fibrosis (IPF). Azithromycin (AZT) is a macrolide antibiotic known to alter the lung microbiota in several chronic pulmonary diseases, and observational studies have shown a positive effect of AZT on...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
European Respiratory Society
2023-05-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/9/3/00720-2022.full |
| _version_ | 1797689386513465344 |
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| author | Pieter-Jan Gijs Cécile Daccord Eric Bernasconi Martin Brutsche Christian F. Clarenbach Katrin Hostettler Sabina A. Guler Louis Mercier Niki Ubags Manuela Funke-Chambour Christophe von Garnier |
| author_facet | Pieter-Jan Gijs Cécile Daccord Eric Bernasconi Martin Brutsche Christian F. Clarenbach Katrin Hostettler Sabina A. Guler Louis Mercier Niki Ubags Manuela Funke-Chambour Christophe von Garnier |
| author_sort | Pieter-Jan Gijs |
| collection | DOAJ |
| description | Background
High bacterial burden in the lung microbiota predicts progression of idiopathic pulmonary fibrosis (IPF). Azithromycin (AZT) is a macrolide antibiotic known to alter the lung microbiota in several chronic pulmonary diseases, and observational studies have shown a positive effect of AZT on mortality and hospitalisation rate in IPF. However, the effect of AZT on the lung microbiota in IPF remains unknown.
Methods
We sought to determine the impact of a 3-month course of AZT on the lung microbiota in IPF. We assessed sputum and oropharyngeal swab specimens from 24 adults with IPF included in a randomised controlled crossover trial of oral AZT 500 mg 3 times per week. 16S rRNA gene amplicon sequencing and quantitative PCR (qPCR) were performed to assess bacterial communities. Antibiotic resistance genes (ARGs) were assessed using real-time qPCR.
Results
AZT significantly decreased community diversity with a stronger and more persistent effect in the lower airways (sputum). AZT treatment altered the temporal kinetics of the upper (oropharyngeal swab) and lower airway microbiota, increasing community similarity between the two sites for 1 month after macrolide cessation. Patients with an increase in ARG carriage had lower bacterial density and enrichment of the genus Streptococcus. In contrast, patients with more stable ARG carriage had higher bacterial density and enrichment in Prevotella.
Conclusions
AZT caused sustained changes in the diversity and composition of the upper and lower airway microbiota in IPF, with effects on the temporal and spatial dynamics between the two sites. |
| first_indexed | 2024-03-12T01:44:59Z |
| format | Article |
| id | doaj.art-fa18904419d44ceb858658e86c5de4eb |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-03-12T01:44:59Z |
| publishDate | 2023-05-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-fa18904419d44ceb858658e86c5de4eb2023-09-09T13:53:54ZengEuropean Respiratory SocietyERJ Open Research2312-05412023-05-019310.1183/23120541.00720-202200720-2022Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosisPieter-Jan Gijs0Cécile Daccord1Eric Bernasconi2Martin Brutsche3Christian F. Clarenbach4Katrin Hostettler5Sabina A. Guler6Louis Mercier7Niki Ubags8Manuela Funke-Chambour9Christophe von Garnier10 Division of Pulmonology, Department of Medicine, CHUV, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland Division of Pulmonology, Department of Medicine, CHUV, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland Division of Pulmonology, Department of Medicine, CHUV, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland Lungenzentrum, Kantonsspital St Gallen, St Gallen, Switzerland Division of Pulmonary Medicine, University Hospital of Zurich, Zurich, Switzerland Clinics of Respiratory Medicine, University Hospital Basel, Basel, Switzerland Department of Pulmonary Medicine, Inselspital, Bern University Hospital, Bern, Switzerland Division of Pulmonology, Department of Medicine, CHUV, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland Division of Pulmonology, Department of Medicine, CHUV, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland Department of Pulmonary Medicine, Inselspital, Bern University Hospital, Bern, Switzerland Division of Pulmonology, Department of Medicine, CHUV, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland Background High bacterial burden in the lung microbiota predicts progression of idiopathic pulmonary fibrosis (IPF). Azithromycin (AZT) is a macrolide antibiotic known to alter the lung microbiota in several chronic pulmonary diseases, and observational studies have shown a positive effect of AZT on mortality and hospitalisation rate in IPF. However, the effect of AZT on the lung microbiota in IPF remains unknown. Methods We sought to determine the impact of a 3-month course of AZT on the lung microbiota in IPF. We assessed sputum and oropharyngeal swab specimens from 24 adults with IPF included in a randomised controlled crossover trial of oral AZT 500 mg 3 times per week. 16S rRNA gene amplicon sequencing and quantitative PCR (qPCR) were performed to assess bacterial communities. Antibiotic resistance genes (ARGs) were assessed using real-time qPCR. Results AZT significantly decreased community diversity with a stronger and more persistent effect in the lower airways (sputum). AZT treatment altered the temporal kinetics of the upper (oropharyngeal swab) and lower airway microbiota, increasing community similarity between the two sites for 1 month after macrolide cessation. Patients with an increase in ARG carriage had lower bacterial density and enrichment of the genus Streptococcus. In contrast, patients with more stable ARG carriage had higher bacterial density and enrichment in Prevotella. Conclusions AZT caused sustained changes in the diversity and composition of the upper and lower airway microbiota in IPF, with effects on the temporal and spatial dynamics between the two sites.http://openres.ersjournals.com/content/9/3/00720-2022.full |
| spellingShingle | Pieter-Jan Gijs Cécile Daccord Eric Bernasconi Martin Brutsche Christian F. Clarenbach Katrin Hostettler Sabina A. Guler Louis Mercier Niki Ubags Manuela Funke-Chambour Christophe von Garnier Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis ERJ Open Research |
| title | Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis |
| title_full | Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis |
| title_fullStr | Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis |
| title_full_unstemmed | Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis |
| title_short | Azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis |
| title_sort | azithromycin alters spatial and temporal dynamics of airway microbiota in idiopathic pulmonary fibrosis |
| url | http://openres.ersjournals.com/content/9/3/00720-2022.full |
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