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Abstract
Increasing evidence has indicated the intimate relationship between the gastrointestinal
tract and respiratory tract. The microbial ecosystem has been confirmed to share key
conceptual features with gut-lung microbiome disorder and dysregulation during chronic
obstructive pulmonary disease (COPD) exacerbations. However, the dynamic changes of
the gut-lung microbiome during COPD exacerbations and its potential role in disease
etiology remain poorly understood. The present study investigated the dynamic changes
of gut and lung microorganisms during acute exacerbation of chronic obstructive pulmonary
disease (AECOPD). A longitudinal 16S ribosomal DNA survey of the gut and lung microbiome
was completed on 90 feces and sputum samples collected from 15 subjects with AECOPD
at three visits, which were defined as exacerbation, seven-day stable state. The present
analysis revealed a dynamic gut-lung microbiota, where changes appeared to be associated
with exacerbation events indicative of specific exacerbation phenotypes. Antibiotic
and steroid treatments appeared to have differential effects on the gut-lung microbiome,
and the microbiome was associated with disease progression, but not with severity.
The abundance and diversity of the microbiome was strongly influenced by the disease
progression and therapy. Using culture-independent methods to impact the gut and lung
microbiota on AECOPD may be the key to understanding the interactions between the
gut and lung, highlighting its potential as a biomarker, and possibly a target for
future respiratory therapeutics.