Open AccessThe airways microbiome of individuals with asthma treated with high and low doses of inhaled corticosteroids
Author(s) -
Matthew J. Martin,
Nur Masirah M. Zain,
Glenn Hearson,
Damian Rivett,
Garrit Koller,
David Wooldridge,
Graham Rose,
Saheer E. Gharbia,
Ben Forbes,
Kenneth D. Bruce,
Tim Harrison
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0244681
Subject(s) - fluticasone propionate , microbiome , sputum , fluticasone , asthma , medicine , haemophilus parainfluenzae , haemophilus , bronchiectasis , microbiology and biotechnology , gastroenterology , immunology , biology , haemophilus influenzae , antibiotics , bioinformatics , pathology , bacteria , lung , tuberculosis , genetics
Background Inhaled corticosteroids (ICS) are the mainstay of asthma treatment, but evidence suggests a link between ICS usage and increased rates of respiratory infections. We assessed the composition of the asthmatic airways microbiome in asthma patients taking low and high dose ICS and the stability of the microbiome over a 2 week period. Methods We prospectively recruited 55 individuals with asthma. Of these, 22 were on low-dose ICS and 33 on high-dose ICS (16 on budesonide, 17 on fluticasone propionate). Sputum from each subject underwent DNA extraction, amplification and 16S rRNA gene sequencing of the bacterial component of the microbiome. 19 subjects returned for further sputum induction after 24 h and 2 weeks. Results A total of 5,615,037 sequencing reads revealed 167 bacterial taxa in the asthmatic airway samples, with the most abundant being Streptococcus spp. No significant differences in sputum bacterial load or overall community composition were seen between the low- and high-dose ICS groups. However, Streptococcus spp. showed significantly higher relative abundance in subjects taking low-dose ICS (p = 0.002). Haemophilus parainfluenzae was significantly more abundant in subjects on high-dose fluticasone propionate than those on high-dose budesonide (p = 0.047). There were no statistically significant changes in microbiota composition over a 2-week period. Discussion Whilst no significant differences were observed between the low- and high-dose ICS groups, increased abundance of the potential pathogen H . parainfluenzae was observed in patients taking high-dose fluticasone propionate compared to those taking high-dose budesonide. The microbiota were stable over fourteen days, providing novel evidence of the established community of bacteria in the asthmatic airways. Clinical trial registration ClinicalTrials.gov NCT02671773