title: Changes in the respiratory microbiome during acute exacerbations of idiopathic pulmonary fibrosis.
abstract: Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) have been defined as events of clinically significant respiratory deterioration with an unidentifiable cause. They carry a significant mortality and morbidity and while their exact pathogenesis remains unclear, the possibility remains that hidden infection may play a role. The aim of this pilot study was to determine whether changes in the respiratory microbiota occur during an AE-IPF. Bacterial DNA was extracted from bronchoalveolar lavage from patients with stable IPF and those experiencing an AE-IPF. A hyper-variable region of the 16S ribosomal RNA gene (16S rRNA) was amplified, quantified and pyrosequenced. Culture independent techniques demonstrate AE-IPF is associated with an increased BAL bacterial burden compared to stable disease and highlight shifts in the composition of the respiratory microbiota during an AE-IPF.
authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK.|Royal Brompton Hospital, London, UK.
authors.forename: Philip L
authors.initials: PL
authors.lastname: Molyneaux
authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Cox
authors.affiliation: Royal Brompton Hospital, London, UK.
authors.forename: Athol U
authors.initials: AU
authors.lastname: Wells
authors.affiliation: Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Ho Cheol
authors.initials: HC
authors.lastname: Kim
authors.affiliation: Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Wonjun
authors.initials: W
authors.lastname: Ji
authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: William O C
authors.initials: WO
authors.lastname: Cookson
authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK.
authors.forename: Miriam F
authors.initials: MF
authors.lastname: Moffatt
authors.affiliation: Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Dong Soon
authors.initials: DS
authors.lastname: Kim
authors.affiliation: National Heart and Lung Institute, Imperial College, London, UK. t.maher@imperial.ac.uk.|Royal Brompton Hospital, London, UK. t.maher@imperial.ac.uk.|Fibrosis Research Group, Inflammation, Repair & Development Section, NHLI, Sir Alexander Fleming Building, Imperial College, London, SW7 2AZ, UK. t.maher@imperial.ac.uk.
authors.forename: Toby M
authors.initials: TM
authors.lastname: Maher
mesh_terms: D000208:Acute Disease; D000368:Aged; D001419:Bacteria / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology*; D005260:Female; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000382:microbiology*; D008168:Lung / Q000382:microbiology*; D008297:Male; D064307:Microbiota / Q000235:genetics*; D012008:Recurrence; D013045:Species Specificity
keywords: 16S; Acute exacerbation; Bacterial infection; Idiopathic pulmonary fibrosis