Young adults with cystic fibrosis with low microbiome diversity in their sputum have a greater risk of early end-stage lung disease, a novel study finds.
According to the researchers from the Canada their findings could be used to identify patients with CF at increased risk of disease progression for more intensive monitoring and treatment.
In the study the researchers performed 16S rRNA gene sequencing of biobanked sputum samples collected prospectively over two decades from a cohort of 104 clinically stable young adults with CF.
Overall, the 17 individuals (16%) who subsequently progressed to end-stage lung disease were more likely to have sputum with low alpha diversity, dominated by specific pathogens including Pseudomonas.
Conversely, those with a diverse community, dominated by organisms such as Streptococcus, were more likely to have a milder clinical course, the study authors noted in their paper published in Thorax.
Multivariate analysis conducted by the authors showed that baseline lung function and alpha diversity were independent predictors of early end-stage lung disease.
According to the authors their findings supported large-scale collaborative multicentre studies evaluating the microbiome as a novel biomarker.
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Prof Scott Bell
In an accompanying editorial, Professor Scott Bell from the Adult CF Centre at The Prince Charles Hospital in Brisbane and Laura Sherrard from the Queen’s University in Belfast, UK, said that novel biomarkers that identified patients at an increased risk of worse outcomes could help inform clinical decision making.