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      Altered community compositions of Proteobacteria in adults with bronchiectasis

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          Bronchiectasis is a debilitating disease with chronic airway infection. Proteobacteria, the dominant phylum, can be detected with high-throughput sequencing.


          To stratify Proteobacteria compositions according to culture findings in bronchiectasis.

          Patients and methods

          We sampled sputum, split for culture and 16srRNA sequencing, from 106 patients with stable bronchiectasis and 17 healthy subjects. Paired sputa from 22 bronchiectasis patients were collected during exacerbations and convalescence.


          Forty-five, 41, and 20 patients with clinically stable bronchiectasis had isolated Pseudomonas aeruginosa (PA), other potentially pathogenic microorganisms, and commensals at the initial visit, respectively. The PA group (but not other groups) demonstrated significantly greater relative abundance of Proteobacteria, and lower Shannon–Wiener Diversity Index, Simpson Diversity Index, and richness compared with healthy subjects. Pseudomonas was the dominant genus that discriminated bronchiectasis patients (particularly in the PA group) from healthy subjects. Compared with baseline levels, Proteobacteria community compositions in the PA group, but not in other groups, were more resilient during exacerbations and convalescence.


          Proteobacteria community compositions could be partially reflected by conventional sputum bacterial culture. Significantly altered Proteobacteria community compositions – particularly, the increased relative abundance of Pseudomonas and diminished community diversity – represent critical targets for novel interventions to restore normal airway microen-vironment in patients with bronchiectasis.

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          Most cited references 10

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          Pathogen-host interactions in Pseudomonas aeruginosa pneumonia.

          Pseudomonas aeruginosa is an important pathogen causing a wide range of acute and chronic infections. P. aeruginosa rarely causes infection in the normal host, but is an efficient opportunistic pathogen causing serious infections in patients who are mechanically ventilated, individuals who are immunocompromised, and patients with malignancies or HIV infection. Among these risk groups, the most vulnerable hosts are neutropenic and patients who are mechanically ventilated. In addition, P. aeruginosa is the most prevalent chronic infection contributing to the pathogenesis of cystic fibrosis. Because of the ubiquitous nature of P. aeruginosa and its ability to develop resistance to antibiotics, it continues to be problematic from a treatment perspective. The pathogenicity of P. aeruginosa is largely caused by multiple bacterial virulence factors and genetic flexibility enabling it to survive in varied environments. Lung injury associated with P. aeruginosa infection results from both the direct destructive effects of the organism on the lung parenchyma and exuberant host immune responses. This article focuses on the major bacterial virulence factors and important aspects of the host immunity that are involved in the pathogenesis of serious P. aeruginosa infection. In addition to antibiotic therapy, strategies directed toward enhancing host defense and/or limiting excessive inflammation could be important to improve outcome in P. aeruginosa lung infections.
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              Inflammation: a two-edged sword--the model of bronchiectasis.

               Jonathan Cole (1985)
              A short-lived, controlled inflammatory response by the host is required to protect against incursions by foreign material into the upper and lower respiratory tract. If this response fails to eliminate the aggressor, inflammation is amplified and becomes chronic in an attempt to rectify the situation. This unsuccessful response is poorly controlled and caused damage to surrounding normal tissue, leading to progressive disease. Hence, inflammation can be helpful or harmful--a two-edged sword. Chronic bronchial sepsis, of which bronchiectasis is an example, and chronic sinusitis display the hallmarks of this 'vicious circle' of host-mediated, inflammatory tissue damage and provide a useful model in man in which to ask questions, the answers to which provide valuable information about the pathogenesis of chronic inflammatory disease of the lung.

                Author and article information

                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                17 July 2018
                : 13
                : 2173-2182
                [1 ]State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, People’s Republic of China, battery203@ ; chenrc@
                [2 ]Sino-French Hoffmann Institute, Guangzhou Medical University, Guangzhou, People’s Republic of China, battery203@
                [3 ]Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
                Author notes
                Correspondence: Wei-Jie Guan; Rong-Chang Chen, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, Guangdong 510120, People’s Republic of China, Tel +86 20 8306 2876; +86 20 8306 2719, Fax +86 20 8306 2729; +86 20 8306 2719, Email battery203@ ; chenrc@
                © 2018 Guan et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                Original Research

                Respiratory medicine

                bronchiectasis, proteobacteria, pseudomonas aeruginosa, culture, exacerbation


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