The airway microbiome in Bronchiectasis-COPD overlap: data from the EMBARC-BRIDGE study

Holly R. Keir, Alison j. Dicker, Hollian Richardson, Ellie Kewin, Lidia Perea Soriano, Jennifer Pollock, Yan H Giam, Megan Crichton, Hayoung Choi, Erin Cant, Simon Finch, Christopher J. Fong, Francesco Blasi, Amelia Shoemark, Oriol Sibila, Stefano Aliberti, James D Chalmers

Research output: Contribution to journalMeeting abstractpeer-review


Introduction: Bronchiectasis (BE) and chronic obstructive pulmonary disease (COPD) share similar clinical characteristics and are frequently co-diagnosed (BE-COPD). BE-COPD is associated with worse outcomes but the mechanisms of this are unknown.
Aim: To investigate differences in the lung microbiome in BE and BE-COPD overlap.
Methods: Stable BE and BE-COPD patients were enrolled from a single UK centre. BE-COPD was defined using the objective ROSE criteria. The sputum microbiome was evaluated using 16S rRNA sequencing. Alpha-diversity was analysed using Shannon Wiener (SWDI), Chao1 (CI) and Simpson Index (SI). Results were validated in the EMBARC-BRIDGE cohort from UK, Italy and Spain.
Results: 281 patients were enrolled (BE n=176, BE-COPD n=105), 52.3% female, age 68 (±12.6). Proteobacteria were the most abundant phyla, and Haemophilus and Streptococcus the most abundant genera. Alpha diversity was significantly lower in BE-COPD group (SWDI p=0.02, CI p=0.04, SI p=0.03). No difference in beta-diversity was seen between the groups (PERMANOVA, p=0.33). Random Forest analysis identified reduced commensal taxa in the BE-COPD group, including lower Neisseria, Prevotella, Campylobacter and Fusobacterium. 208 patients were enrolled in the EMBARC BRIDGE cohort (BE=147, BE-COPD=61). Alpha diversity was reduced in the BE-COPD group (SWDI p=0.06, CI p=0.02, SI p=0.03) and there were significant changes in beta-diversity (PERMANOVA, p=0.02). Similarly, Random Forest detected depletion of Neisseria, Prevotella, Campylobacter in the BE-COPD arm.
Conclusion: We demonstrate in two large cohorts that BE-COPD is associated with reduced microbial diversity and depletion of anti-inflammatory commensal taxa.
Original languageEnglish
Pages (from-to)PA382
JournalEuropean Respiratory Journal
Issue number67
Publication statusPublished - 27 Oct 2023
EventEuropean Respiratory Society (ERS) 2023: International Congress - Allianz MiCo, Milan, Italy
Duration: 9 Sept 202313 Sept 2023


  • Bronchiectasis
  • COPD
  • Mirobiome/Microbiota


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