
| 10.1016/S2213-2600(14)70069-4
http://scihub22266oqcxt.onion/10.1016/S2213-2600(14)70069-4
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Lancet+Respir+Med 2014 ; 2 (7): 548-56 Nephropedia Template TP
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Association Between Lung Microbiome and Disease Progression in IPF: A Prospective Cohort Study #MMPMID24767767Han MK; Zhou Y; Murray S; Tayob N; Noth I; Lama VN; Moore BB; White ES; Flaherty KR; Huffnagle GB; Martinez FJLancet Respir Med 2014[Jul]; 2 (7): 548-56 PMID24767767show ga
Background: The lung microbiome?s contribution to IPF pathogenesisis unknown. Using COMET-IPF (Correlating Outcomes with biochemical Markers to Estimate Time-progression in Idiopathic Pulmonary Fibrosis), the goal of this study was to determine whether unique microbial signatures would associate with disease progression. Methods: IPF subjects within four years of diagnosis aged 35?80 were eligible for inclusion. Subjects were followed for up to a maximum of 80 weeks. This completed observational study is registered with ClinicalTrials.gov, number NCT01071707. Progression-free survival was defined as death, acute exacerbation, lung transplant, or decline in FVC of 10% or DLCO of 15%.DNA was isolated from 55 bronchoscopic alveolar lavage (BAL) samples. 454 pyrosequencing was used to assign operational taxonomic units (OTUs) based on a 3% sequence divergence. Adjusted Cox models identified OTUs significantly associated with progression-free survival at a p<0�10 level. These OTUs were then used in principal components (PC) analysis. The association between PCs and microbes with high factor loadings from the PC analysis and progression-free survival were examined via Cox regression analyses. Findings: Mean FVC was 70�1% and mean DLCO 42�3 %predicted. Significant associations with disease progression were noted with increased % relative abundance of two OTUs identified by PC analysis, a Streptococcus OTU. (p<0�0009) and a Staphylococcus OTU(p=0�01). Strength of associations using PCs versus two OTUs alone was similar. Threshold analysis helped define a cut point for % relative abundance for each OTU associated with progression-free survival, >3�9% for the Streptococcus OTU, HR 10�19 (95% CI 2�94, 35�35; p=0�0002) and >1�8% for the Staphylococcus OTU, HR 5�06 (1�71, 14�93; p=0�003). Interpretation: These preliminary data suggest IPF disease progression is associated with presence of specific members within the Staphylococcus and Streptococcus genera.�
  
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