Patients with COPD had distinct endotypes following microbiome analysis of sputum, and these endotypes had different inflammatory profiles and long-term survival, according to the results of a study published in the Journal of Allergy and Clinical Immunology.

Gene sequencing data from the sputum of clinically stable patients with COPD was analyzed to determine the dominant species. Samples were classified as either Proteobacteria or Firmicutes and Haemophilus or Streptococcus dominant. Associations were then determined between a patient’s sputum microbiome and clinical features of COPD.

Of the 252 clinically stable patients with COPD who had gene sequencing performed on the sputum, the predominant phyla observed were Proteobacteria and Firmicutes. At the genus level the most abundant genera were Haemophilus, Streptococcus, Neisseria, Veillonella, and Prevotella. Clear relationships were observed between microbiome and clinical phenotypes. Proteobacteria dominated microbiomes were associated with poorer lung function and more frequent exacerbations, while Streptoccocus dysbiotic microbiomes were more likely to be classified as GOLD (Global Initiative for Chronic Obstructive Lung Disease) group D.

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“[W]e have identified microbiome associated subtypes of COPD associated with clinical phenotypes and increased mortality,” the study authors wrote. “Our results support a personalized medicine approach to therapy in COPD.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.


Dicker AJ, Huang JTJ, Lonergan M, et al. The sputum microbiome, airway inflammation and mortality in chronic obstructive pulmonary disease [published online April 27, 2020]. J Allergy Clin Immunol. doi:10.1016/j.jaci.2020.02.040