Highlights
- •Absolute abundance of fungi differed significantly among CF sputa; therefore, qPCR corrected abundance to account for total fungal abundance may be valuable for mycobiome studies.
- •Members of the Candida genus are highly abundant in sputa of adults with cystic fibrosis and are associated with pulmonary exacerbation state.
- •Higher lung function is associated with greater fungal richness and alpha-diversity and CFTR modulator use is associated with greater fungal alpha-diversity; whereas chronic azithromycin use is associated with lower fungal richness and alpha-diversity.
Abstract
Background
The respiratory tract fungal microbiome in cystic fibrosis (CF) has been understudied
despite increasing recognition of fungal pathogens in CF lung disease. We sought to
better understand the fungal communities in adults with CF, and to define relationships
between fungal profiles and clinical characteristics.
Methods
We enrolled 66 adults with CF and collected expectorated sputum, spirometry, Cystic
Fibrosis Questionnaire-revised, and clinical data. Fungi were molecularly profiled
by sequencing of the internal transcribed spacer (ITS) region. Total fungal abundance
was measured by quantitative PCR. Relative abundance and qPCR-corrected abundances
were determined. Selective fungus culture identified cultivable fungi. Alpha diversity
and beta diversity were measured and relationships with clinical parameters were interrogated.
Results
Median age was 29 years and median FEV1 percent predicted 58%. Members of the Candida genus were the most frequent dominant taxa in CF sputum. Apiotrichum, Trichosporon, Saccharomyces cerevisiae, and Scedosporium were present in high relative abundance in few samples; whereas, Aspergillus species were detected at low levels. Higher FEV1% predicted and CFTR modulator use were associated with greater alpha-diversity. Chronic
azithromycin use was associated with lower alpha-diversity. Patients with acute pulmonary
had distinct fungal community composition compared to clinically stable subjects.
Differing yeast species were mainly responsible for the community differences.
Conclusion
The respiratory tract fungal microbiome in adults with CF is associated with lung
function, pulmonary exacerbation status, macrolide use, and CFTR modulator use. Future
work to better understand fungal diversity in the CF airway and its impact on lung
health is necessary.
Keywords
Abbreviations:
FEV1 (forced expiratory volume in one second), CFQ-R (cystic fibrosis questionnaire-revised), DTT (dithiothreitol), ITS (internal transcribed spacer), QPCR (quantitative polymerase chain reaction), OTU (operational taxonomic unit), CFTR (cystic fibrosis transmembrane conductance regulator), ABPA (allergic bronchopulmonary aspergillosis), IV (intravenous), BAL (bronchoalveolar lavage)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: February 21, 2023
Accepted:
February 6,
2023
Received in revised form:
January 5,
2023
Received:
October 12,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 European Cystic Fibrosis Society. Published by Elsevier B.V. All rights reserved.
