History of pulmonary tuberculosis was associated with lung microbiome change in patients with chronic obstructive pulmonary disease

Background: Patients with COPD had history of pulmonary tuberculosis (TB) which is a relative contraindication for the use of inhaled corticosteroid, however, the lung microbiome of this population have seldom been evaluated. Aim: We aim to investigate the difference of lung microbiome and airway inflammation in COPD patients with or without history of TB. Methods: Stable COPD patients with or without history of pulmonary TB were prospectively enrolled. The pellet of bronchoalveolar lavage (BAL) were collected for lung microbiome analysis via 16S rRNA sequencing. Neutrophil extracellular traps (NETs) and Inflammatory cytokines of BAL were examined. The associated clinical information and blood samples of the patients were collected for further analysis. Results: A total of 25 patients were enrolled for analysis, including 10 patients with COPD, 9 COPD patients with history of TB infection and 6 non-COPD patients. Lung microbiome analysis showed COPD patients with history of TB had predominant Proteobacteria spp. (Pseudomonas. aeruginosa) colonization and the lower shannon diversity compared to COPD and non-COPD groups. Moreover, beta diversity revealed that COPD with history of TB had significantly change of lung microbiome composition compared to COPD and non-COPD groups. Nevertheless, the NET level and inflammatory cytokines were only relatively higher in COPD with history of TB group, which do not reach statistical significance. Conclusions: Our study demonstrated that the composition of lung microbiome is different in COPD patients after TB infection compared to COPD and non-COPD patients, but without significantly change of airway inflammation