Changes in Microbiome with Treatment in Chronic Lung Diseases
Research type
Research Study
Full title
Changes of Microbiome in Response to Treatment in Patients with Chronic Lung Diseases
IRAS ID
202883
Contact name
Timothy D. McHugh
Contact email
Sponsor organisation
University College of London
Duration of Study in the UK
2 years, 10 months, 17 days
Research summary
Frequent courses of antibiotics and corticosteroids are often prescribed to patients with chronic lung diseases to treat chronic lung infections and manage acute exacerbations (AE). Currently, there is scientific evidence on the clinical usefulness of prolonged Azithromycin prophylactic therapy in reducing the frequency of exacerbations in COPD and bronchiectasis. There is a growing concern that the excessive administration of antibiotics in this patient cohort may enrich the prevalence of antimicrobial resistance genes among the body’s microflora (resistome). This may act as a potential reservoir for antimicrobial resistance genes in the body and the whole population. In addition, the excessive inappropriate use of antimicrobials may result in collateral damage in the homeostasis of the microbial ecology in different parts of the body (microbiome).
This study is an observational study that addresses the following question; What is the impact of therapeutic interventions on the airway, oral and gut microbiome and resistome in patients with chronic lung diseases?
COPD and bronchiectasis patients from Royal Free NHS Trust will be recruited and allocated into two groups; a group who are commencing or already on Azithromycin prophylactic therapy and a comparable control group who are not. The participants will be followed up for one year. Repeated biological samples (sputum, nasopharyngeal swabs, saliva, stool, blood) will be collected five times over one year. The changes in the microbiome and resistome in the repeated samples within the same individual will be analyzed and correlated to therapies given to patients.
This study will provide deeper insights into how antibiotics affect the airway, gut and oral microbiome and resistome. This may help in the development of individualized medicine based on tailoring therapy according to the individual microbiome in a way that may limit excessive inappropriate antibiotics utilization and control the development and spread of antimicrobial resistance in population.REC name
London - Harrow Research Ethics Committee
REC reference
16/LO/1490
Date of REC Opinion
25 Oct 2016
REC opinion
Further Information Favourable Opinion