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Association of chronic obstructive pulmonary disease severity and Pneumocystis colonization

Alison Morris1, Frank C Sciurba, Irina P Lebedeva

  • 1M.S., Division of Pulmonary and Critical Care Medicine, 2011 Zonal Avenue, Los Angeles, CA 90033, USA. alison.morris@usc.edu

American Journal of Respiratory and Critical Care Medicine
|May 1, 2004
PubMed

Insights

Pneumocystis colonization is strongly linked to severe chronic obstructive pulmonary disease (COPD) progression in smokers. This finding suggests a potential role for Pneumocystis in the development and worsening of COPD.

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Microbiology

Background:

  • The variable progression of chronic obstructive pulmonary disease (COPD) is not fully understood, with infectious agents being a potential factor.
  • Pneumocystis induces an immune response (CD8(+) lymphocyte- and neutrophil-predominant) similar to that observed in COPD patients.

Purpose of the Study:

  • To investigate the association between Pneumocystis colonization and accelerated disease progression in smokers.
  • To determine if Pneumocystis colonization correlates with the severity of airflow obstruction in COPD patients.

Main Methods:

  • Nested polymerase chain reaction (PCR) was used to detect Pneumocystis colonization in lung tissue samples.
  • Lung tissue was obtained from smokers with varying degrees of airway obstruction (COPD stages) and a control group without COPD.

Main Results:

  • Pneumocystis colonization was detected in 36.7% of very severe COPD (GOLD Stage IV) patients, significantly higher than in smokers with less severe COPD (5.3%) or controls (9.1%).
  • Colonized individuals exhibited significantly more severe airflow obstruction (median FEV(1) 21% predicted vs. 62% in non-colonized).
  • GOLD Stage IV was the strongest predictor of Pneumocystis colonization, independent of smoking history.

Conclusions:

  • A strong association exists between Pneumocystis colonization and the severity of airflow obstruction in smokers.
  • These findings suggest a potential pathogenic role for Pneumocystis in the progression of chronic obstructive pulmonary disease.

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