Objectives

To characterize the microbiome of the lung and respiratory tract, and enhance understanding of the role of the lung microbiome in preserving health or causing disease and in the divergent effects observed in HIV-infected versus uninfected individuals.

Background

The respiratory tract is constantly exposed to the external environment and serves as the portal of entry for many microbes. The characteristics and mix of organisms populating the respiratory tract, coupled with the state of local respiratory defenses are key factors in determining whether a person remains healthy or develops acute, chronic, or latent infection. Inflammation in the airways and lungs and how it progresses or is resolved affects not only local immune mediators and primary gas exchange functions, but may also have consequences for the whole immune system and the progression of diseases in other organs.

HIV-infected individuals are at high risk of developing pneumonias caused by pathogenic and opportunistic microorganisms. These respiratory infections frequently cause morbidity, are often life threatening, and may increase the rate of replication of HIV, accelerating the course of the disease. HIV-infected individuals experience a decrease in lung function following pneumonias which are not observed in normal, HIV-uninfected populations. Furthermore, lung infections and microbial colonizations are suspected in the etiology of HIV-associated emphysema and pulmonary hypertension. An increasingly important issue is that lung infections may play a role in inducing the immune reconstitution syndrome seen in some HIV-infected patients following initiation of multi-drug antiretroviral regimens.

Therefore, knowledge of the lung microbiome in healthy and diseased states may lead to the identification of predictors of disease progression and therapeutic targets for translation into better preventive and treatment strategies. The LHMP was developed as a cooperative network responsible for carrying out both joint protocols and integrating independent protocols that benefit from increased sample size. This effort was meant to provide initial data to develop further hypotheses addressing differences between HIV-infected and HIV-uninfected individuals.

Participants

Eligible subjects included HIV positive and HIV negative adults. Participant eligibility for the LHMP was confirmed by each center according to the parameters of their individual protocols, which may also define additional inclusion or exclusion criteria.

Design

The LHMP brought the distinct efforts of six clinical centers together under a single infrastructure, creating a network that combined the expertise accumulated across the range of involved disciplines in a focused and concentrated collaboration. Since multiple studies were involved in the project, the research design of each study will vary with the objective of that study. All data and samples were collected during a baseline assessment for LHMP.

Sequencing Data

Study sequencing files of the microbiome are available for request from dbGap at http://www.ncbi.nlm.nih.gov/gap. The dbGaP accession assigned to this study is phs000769.v1.p1.

Additional Details

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