Evaluation Of The Lung Microbiome In NTM Bronchiectasis
Evaluation Of The Lung Microbiome In NTM Bronchiectasis
A biomarker cohort study design is proposed to study whether specific airway microbiota
 alterations are associated with pulmonary Non-tuberculous mycobacteria (NTM) disease. In a
 cohort of 200 subjects suspected of having pulmonary NTM disease, the investigators will
 evaluate the airway microbiome using an aliquot of the induced sputum and upper airway
 samples. Since induced sputum may reflect different regions of the upper/lower airways, the
 investigators will evaluate the upper and lower airway microbiome in a subgroup (case-control
 group) of patients using samples obtained through upper airway sampling and bronchoscopy,
 respectively.
Inclusion Criteria:

 -  History of pulmonary symptoms: cough, fatigue, malaise, fever, weight loss, dyspnea,
 hemoptysis, or chest discomfort

 -  Imaging abnormalities (within 2 years): defined as nodular or cavitary opacities on
 chest radiograph, or a computed tomography scan that shows bronchiectasis or bronchial
 wall thickening with associated multiple small nodules.

 Definition of NTM case:

 -  Subjects that meet inclusion criteria and have culture positivity for NTM: at least
 two separate expectorated induced sputum samples or from one bronchoalveolar lavage
 (BAL) or lung biopsy

 Definition of NTM control:

 -  Subjects that meet inclusion criteria and have less than two separate expectorated
 induced sputum samples culture negative or culture negative bronchoalveolar lavage
 (BAL) or lung biopsy.

 Exclusion Criteria for cohort study (Aim 1-2):

 -  Recent (<1 months prior) oral antibiotic or steroid use. (Continuous treatment with
 macrolides and inhaled steroids are acceptable >1 month prior)

 -  Recent smoking history

 Exclusion Criteria for bronchoscopic study (Aims 3-4):

 -  Forced expiratory volume at one second (FEV1) < 70%of predicted.

 -  Significant cardiovascular disease defined as abnormal EKG, known or suspected
 coronary artery disease or congestive heart failure.

 -  Diabetes mellitus

 -  Significant liver or renal disease

 -  Severe coagulopathy (INR > 1.4, Partial Thromboplastin Time (PTT) > 40 seconds and
 platelet count < 150x103 cells).

 -  Pregnancy

 -  Ethanol (ETOH) use of more than >6 beers or >4 mixed drinks daily

 -  Lack of capacity to provide informed consent.