{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T01:33:23Z","timestamp":1794360803862,"version":"4.9.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100008593","name":"European Respiratory Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008593","name":"European Respiratory Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Although inflammation and infection are key disease drivers in bronchiectasis, few studies have integrated host inflammatory and microbiome data to guide precision medicine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify clusters among patients with bronchiectasis on the basis of inflammatory markers and to assess the association between inflammatory endotypes, microbiome characteristics, and exacerbation risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with stable bronchiectasis were enrolled at three European centers, and cluster analysis was used to stratify the patients according to the levels of 33 sputum and serum inflammatory markers. Clusters were compared in terms of microbiome composition (16S ribosomal RNA sequencing) and exacerbation risk over a 12-month follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>A total of 199 patients were enrolled (109 [54.8%] female; median age, 69\u2009yr). Four clusters of patients were defined according to their inflammatory profiles: cluster 1, milder neutrophilic inflammation; cluster 2, mixed-neutrophilic and type 2; cluster 3, most severe neutrophilic; and cluster 4, mixed-epithelial and type 2. Lower microbiome diversity was associated with more severe inflammatory clusters (P\u2009&amp;lt;\u20090.001), and \u03b2-diversity analysis demonstrated distinct microbiome profiles associated with each inflammatory cluster (P\u2009=\u20090.001). Proteobacteria and Pseudomonas at phylum and genus levels, respectively, were more enriched in clusters 2 and 3 than in clusters 1 and 4. Furthermore, patients in cluster 2 (rate ratio [RR], 1.49; 95% confidence interval [CI], 1.16\u20131.92) and cluster 3 (RR, 1.61; 95% CI, 1.12\u20132.32) were at higher risk of exacerbation over a 12-month follow-up compared with cluster 1, even after adjustment for prior exacerbation history.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Bronchiectasis inflammatory endotypes are associated with distinct microbiome profiles and future exacerbation risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202303-0499oc","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T14:59:47Z","timestamp":1695913187000},"page":"1166-1176","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":88,"title":["Inflammatory Molecular Endotypes in Bronchiectasis: A European Multicenter Cohort Study"],"prefix":"10.1093","volume":"208","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4812-0653","authenticated-orcid":false,"given":"Hayoung","family":"Choi","sequence":"first","affiliation":[{"name":"Division of Molecular and Clinical Medicine and"},{"name":"Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soorack","family":"Ryu","sequence":"additional","affiliation":[{"name":"Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly R.","family":"Keir","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan Hui","family":"Giam","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison J.","family":"Dicker","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lidia","family":"Perea","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hollian","family":"Richardson","sequence":"additional","affiliation":[{"name":"Division of Molecular and Clinical Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T. 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