MUC5AC drives COPD exacerbation severity through amplification of virus-induced airway inflammation

Aran Singanayagam; Joseph Footitt; Benjamin T Kasdorf; Matthias Marczynski; Michael T Cross; Lydia J Finney; Maria-Belen Trujillo Torralbo; Maria Calderazzo; Jie Zhu; Julia Aniscenko; Thomas B Clarke; Philip L Molyneaux; Nathan W Bartlett; Miriam F Moffatt; William O Cookson; Jadwiga Wedzicha; Christopher M Evans; Oliver Lieleg; Patrick Mallia; Sebastian L Johnston

Samples were analysed from subjects recruited to two experimental rhinovirus infection studies that have been published previously 1, 15, 16 . Samples from two groups were included in this analysis: COPD subjects (GOLD stage II, not using regular inhaled therapy) and healthy non-smokers. All subjects gave informed written consent and the protocol was approved by All subjects had an initial visit at baseline when clinically stable for clinical assessment, PEF and clinical sample collection including spontaneous or induced sputum, taken as previously described 1, 44 . Subjects reported to the study team when they developed symptoms of an upper respiratory tract infection or an increase in any of the symptoms of dyspnoea, cough and sputum volume or purulence and an exacerbation was defined using the East London cohort criteria 4 . Subjects were seen within 48 hours of onset of their symptoms for collection of samples and repeat visits were scheduled for two and six weeks after the initial exacerbation visit with clinical assessment, lung function and induced sputum repeated at these time-points. Viruses were detected in sputum by PCR, as described previously 1 .