. 2023 Oct 18;32(170):230084. doi: 10.1183/16000617.0084-2023

TABLE 3.

Studies investigating the effects of inhaled corticosteroids (ICS) on microbiome changes

First author, year [ref.]	Type of study	Sample	Bacterial detection method	COPD patients ICS/no ICS	Key findings
First author, year [ref.]	Type of study	Sample	Bacterial detection method	COPD patients ICS/no ICS	Bacterial load	Species change	Diversity
Garcha, 2012 [ 132 ]	Cohort	Sputum	qPCR	47/5	↑	=	X
Wang, 2019 [ 124 ]	Cohort	Sputum	16S rRNA+qPCR	25/7	=	↑ H. influenzae ↑ M. catarrhalis	↓
Ramsheh, 2021 [ 126 ]	Cohort	Bronchial brush	16S rRNA	192/147	=	=	↓
Beech, 2020 [ 125 ]	Cohort	Sputum	qPCR	199/37	=	=	X
Beech, 2021 [ 46 ]	Cohort	Sputum	qPCR	43/17	=	=	X
Singanayagam, 2019 [ 134 ]	Cohort	Sputum	16S rRNA	10/13	↑	↑ S. pneumoniae	X
Contoli, 2017 [ 98 ]	RCT	Sputum	qPCR	30/30	↑	↑ H. influenzae^# ↑ S. pneumoniae^#	↑
Leitao Filho, 2021 [ 135 ]	RCT	Bronchial brush	16S rRNA	18 FP/20	=	↓ Haemophilus ↑ Firmicutes	↓
Leitao Filho, 2021 [ 135 ]	RCT	Bronchial brush	16S rRNA	18 BD/20	=	=	=

=: no change; ↑: increase; ↓: decrease; X: not measured. qPCR: quantitative PCR; 16S rRNA: 16S ribosomal RNA gene sequencing; H. influenzae: Haemophilus influenzae; M. catarrhalis: Moraxella catarrhalis; S. pneumoniae: Streptococcus pneumoniae; RCT: randomised controlled trial; FP: fluticasone propionate; BD: budesonide. ^#: in eosinophil-low patients.