Evidence map›Paper›PMID 42155010›Full record

ArticleAmerican journal of respiratory and critical care medicine2026

Gut microbiota associate with disease severity and survival in idiopathic pulmonary fibrosis.

John S Kim, Abigail Loe, Shwu-Fan Ma, Piyush Ranjan, Jay H Lipinski, Sheridan G Mikhail, Stephen J Gurczynski, Xiaofeng Zhou, Gary B Huffnagle, John Erb Downward and 10 more

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Article in American journal of respiratory and critical care medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors.

John S KimDepartment of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.
Abigail LoeDepartment of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States.ORCID 0009-0002-3123-067X
Shwu-Fan MaDepartment of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.
Piyush RanjanDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.ORCID 0000-0001-8293-6889
Jay H LipinskiDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.
Sheridan G MikhailDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.
Stephen J GurczynskiDepartment of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, United States.
Xiaofeng ZhouDepartment of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, United States.
Gary B HuffnagleDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.
John Erb DownwardDepartment of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, United States.
Joseph D MetcalfDepartment of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, MI, United States.
Nicole FalkowskiDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.
Kathleen A StringerDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.
Robert P DicksonDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.ORCID 0000-0002-6875-4277
Yong HuangDepartment of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.
Bethany B MooreDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.
Fernando J MartinezDepartment of Medicine, University of Massachusetts (UMass) Chan Medical School/UMass Memorial Health System, Worcester, MA, United States.
Susan MurrayDepartment of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States.
Imre NothDepartment of Medicine, University of Virginia School of Medicine, Charlottesville, VA, United States.
David N O'DwyerDivision of Pulmonary and Critical Care Medicine, Department of Medicine, University of Michigan Medical School, Ann Arbor, MI, United States.

Funding

Gut Microbiota and Host Regulatory Cross-Talk in Pulmonary FibrosisR01HL162659 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI O'DWYER, DAVID NOEL · 2022 to 2025
$1.9M
Drews Sarcoidosis Research Fund K23HL150301Drews Sarcoidosis Research Fund R01HL130796Drews Sarcoidosis Research Fund R01HL153028Drews Sarcoidosis Research Fund R01HL176659Drews Sarcoidosis Research Fund R35GM16312Drews Sarcoidosis Research Fund R35HL176572Drews Sarcoidosis Research Fund UH3 HL145266IPF Foundation, and Veracyte Inc R01HL162659NHLBINHLBI NIH HHS R01 HL162659NIGMSNIH/NHLBI UO1HL128964
6 · The paper itself

Abstract

rationaleGut microbiota modify immunity. Dysregulated immunity plays a key role in the pathogenesis of idiopathic pulmonary fibrosis (IPF). However, the role of gut microbiota in IPF pathogenesis is unknown.

objectivesDetermine associations between gut microbiota, disease severity, and lung transplant-free survival in IPF.

methodsGut microbiota from patients enrolled in the CleanUP-IPF trial were characterized using fecal swab samples (n = 411). CleanUP-IPF investigated the clinical efficacy of long-term antimicrobials in IPF. 16S ribosomal RNA gene amplicon sequencing and shotgun metagenomic sequencing were performed to comprehensively profile gut microbial communities. Associations between baseline microbiota with disease severity, transplant-free survival, and treatment heterogeneity were analyzed using principal component analysis, multivariate generalized linear models, additive models, and Cox regression models. MEASUREMENTS AND MAIN

resultsGut microbiota composition varied significantly with sex, age, and proton pump inhibitor use. Gut microbial diversity and community composition were significantly associated with impaired gas exchange (percent predicted diffusing capacity of lung for carbon monoxide). Several genera including the Lachnospiraceae unclassified genus were associated with improved transplant-free survival (hazard ratio [HR] = 0.34; 95% CI, 0.14-0.87; P = .02) in patients not assigned to antimicrobial treatment. Patients with a higher abundance of the Lachnospiraceae unclassified genus exposed to long-term cotrimoxazole had worse survival (HR = 6.09; 95% CI, 1.36-27.27; P = .02). Survival in pirfenidone-treated patients was significantly associated with a higher abundance of the gut Lachnospiraceae unclassified genus.

conclusionsIn exploratory post hoc analysis, gut microbiota correlated with disease severity, associated with treatment heterogeneity and transplant-free survival in patients with IPF.

Indexed as

Gastrointestinal MicrobiomeIdiopathic Pulmonary FibrosisAgedFemaleHumansMaleMiddle AgedPyridonesSeverity of Illness IndexpirfenidonePyridonesantibioticsantifibroticsgut microbiotaidiopathic pulmonary fibrosis

Identifiers

PMID42155010
PMCPMC13624794

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.