The microbiome in respiratory medicine: current challenges and future perspectives

TY - JOUR

T1 - The microbiome in respiratory medicine

T2 - current challenges and future perspectives

AU - Faner, Rosa

AU - Sibila, Oriol

AU - Agustí, Alvar

AU - Bernasconi, Eric

AU - Chalmers, James D.

AU - Huffnagle, Gary B.

AU - Manichanh, Chaysavanh

AU - Molyneaux, Philip L.

AU - Paredes, Roger

AU - Pérez Brocal, Vicente

AU - Ponomarenko, Julia

AU - Sethi, Sanjay

AU - Dorca, Jordi

AU - Monsó, Eduard

N1 - No funding info

PY - 2017/4/1

Y1 - 2017/4/1

N2 - The healthy lung has previously been considered to be a sterile organ because standard microbiological culture techniques consistently yield negative results. However, culture-independent techniques report that large numbers of microorganisms coexist in the lung. There are many unknown aspects in the field, but available reports show that the lower respiratory tract microbiota: 1) is similar in healthy subjects to the oropharyngeal microbiota and dominated by members of the Firmicutes, Bacteroidetes and Proteobacteria phyla; 2) shows changes in smokers and well-defined differences in chronic respiratory diseases, although the temporal and spatial kinetics of these changes are only partially known; and 3) shows relatively abundant non-cultivable bacteria in chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, cystic fibrosis and bronchiectasis, with specific patterns for each disease. In all of these diseases, a loss of diversity, paralleled by an over-representation of Proteobacteria (dysbiosis), has been related to disease severity and exacerbations. However, it is unknown whether dysbiosis is a cause or a consequence of the damage to bronchoalveolar surfaces.Finally, little is known about bacterial functionality and the interactions between viruses, fungi and bacteria. It is expected that future research in bacterial gene expressions, metagenomics longitudinal analysis and host-microbiome animal models will help to move towards targeted microbiome interventions in respiratory diseases.

AB - The healthy lung has previously been considered to be a sterile organ because standard microbiological culture techniques consistently yield negative results. However, culture-independent techniques report that large numbers of microorganisms coexist in the lung. There are many unknown aspects in the field, but available reports show that the lower respiratory tract microbiota: 1) is similar in healthy subjects to the oropharyngeal microbiota and dominated by members of the Firmicutes, Bacteroidetes and Proteobacteria phyla; 2) shows changes in smokers and well-defined differences in chronic respiratory diseases, although the temporal and spatial kinetics of these changes are only partially known; and 3) shows relatively abundant non-cultivable bacteria in chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, cystic fibrosis and bronchiectasis, with specific patterns for each disease. In all of these diseases, a loss of diversity, paralleled by an over-representation of Proteobacteria (dysbiosis), has been related to disease severity and exacerbations. However, it is unknown whether dysbiosis is a cause or a consequence of the damage to bronchoalveolar surfaces.Finally, little is known about bacterial functionality and the interactions between viruses, fungi and bacteria. It is expected that future research in bacterial gene expressions, metagenomics longitudinal analysis and host-microbiome animal models will help to move towards targeted microbiome interventions in respiratory diseases.

KW - Journal article

KW - Review

U2 - 10.1183/13993003.02086-2016

DO - 10.1183/13993003.02086-2016

M3 - Review article

C2 - 28404649

SN - 0903-1936

VL - 49

JO - European Respiratory Journal

JF - European Respiratory Journal

IS - 4

M1 - 1602086

ER -