The Human Respiratory Microbiome: Implications and Impact

Alicia B. Mitchell, BMedSci (Hons); Allan R. Glanville, MBBS, MD, FRACP

Disclosures

Semin Respir Crit Care Med. 2018;39(2):199-212. 

In This Article

Bacterial Studies

Pathological changes that occur in chronic respiratory conditions place selection pressures on the lung microbiome. Resultant shifts in growth patterns of specific bacterial populations are invoked by increased mucus production, changes in oxygen availability,[54] and temperature[55] in certain areas and an exacerbated inflammatory response leading to increased production of cytokines.[56,57] Use of oxygen therapy, antibiotics, and steroids in the treatment of these conditions may also impact the microbiome (Figure 1). As COPD, idiopathic pulmonary fibrosis (IPF), and CF are the respiratory conditions for which lung transplantation is most commonly indicated, the microbiota-associated variations observed in these diseases will be the focus of this chapter. All of these conditions demonstrate characteristic periods of "exacerbations" or deterioration from the stable state. Emerging evidence indicates that these exacerbations may be associated with dysbiosis of the lung microbiota.

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