The Human Respiratory Microbiome: Implications and Impact

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


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

In This Article

Idiopathic Pulmonary Fibrosis

There are a few studies of the microbiome in the interstitial lung diseases. However, recent trials suggest that the microbiota may also have an important role in mediating the development of IPF. A randomized controlled trial showed a decrease in respiratory infections and an all-cause mortality benefit for patients receiving cotrimoxazole,[63] while the PANTHER trial demonstrated that immunosuppression led to increased mortality in patients with IPF.[64] A limited number of studies have shown a role for the microbiota in predicting more severe disease and progression.[65–68] It has also been shown that pneumolysin (pneumococcus-associated toxin) mediates fibrotic progression in animal models of alveolar epithelium injury.[69] Therefore, the presence of certain bacteria within the lung microbiota may predispose certain individuals to the development of IPF.