New opportunities for managing acute and chronic lung infections
William O C M Cookson1, Michael J Cox1, Miriam F Moffatt1
1Asmarley Centre for Genomic Medicine, National Heart and Lung Institute, Imperial College London, Dovehouse Street, London SW3 6LY, UK.
Abstract:
Lung diseases caused by microbial infections affect hundreds of millions of children and adults throughout the world. In Western populations, the treatment of lung infections is a primary driver of antibiotic resistance. Traditional therapeutic strategies have been based on the premise that the healthy lung is sterile and that infections grow in a pristine environment. As a consequence, rapid advances in our understanding of the composition of the microbiota of the skin and bowel have not yet been matched by studies of the respiratory tree. The recognition that the lungs are as populated with microorganisms as other mucosal surfaces provides the opportunity to reconsider the mechanisms and management of lung infections. Molecular analyses of the lung microbiota are revealing profound adverse responses to widespread antibiotic use, urbanization and globalization. This Opinion article proposes how technologies and concepts flowing from the Human Microbiome Project can transform the diagnosis and treatment of common lung diseases.
Insights
The healthy lung is not sterile; its microbial community, or microbiota, is impacted by antibiotics and lifestyle. Understanding the lung microbiota can transform diagnosis and treatment of lung infections.
Area of Science:
- Microbiology
- Pulmonology
- Genomics
Background:
- Lung infections affect millions globally, with antibiotic resistance a major concern in Western populations.
- Traditional views considered the healthy lung sterile, unlike other mucosal surfaces.
- Research on skin and gut microbiota has advanced, but the respiratory tract microbiome remains understudied.
Purpose of the Study:
- To highlight the significance of the lung microbiota in respiratory health and disease.
- To propose novel diagnostic and therapeutic strategies for lung diseases based on microbiome research.
- To re-evaluate lung infection mechanisms in light of the lung's microbial composition.
Main Methods:
- Molecular analyses to characterize the lung microbiota.
- Leveraging concepts and technologies from the Human Microbiome Project.
- Comparative studies of lung microbiota across different populations and environments.
Main Results:
- The lung harbors a complex microbial community, similar to other mucosal sites.
- Antibiotic use, urbanization, and globalization have significant adverse effects on the lung microbiota.
- Current understanding of lung infections needs revision based on microbiome data.
Conclusions:
- The lung is a dynamic ecosystem, not a sterile organ.
- Microbiome-based approaches offer transformative potential for diagnosing and treating lung diseases.
- Further research into the lung microbiota is crucial for combating respiratory infections and antibiotic resistance.
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