Lung and gut microbiomes in pulmonary aspergillosis: Exploring adjunctive therapies to combat the disease

Area of Science:

• Medical Mycology
• Microbiome Research
• Immunology

Background:

• Aspergillus species cause severe human infections like pulmonary aspergillosis (PA), associated with high mortality.
• Increasing incidence of PA and emerging triazole-resistant strains, particularly Aspergillus fumigatus, necessitate new therapeutic strategies.
• Current treatments are limited by resistance, highlighting the need for host-directed and adjunctive therapies.

Purpose of the Study:

• To review pulmonary aspergillosis (PA) through the lens of the microbiome.
• To explore the influence of lung and gut microbiomes on Aspergillus growth and host immune responses.
• To identify the microbiome as a potential therapeutic target for PA.

Main Methods:

• Literature review focusing on the interplay between Aspergillus spp., host immunity, and the microbiome.
• Analysis of existing research on the impact of microbial communities on PA pathogenesis.
• Synthesis of findings to propose microbiome-based therapeutic avenues.

Main Results:

• The lung and gut microbiomes significantly influence the pathogenesis of Aspergillus infections.
• Microbial dysbiosis can exacerbate PA and affect host immune defenses against Aspergillus.
• Specific microbial compositions may either promote or inhibit Aspergillus growth and virulence.

Conclusions:

• The microbiome represents a promising, yet underexplored, therapeutic target for pulmonary aspergillosis.
• Modulating the lung and gut microbiota could offer novel adjunctive strategies to combat PA.
• Further research into microbiome-host-Aspergillus interactions is crucial for developing effective treatments.