Lung microbiome: new insights into bronchiectasis' outcome.

Area of Science:

• Respiratory Medicine
• Microbiology
• Pulmonology

Background:

• Bronchiectasis is a chronic airway disease characterized by pathological dilatation, increasing globally.
• Current treatments offer only symptom relief and exacerbation management, lacking disease-modifying options.
• The complex pathophysiology involves chronic infection, inflammation, and impaired mucociliary clearance, with limited understanding of the lung microbiome's role.

Purpose of the Study:

• To review recent findings on the lung microbiota in bronchiectasis.
• To explore the association between lung microbiome composition and disease severity.
• To highlight the need for further research into the microbiome's role in bronchiectasis progression.

Main Methods:

• Literature review of recent studies on bronchiectasis and lung microbiota.
• Discussion of next-generation sequencing techniques, such as 16S rRNA sequencing, for microbiome analysis.
• Analysis of dominant bacterial genera and their clinical implications.

Main Results:

• The lung microbiome in bronchiectasis is dominated by bacteria including *Haemophilus*, *Pseudomonas*, and *Streptococcus*.
• These bacterial ecosystems exhibit significant stability within individuals but heterogeneity between individuals.
• *Pseudomonas* and *Haemophilus*-dominated microbiomes are associated with increased disease severity and exacerbations.

Conclusions:

• The lung microbiome plays a critical role in bronchiectasis pathogenesis and progression.
• Further research is essential to fully elucidate the microbiome's impact and to develop targeted microbiome-based therapies.
• Understanding the lung microbiota offers a promising avenue for novel bronchiectasis treatment strategies.