Respiratory microbiome-host interaction on lung carcinogenesis, immunity, and immunotherapy

Area of Science:

• Pulmonology and Oncology
• Microbiome Research
• Immunotherapy

Background:

• The respiratory microbiome is a key factor in the lung cancer microenvironment, affecting tumorigenesis, immune balance, and treatment outcomes.
• Current lung cancer immunotherapies face challenges like varied responses, immune side effects, and a lack of predictive biomarkers.

Purpose of the Study:

• To analyze the role of the respiratory microbiome in lung cancer pathogenesis and its impact on the immune landscape.
• To explore the association between respiratory dysbiosis and lung cancer characteristics, including staging, subtypes, and prognosis.
• To investigate the potential of microbiome-targeting strategies for improving lung cancer immunotherapy.

Main Methods:

• Systematic review of literature on respiratory microbiome alterations (dysbiosis) in lung cancer.
• Analysis of associations between microbial signatures, lung cancer staging, histology, and prognosis.
• Elucidation of metabolic-epigenetic-immune pathways linking microbial changes to tumor progression.
• Correlation of microbiome profiles with immune checkpoint inhibitor efficacy and toxicity.
• Examination of antibiotic effects on immunotherapy outcomes.

Main Results:

• Respiratory dysbiosis, characterized by reduced alpha-diversity and enrichment of Streptococcus and Veillonella, is linked to lung cancer.
• Microbial alterations influence tumor progression through metabolic, epigenetic, and immune pathways.
• Microbiome signatures correlate with immune checkpoint inhibitor efficacy and toxicity, and antibiotic exposure can paradoxically affect immunotherapy.

Conclusions:

• The respiratory microbiome plays a dual role as both a biomarker and a therapeutic target in lung cancer.
• Emerging strategies like probiotics and engineered bacteria show promise in modulating antitumor immunity.
• Further research is crucial for translating these findings into clinical applications for lung cancer management.