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Host–microorganism interactions in lung diseases

Abstract

Until recently, the airways were thought to be sterile unless infected; however, a shift towards molecular methods for the quantification and sequencing of bacterial DNA has revealed that the airways harbour a unique steady-state microbiota. This paradigm shift is changing the way that respiratory research is approached, with a clear need now to consider the effects of host–microorganism interactions in both healthy and diseased lungs. We propose that akin to recent discoveries in intestinal research, dysbiosis of the airway microbiota could underlie susceptibility to, and progression and chronicity of lung disease. In this Opinion article, we summarize current knowledge of the airway microbiota and outline how host–microorganism interactions in the lungs and other tissues might influence respiratory health and disease.

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Figure 1: The composition of the bacterial, fungal and viral microbiota at distinct body sites.
Figure 2: Heterogeneous microbial habitats within the lungs.
Figure 3: Microbial influences on immune status and lung disease.
Figure 4: Bacterial dysbiosis during chronic lung disorders.

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Acknowledgements

This work was supported by Swiss National Science Foundation grant 310030_146983 (awarded to B.J.M.). B.J.M. is part of the European Cooperation in Science and Technology (COST) action BM1201, which is entitled “Developmental Origins of Chronic Lung Disease”.

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Correspondence to Benjamin J. Marsland.

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Supplementary information

Supplementary information S1 (table)

Constituents of the airway microbiota in health and disease. (PDF 613 kb)

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Glossary

Bronchoalveolar lavage fluid

Fluid containing bronchoalveolar cells that is obtained by infusing and extracting saline during bronchoscopy.

Chronic obstructive pulmonary disease

(COPD). A chronic lung disorder that is particularly associated with cigarette smoking and is characterized by the presence of emphysema and chronic bronchitis.

Cystic fibrosis

A genetic disorder caused by a mutation in the cystic fibrosis transmembrane conductance regulator that leads to recurrent respiratory infections and a progressive loss of lung function.

Short-chain fatty acids

(SCFAs). Fatty acids with aliphatic tails of less than six carbons in length that are produced during bacterial fermentation of dietary fibres.

Systemic metabolome

The complete set of small-molecule chemicals (metabolites) found within the bloodstream.

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Marsland, B., Gollwitzer, E. Host–microorganism interactions in lung diseases. Nat Rev Immunol 14, 827–835 (2014). https://doi.org/10.1038/nri3769

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