The emerging relationship between the airway microbiota and chronic respiratory disease: clinical implications

Abstract

Until recently, relationships between evidence of colonization or infection by specific microbial species and the development, persistence or exacerbation of pulmonary disease have informed our opinions of airway microbiology. However, recent applications of culture-independent tools for microbiome profiling have revealed a more diverse microbiota than previously recognized in the airways of patients with chronic pulmonary disease. New evidence indicates that the composition of airway microbiota differs in states of health and disease and with severity of symptoms and that the microbiota, as a collective entity, may contribute to pathophysiologic processes associated with chronic airway disease. Here, we review the evolution of airway microbiology studies of chronic pulmonary disease, focusing on asthma, chronic obstructive pulmonary disease and cystic fibrosis. Building on evidence derived from traditional microbiological approaches and more recent culture-independent microbiome studies, we discuss the implications of recent findings on potential microbial determinants of respiratory health or disease.

Keywords::

• 16S ribosomal RNA
• asthma
• COPD
• cystic fibrosis
• microbiota
• next-generation sequencing
• PhyloChip

Financial & competing interests disclosure

YJ Huang is supported by NIH award 1K23HL105572 and a Cystic Fibrosis Foundation PACE award. SV Lynch is supported by NIH awards AI075410, A113916 and a Cystic Fibrosis Foundation award. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.