Chronic obstructive pulmonary disease (COPD) and bronchiectasis represent chronic airway diseases associated with significant morbidity and mortality. Bacteria and viruses are commonly implicated in acute exacerbations; however the significance of fungi in these airways remains poorly defined. While COPD and bronchiectasis remain recognized risk factors for the occurrence of Aspergillus-associated disease including chronic and invasive aspergillosis, underlying mechanisms that lead to the progression from colonization to invasive disease remain uncertain. Nonetheless, advances in molecular technologies have improved our detection, identification and understanding of resident fungi characterizing these airways. Mycobiome sequencing has revealed the complex varied and myriad profile of airway fungi in COPD and bronchiectasis, including their association with disease presentation, progression, and mortality. In this review, we outline the emerging evidence for the clinical importance of fungi in COPD and bronchiectasis, available diagnostic modalities, mycobiome sequencing approaches and association with clinical outcomes.

慢性阻塞性肺疾病 (COPD) 和支气管扩张是与显着发病率和死亡率相关的慢性气道疾病。细菌和病毒通常与急性加重有关；然而，真菌在这些气道中的重要性仍然不明确。虽然 COPD 和支气管扩张仍然是公认的曲霉菌发生的危险因素- 相关疾病，包括慢性和侵袭性曲霉病，导致从定植发展为侵袭性疾病的潜在机制仍然不确定。尽管如此，分子技术的进步提高了我们对表征这些气道的常驻真菌的检测、识别和理解。真菌生物组测序揭示了 COPD 和支气管扩张气道真菌的复杂多样和无数特征，包括它们与疾病表现、进展和死亡率的关联。在这篇综述中，我们概述了真菌在 COPD 和支气管扩张中的临床重要性的新证据、可用的诊断方式、真菌组测序方法以及与临床结果的关联。