Once thought to be a sterile environment, it is now established that lungs are populated by various microorganisms that participate in maintaining lung function and play an important role in shaping lung immune surveillance. Although our comprehension of the molecular and metabolic interactions between microbes and lung cells is still in its infancy, any event causing a persistent qualitative or quantitative variation in the composition of lung microbiome, termed “dysbiosis”, has been virtually associated with many respiratory diseases. A deep understanding of the composition and function of the “healthy” lung microbiota and how dysbiosis can cause or participate in disease progression will be pivotal in finding specific therapies aimed at preventing diseases and restoring lung function. Here, we review lung microbiome dysbiosis in different lung pathologies and the mechanisms by which these bacteria can cause or contribute to the severity of the disease. Furthermore, we describe how different respiratory disorders can be caused by the same pathogen, and that the real pathogenetic mechanism is not only dependent by the presence and amount of the main pathogen but can be shaped by the interaction it can build with other bacteria, fungi, and viruses present in the lung. Understanding the nature of this bacteria crosstalk could further our understanding of each respiratory disease leading to the development of new therapeutic strategies.

曾经被认为是一个无菌环境，现在已经确定，肺部充满了各种微生物，这些微生物参与维持肺功能，并在塑造肺部免疫监视方面发挥重要作用。尽管我们对微生物与肺细胞之间分子和代谢相互作用的理解仍处于起步阶段，但任何导致肺微生物组组成持续定性或定量变化的事件（称为“生态失调”）实际上都与许多呼吸系统疾病有关。深入了解“健康”肺部微生物群的组成和功能，以及生态失调如何导致或参与疾病进展，对于寻找旨在预防疾病和恢复肺功能的具体疗法至关重要。在这里，我们回顾了不同肺部病理中的肺微生物群失调以及这些细菌导致或加剧疾病严重程度的机制。此外，我们描述了相同病原体如何引起不同的呼吸系统疾病，并且真正的发病机制不仅取决于主要病原体的存在和数量，而且可以通过它与其他细菌、真菌建立的相互作用来形成，以及肺部存在的病毒。了解这种细菌串扰的本质可以进一步加深我们对每种呼吸道疾病的了解，从而开发新的治疗策略。