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Lung Microbiome as a Treatable Trait in Chronic Respiratory Disorders

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Abstract

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.

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Abbreviations

URT:

Upper respiratory tract

LRT:

Lower respiratory tract

BE:

Bronchiectasis

CF:

Cystic fibrosis

COPD:

Chronic obstructive pulmonary disease

PDE:

Phosphodiesterase

CFTR:

Cystic fibrosis transmembrane regulator

AMP:

Antimicrobial peptide

BAL:

Bronchoalveolar lavage

SCLC:

Small cell lung cancer

NSCLC:

Non small cell lung cancer

EBC:

Exhaled breath condensate

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Author notes

  1. Filippo Scialò and Maria Vitale have contributed equally to this work.

Authors and Affiliations

  1. Department of Translational Medical Science, University of Campania Luigi Vanvitelli, Naples, Italy

    Filippo Scialò, Vito D’Agnano, Domenica Francesca Mariniello, Fabio Perrotta, Susan F. M. Campbell & Andrea Bianco

  2. CEINGE-Biotecnologie Avanzate-Franco Salvatore, Naples, Italy

    Filippo Scialò, Maria Vitale & Lucio Pastore

  3. Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy

    Alice Castaldo

  4. Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy

    Lucio Pastore

  5. Dipartimento di Medicina Sperimentale, University of Rome “Tor Vergata”, Rome, Italy

    Mario Cazzola

Authors
  1. Filippo Scialò
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  2. Maria Vitale
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  3. Vito D’Agnano
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  4. Domenica Francesca Mariniello
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  6. Alice Castaldo
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  7. Susan F. M. Campbell
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  8. Lucio Pastore
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  9. Mario Cazzola
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  10. Andrea Bianco
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Contributions

AB: Conceptualization. VD, DM: Software. FS, MV, AC, SFMC, FP: Writing—original draft preparation, AB, MC, LP, SFMC, FS: Writing—review and editing; visualization, FS, VD, DM. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Andrea Bianco.

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Scialò, F., Vitale, M., D’Agnano, V. et al. Lung Microbiome as a Treatable Trait in Chronic Respiratory Disorders. Lung 201, 455–466 (2023). https://doi.org/10.1007/s00408-023-00645-3

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