Chronic obstructive pulmonary disease and the airway microbiome: A review for clinicians

• Published in: Respiratory medicine Vol. 225; p. 107586
• Main Authors: Luo, Lingxin, Tang, Junli, Du, Xianzhi, Li, Na
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2024
• Subjects: Chronic obstructive pulmonary disease; Dysbiosis; Infection; Inflammation; Pulmonary microbiome; Pulmonary microbiome; Infection; Chronic obstructive pulmonary disease; Inflammation; Dysbiosis
• ISSN: 0954-6111; 1532-3064; 1532-3064
• DOI: 10.1016/j.rmed.2024.107586

Chronic obstructive pulmonary disease (COPD) is a complex heterogeneous disease characterized by progressive airflow limitation and chronic inflammation. The progressive development and long-term repeated acute exacerbation of COPD make many patients still unable to control the deterioration of the disease after active treatment, and even eventually lead to death. An increasing number of studies have shown that the occurrence and development of COPD are closely related to the composition and changes of airway microbiome. This article reviews the interaction between COPD and airway microbiome, the potential mechanisms of interaction, and the treatment methods related to microbiome. We elaborated the internal correlation between airway microbiome and different stages of COPD, inflammatory endotypes, glucocorticoid and antibiotic treatment, analyze the pathophysiological mechanisms such as the “vicious cycle” hypothesis, abnormal inflammation-immune response of the host and the “natural selection” of COPD to airway microbiome, introduce the treatment of COPD related to microbiome and emphasize the predictive value of airway microbiome for the progression, exacerbation and prognosis of COPD, as well as the guiding role for clinical management of patients, in order to provide a new perspective for exploring the pathogenesis of COPD, and also provide clues and guidance for finding new treatment targets. •Patients of chronic obstructive pulmonary disease have heterogeneity of airway microbiome.•Changes in airway microbiome can reflect or even predict the development of chronic obstructive pulmonary disease.•The interaction between airway microbiome and host affects the development of chronic obstructive pulmonary disease.•Microbiome-related therapies have significant potential for chronic obstructive pulmonary disease.