Microbiome in the pathogenesis of cystic fibrosis and lung transplant-related disease

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• 作者：Sushma K. Cribbs^a ; ^b ; ^{skomaku@emory.edu} ; James M. Beck^c ; ^d
• 关键词：CF ; cystic fibrosis ; BOS ; bronchiolitis obliterans syndrome ; rRNA ; ribosomal small subunit RNA ; HIV ; human immunodeficiency virus-1 ; COPD ; chronic obstructive pulmonary disease ; CFTR ; CF transmembrane conductance regulator ; BAL ; bronchoalveolar lavage ; OP ; oropharyngeal ; IS ; induced sputum ; ES ; expectorated sputum ; GI ; gastrointestinal ; OW ; oral wash
• 刊名：Translational Research
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：179
• 期：Complete
• 页码：84-96
• 全文大小：410 K
• 卷排序：179

文摘

Significant advances in culture-independent methods have expanded our knowledge about the diversity of the lung microbial environment. Complex microorganisms and microbial communities can now be identified in the distal airways in a variety of respiratory diseases, including cystic fibrosis (CF) and the posttransplantation lung. Although there are significant methodologic concerns about sampling the lung microbiome, several studies have now shown that the microbiome of the lower respiratory tract is distinct from the upper airway. CF is a disease characterized by chronic airway infections that lead to significant morbidity and mortality. Traditional culture–dependent methods have identified a select group of pathogens that cause exacerbations in CF, but studies using bacterial 16S rRNA gene–based microarrays have shown that the CF microbiome is an intricate and dynamic bacterial ecosystem, which influences both host immune health and disease pathogenesis. These microbial communities can shift with external influences, including antibiotic exposure. In addition, there have been a number of studies suggesting a link between the gut microbiome and respiratory health in CF. Compared with CF, there is significantly less knowledge about the microbiome of the transplanted lung. Risk factors for bronchiolitis obliterans syndrome, one of the leading causes of death, include microbial infections. Lung transplant patients have a unique lung microbiome that is different than the pretransplanted microbiome and changes with time. Understanding the host-pathogen interactions in these diseases may suggest targeted therapies and improve long-term survival in these patients.