Abstract
Bronchiectasis is increasing in prevalence worldwide, yet current treatments available are limited to those alleviating symptoms and reducing exacerbations. The pathogenesis of the disease and the inflammatory, infective and molecular drivers of disease progression are not fully understood, making the development of novel treatments challenging. Understanding the role bacteria play in disease progression has been enhanced by the use of next-generation sequencing techniques such as 16S rRNA sequencing. The microbiome has not been extensively studied in bronchiectasis, but existing data show lung bacterial communities dominated by Pseudomonas, Haemophilus and Streptococcus, while exhibiting intraindividual stability and large interindividual variability. Pseudomonas- and Haemophilus-dominated microbiomes have been shown to be linked to severe disease and frequent exacerbations. Studies completed to date are limited in size and do not fully represent all clinically observed disease subtypes. Further research is required to understand the microbiomes role in bronchiectasis disease progression. This review discusses recent developments and future perspectives on the lung microbiome in bronchiectasis.
Abstract
Studies of the microbiome in bronchiectasis demonstrate an association between Pseudomonas, Haemophilus and other genera with exacerbations. Lower microbiome diversity correlates with greater disease severity. Larger studies are needed. http://bit.ly/2xwROOR
Footnotes
Provenance: Commissioned article, peer reviewed.
Conflict of interest: H. Richardson has nothing to disclose.
Conflict of interest: A.J. Dicker has nothing to disclose.
Conflict of interest: H. Barclay has nothing to disclose.
Conflict of interest: J.D. Chalmers reports grants and personal fees from GlaxoSmithKline, Boehringer-Ingelheim, Pfizer, Bayer Healthcare, Grifols and Insmed, grants from AstraZeneca, and personal fees from Napp and Aradigm corporation, outside the submitted work.
- Received April 28, 2019.
- Accepted July 1, 2019.
- Copyright ©ERS 2019.
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.