TY - JOUR T1 - The contribution of infection and the respiratory microbiome in acute exacerbations of idiopathic pulmonary fibrosis JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW DO - 10.1183/16000617.0045-2019 VL - 28 IS - 152 SP - 190045 AU - Rachele Invernizzi AU - Philip L. Molyneaux Y1 - 2019/06/30 UR - http://err.ersjournals.com/content/28/152/190045.abstract N2 - Idiopathic pulmonary fibrosis (IPF) arises in genetically susceptible individuals as a result of an aberrant wound-healing response following repetitive alveolar injury. The clinical course of the disease remains both variable and unpredictable with periods of more rapid decline, termed acute exacerbation of IPF (AE-IPF), often punctuating the disease trajectory. Exacerbations carry a significant morbidity and mortality, and their exact pathogenesis remains unclear. Given the emerging evidence that disruption and alteration in the lung microbiome plays a role in the pathogenesis and progression of IPF, this review discusses the current knowledge of the contribution of infection and the respiratory microbiome to AE-IPF.Microbial dysbosis plays a role in the pathogenesis of IPF and further changes occur during acute exacerbations despite exclusion of overt infection. http://bit.ly/2MQkfBN ER -