TY - JOUR T1 - The microbiome in bronchiectasis JF - European Respiratory Review JO - EUROPEAN RESPIRATORY REVIEW DO - 10.1183/16000617.0048-2019 VL - 28 IS - 153 SP - 190048 AU - Hollian Richardson AU - Alison J. Dicker AU - Heather Barclay AU - James D. Chalmers Y1 - 2019/09/30 UR - http://err.ersjournals.com/content/28/153/190048.abstract N2 - 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.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 ER -