Infection and the microbiome in bronchiectasis.

Autor:	Mac Aogáin M; Biochemical Genetics Laboratory, Department of Biochemistry, St. James's Hospital, Dublin, Ireland.; Clinical Biochemistry Unit, School of Medicine, Trinity College Dublin, Dublin, Ireland., Dicker AJ; Respiratory Research Group, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK., Mertsch P; Department of Medicine V, LMU University Hospital, LMU Munich, Comprehensive Pneumology Center (CPC), Member of the German Center of Lung Research (DZL), Munich, Germany., Chotirmall SH; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore schotirmall@ntu.edu.sg.; Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, Singapore, Singapore.
Jazyk:	angličtina
Zdroj:	European respiratory review : an official journal of the European Respiratory Society [Eur Respir Rev] 2024 Jul 03; Vol. 33 (173). Date of Electronic Publication: 2024 Jul 03 (Print Publication: 2024).
DOI:	10.1183/16000617.0038-2024
Abstrakt:	Bronchiectasis is marked by bronchial dilatation, recurrent infections and significant morbidity, underpinned by a complex interplay between microbial dysbiosis and immune dysregulation. The identification of distinct endophenotypes have refined our understanding of its pathogenesis, including its heterogeneous disease mechanisms that influence treatment and prognosis responses. Next-generation sequencing (NGS) has revolutionised the way we view airway microbiology, allowing insights into the "unculturable". Understanding the bronchiectasis microbiome through targeted amplicon sequencing and/or shotgun metagenomics has provided key information on the interplay of the microbiome and host immunity, a central feature of disease progression. The rapid increase in translational and clinical studies in bronchiectasis now provides scope for the application of precision medicine and a better understanding of the efficacy of interventions aimed at restoring microbial balance and/or modulating immune responses. Holistic integration of these insights is driving an evolving paradigm shift in our understanding of bronchiectasis, which includes the critical role of the microbiome and its unique interplay with clinical, inflammatory, immunological and metabolic factors. Here, we review the current state of infection and the microbiome in bronchiectasis and provide views on the future directions in this field. Competing Interests: Conflict of interest: S.H. Chotirmall serves on advisory boards for CSL Behring, Pneumagen Ltd and Boehringer Ingelheim, has received lecture fees from AstraZeneca and Chiesi Farmaceutici and has served on data safety and monitoring boards (DSMBs) for Inovio Pharmaceuticals Ltd and Imam Abdulrahman Bin Faisal University. All other authors have no conflicts to disclose. (Copyright ©The authors 2024.)
Databáze:	MEDLINE
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