COPD AND THE AIRWAY MICROBIOME: WHAT RESPIROLOGISTS NEED TO KNOW

Sin, Don D.

doi:.0..

Tuberc Respir Dis > Accepted Articles

Review

DOI: https://doi.org/10.4046/trd.2023.0015 [Accepted]
Published online April 11, 2023.

COPD AND THE AIRWAY MICROBIOME: WHAT RESPIROLOGISTS NEED TO KNOW

Don D. Sin, MD, MPH

Centre for Heart Lung Innovation, St. Paul’s Hospital and University of British Columbia Division of Respiratory Medicine, Vancouver, BC, Canada

Correspondence: Don D. Sin,
Email: don.sin@hli.ubc.ca

Received: 31 January 2023 • Revised: 27 March 2023 • Accepted: 10 April 2023

Abstract

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. The lower airways contain a rich and diverse microbiome, which may play a significant regulatory role in both health and disease. In COPD, the microbiome becomes perturbed, causing dysbiosis. Increased representation of members in the Proteobacteria phylum and certain members in the Firmicutes phylum has been associated with increased risk of exacerbations and mortality. Therapies such as inhaled corticosteroids and azithromycin may modulate the airway microbiome or its metabolites in patients with COPD. This paper provides an up-to-date overview of the airway microbiome and its importance in the pathophysiology of COPD and as potential therapeutic target in the future.

Key Words: COPD, airway microbiome, dysbiosis, sequencing