Dickson Robert P, Erb-Downward John R, Martinez Fernando J, Huffnagle Gary B
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan 48109; email:
Department of Internal Medicine, Weill Cornell Medical College, New York, NY 10065.
Annu Rev Physiol. 2016;78:481-504. doi: 10.1146/annurev-physiol-021115-105238. Epub 2015 Nov 2.
Although the notion that "the normal lung is free from bacteria" remains common in textbooks, it is virtually always stated without citation or argument. The lungs are constantly exposed to diverse communities of microbes from the oropharynx and other sources, and over the past decade, novel culture-independent techniques of microbial identification have revealed that the lungs, previously considered sterile in health, harbor diverse communities of microbes. In this review, we describe the topography and population dynamics of the respiratory tract, both in health and as altered by acute and chronic lung disease. We provide a survey of current techniques of sampling, sequencing, and analysis of respiratory microbiota and review technical challenges and controversies in the field. We review and synthesize what is known about lung microbiota in various diseases and identify key lessons learned across disease states.
尽管“正常肺部没有细菌”这一观念在教科书中仍然很常见，但几乎总是在没有引用或论证的情况下陈述。肺部不断接触来自口咽和其他来源的各种微生物群落，在过去十年中，新型的不依赖培养的微生物鉴定技术表明，以前被认为在健康状态下无菌的肺部含有各种各样的微生物群落。在这篇综述中，我们描述了健康状态下以及因急性和慢性肺部疾病而改变的呼吸道的地形和种群动态。我们对当前呼吸道微生物群的采样、测序和分析技术进行了综述，并回顾了该领域的技术挑战和争议。我们回顾并综合了关于各种疾病中肺部微生物群的已知信息，并确定了在不同疾病状态下吸取的关键经验教训。
