South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
SAHMRI Microbiome Research Laboratory, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia.
Respirology. 2019 Jan;24(1):19-28. doi: 10.1111/resp.13411. Epub 2018 Oct 3.
The composition of the airway microbiome in patients with chronic airway diseases, such as severe asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and cystic fibrosis (CF), has the potential to inform a precision model of clinical care. Patients with these conditions share overlapping disease characteristics, including airway inflammation and airflow limitation. The clinical management of chronic respiratory conditions is increasingly moving away from a one-size-fits-all model based on primary diagnosis, towards care targeting individual disease traits, and is particularly useful for subgroups of patients who respond poorly to conventional therapies. Respiratory microbiome analysis is an important potential contributor to such a 'treatable traits' approach, providing insight into both microbial drivers of airways disease, and the selective characteristics of the changing lower airway environment. We explore the potential to integrate respiratory microbiome analysis into a treatable traits model of clinical care and provide a practical guide to the application and clinical interpretation of respiratory microbiome analysis.
慢性气道疾病（如重度哮喘、慢性阻塞性肺疾病 [COPD]、支气管扩张症和囊性纤维化 [CF]）患者的气道微生物组构成有可能为临床精准护理模型提供信息。这些病症的患者具有重叠的疾病特征，包括气道炎症和气流受限。慢性呼吸系统疾病的临床管理正逐渐从基于主要诊断的一刀切模式转变为针对个体疾病特征的护理模式，对于那些对常规治疗反应不佳的患者亚组尤其有用。呼吸道微生物组分析是这种“可治疗特征”方法的一个重要潜在贡献者，为气道疾病的微生物驱动因素以及不断变化的下呼吸道环境的选择性特征提供了深入了解。我们探讨了将呼吸道微生物组分析纳入临床护理可治疗特征模型的潜力，并提供了呼吸道微生物组分析应用和临床解释的实用指南。
