Narayana Jayanth Kumar, Mac Aogáin Micheál, Hansbro Philip M, Chotirmall Sanjay H
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Department of Biochemistry, St. James's Hospital.
Curr Opin Pulm Med. 2025 Mar 1;31(2):135-144. doi: 10.1097/MCP.0000000000001131. Epub 2024 Nov 2.
Advances in DNA sequencing and analysis of the respiratory microbiome highlight its close association with bronchiectasis phenotypes, revealing fresh opportunities for diagnosis, stratification, and personalized clinical intervention. An under-recognized condition, bronchiectasis is increasingly the subject of recent large-scale, multicentre, and longitudinal clinical studies including detailed analysis of the microbiome. In this review, we summarize recent progress in our understanding of the bronchiectasis microbiome within the context of its potential use in treatment decisions.
Diverse microbiome profiles exist in bronchiectasis, in line with the established disease heterogeneity including treatment response. Classical microbiology has established Pseudomonas aeruginosa and Haemophilus influenza as two microbial markers of disease, while holistic microbiome analysis has uncovered important associations with less common bacterial taxa including commensal an/or pathobiont species, including the emerging role of the fungal mycobiome, virome, and interactome. Integration of airway microbiomes with other high-dimensional biological and clinical datasets holds significant promise to determining treatable traits and mechanisms of disease related to the microbiome.
The bronchiectasis microbiome is an emerging and key area of study with significant implications for understanding bronchiectasis, influencing treatment decisions and ultimately improving patient outcomes.
DNA测序及呼吸道微生物组分析的进展突显了其与支气管扩张症表型的密切关联，为诊断、分层及个性化临床干预带来了新机遇。支气管扩张症这一未得到充分认识的疾病，正日益成为近期大规模、多中心及纵向临床研究的主题，其中包括对微生物组的详细分析。在本综述中，我们在支气管扩张症微生物组可能用于治疗决策的背景下，总结了我们对其理解的最新进展。
支气管扩张症存在多种微生物组特征，这与既定的疾病异质性相符，包括治疗反应。传统微生物学已将铜绿假单胞菌和流感嗜血杆菌确立为该疾病的两种微生物标志物，而整体微生物组分析则揭示了与不太常见的细菌类群的重要关联，包括共生菌和/或致病共生菌物种，以及真菌微生物组、病毒组和相互作用组的新作用。将气道微生物组与其他高维生物学和临床数据集相结合，对于确定与微生物组相关的可治疗特征和疾病机制具有重大前景。
支气管扩张症微生物组是一个新兴的关键研究领域，对理解支气管扩张症、影响治疗决策并最终改善患者预后具有重要意义。
