New opportunities for managing acute and chronic lung infections

• Published in: Nature reviews. Microbiology Vol. 16; no. 2; pp. 111 - 120
• Main Authors: Cookson, William O. C. M., Cox, Michael J., Moffatt, Miriam F.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-02-2018; Nature Publishing Group
• Subjects: 631/326/107; 631/326/22; 631/326/2521; 692/699/255; Acute Disease; Adults; Analysis; Anti-Bacterial Agents - therapeutic use; Antibiotic resistance; Antibiotics; Bacterial Infections - drug therapy; Bacterial Infections - microbiology; Care and treatment; Children; Chronic Disease; Diagnosis; Drug Resistance, Bacterial; Global Health; Globalization; Health aspects; Humans; Infections; Infectious Diseases; Intestine; Life Sciences; Lung - microbiology; Lung diseases; Lung Diseases - drug therapy; Lung Diseases - microbiology; Lungs; Medical Microbiology; Microbiology; Microbiomes; Microbiota; Microbiota (Symbiotic organisms); Microorganisms; Mucosa; opinion-2; Parasitology; Pathogenic microorganisms; Physiological aspects; Respiratory tract infections; Skin; Urbanization; Virology; United Kingdom
• ISSN: 1740-1526; 1740-1534
• DOI: 10.1038/nrmicro.2017.122

Traditional strategies to treat lung infections are based on the premise that the lung is sterile; however, it is now thought that the lung contains a resident microbiota. Here, Cookson
et al
. propose that concepts flowing from the Human Microbiome Project can transform the treatment of lung infections.
Lung diseases caused by microbial infections affect hundreds of millions of children and adults throughout the world. In Western populations, the treatment of lung infections is a primary driver of antibiotic resistance. Traditional therapeutic strategies have been based on the premise that the healthy lung is sterile and that infections grow in a pristine environment. As a consequence, rapid advances in our understanding of the composition of the microbiota of the skin and bowel have not yet been matched by studies of the respiratory tree. The recognition that the lungs are as populated with microorganisms as other mucosal surfaces provides the opportunity to reconsider the mechanisms and management of lung infections. Molecular analyses of the lung microbiota are revealing profound adverse responses to widespread antibiotic use, urbanization and globalization. This Opinion article proposes how technologies and concepts flowing from the Human Microbiome Project can transform the diagnosis and treatment of common lung diseases.