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The lung microbiome: clinical and therapeutic implications

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Abstract

The human respiratory tract, usually considered sterile, is currently being investigated for human-associated microbial communities. According to Dickson's conceptual model, the lung microbiota (LMt) is a dynamic ecosystem, whose composition, in healthy lungs, is likely to reflect microbial migration, reproduction, and elimination. However, which microbial genera constitutes a “healthy microbiome” per se remains hotly debated. It is now widely accepted that a bi-directional gut-lung axis connects the intestinal with the pulmonary microbiota and that the diet could have a role in modulating both microbiotas as in health as in pathological status. The LMt is altered in numerous respiratory disorders such as obstructive airway diseases, interstitial lung diseases, infections, and lung cancer. Some authors hypothesize that the use of specific bacterial strains, termed “probiotics,” with positive effects on the host immunity and/or against pathogens, could have beneficial effects in the treatment of intestinal disorders and pulmonary diseases. In this manuscript, we have reviewed the literature available on the LMt to delineate and discuss the potential relationship between composition alterations of LMt and lung diseases. Finally, we have reported some meaningful clinical studies that used integrated probiotics’ treatments to contrast some lung-correlated disorders.

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  1. Department of Clinical and Experimental Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy

    Alessio Fabbrizzi, Amedeo Amedei, Federico Lavorini & Giovanni Fontana

  2. Respiratory Unit, Careggi University Hospital, Florence, Italy

    Teresa Renda

  3. Sod of Interdisciplinary Internal Medicine, Azienda Ospedaliera Universitaria Careggi (AOUC), University of Florence, 50134, Florence, Italy

    Amedeo Amedei

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  1. Alessio Fabbrizzi
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Correspondence to Amedeo Amedei.

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Fabbrizzi, A., Amedei, A., Lavorini, F. et al. The lung microbiome: clinical and therapeutic implications. Intern Emerg Med 14, 1241–1250 (2019). https://doi.org/10.1007/s11739-019-02208-y

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