RT Journal Article SR Electronic T1 The microbiome in respiratory medicine: current challenges and future perspectives JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1602086 DO 10.1183/13993003.02086-2016 VO 49 IS 4 A1 Rosa Faner A1 Oriol Sibila A1 Alvar Agustí A1 Eric Bernasconi A1 James D. Chalmers A1 Gary B. Huffnagle A1 Chaysavanh Manichanh A1 Philip L. Molyneaux A1 Roger Paredes A1 Vicente Pérez Brocal A1 Julia Ponomarenko A1 Sanjay Sethi A1 Jordi Dorca A1 Eduard Monsó YR 2017 UL http://erj.ersjournals.com/content/49/4/1602086.abstract AB The healthy lung has previously been considered to be a sterile organ because standard microbiological culture techniques consistently yield negative results. However, culture-independent techniques report that large numbers of microorganisms coexist in the lung. There are many unknown aspects in the field, but available reports show that the lower respiratory tract microbiota: 1) is similar in healthy subjects to the oropharyngeal microbiota and dominated by members of the Firmicutes, Bacteroidetes and Proteobacteria phyla; 2) shows changes in smokers and well-defined differences in chronic respiratory diseases, although the temporal and spatial kinetics of these changes are only partially known; and 3) shows relatively abundant non-cultivable bacteria in chronic obstructive pulmonary disease, idiopathic pulmonary fibrosis, cystic fibrosis and bronchiectasis, with specific patterns for each disease. In all of these diseases, a loss of diversity, paralleled by an over-representation of Proteobacteria (dysbiosis), has been related to disease severity and exacerbations. However, it is unknown whether dysbiosis is a cause or a consequence of the damage to bronchoalveolar surfaces.Finally, little is known about bacterial functionality and the interactions between viruses, fungi and bacteria. It is expected that future research in bacterial gene expressions, metagenomics longitudinal analysis and host–microbiome animal models will help to move towards targeted microbiome interventions in respiratory diseases.The respiratory system bacterial community is dominated by specific phyla that change in chronic respiratory diseases http://ow.ly/j68Z30967DB