Therapeutic Targeting of the Respiratory Microbiome

Culture-independent microbiology hastransformed our understanding of therespiratory microbiome in health and disease(1). Enabled by advances in next-generationsequencing and other technologies, we nowappreciate the complexity of microbialcommunities within the respiratory tract,together with their metabolic, immunologic,and pathophysiologic consequences. Acrossthe spectrum of acute and chronicrespiratory disease, respiratory microbiotaare detectable, viable, and variable acrosspatients (2–5); correlated with disease statusand severity (1); associated with airway andalveolar inflammation (5, 6); metabolicallyactive and immunologically consequential(7, 8); predictive of clinical outcomes (9–11);influenced by environment and geography(6, 12); and causally involved in diseasepathogenesis in animal models (11, 13).