The pulmonary microbiome: unlocking mechanistic insights and novel therapeutic horizons in pulmonary fibrosis

Pulmonary fibrosis (PF) is a progressive interstitial lung disease with poorly understood mechanisms. Emerging evidence reveals that pulmonary microbiota dysbiosis serves as a critical link between environmental factors, host responses, and fibrotic progression. Microbial imbalance, increased bacterial burden, and altered metabolites contribute to PF through epithelial injury, immune–metabolic reprogramming, and signaling regulation. This review summarizes the multidimensional roles of the pulmonary microbiome in PF and explores its potential for therapy.