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  • Opinion
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New opportunities for managing acute and chronic lung infections

Nature Reviews Microbiology volume 16, pages 111–120 (2018)Cite this article

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Abstract

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.

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Figure 1: Pulmonary infections associated with bacterial pathogens.
Figure 2: Current therapeutic strategies for lung infections.
Figure 3: New therapeutic strategies for lung infections.

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Acknowledgements

W.O.C.M.C., M.J.C. and M.F.M. receive funding from the Wellcome Trust and from the Asmarley Trust. W.O.C.M.C. and M.F.M. are joint Wellcome Senior Investigators. W.O.C.M.C. also received funding for microbiome studies with a Senior Investigator award from the National Institute for Health Research, United Kingdom.

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  1. Asmarley Centre for Genomic Medicine, National Heart and Lung Institute, Imperial College London, Dovehouse Street, London, SW3 6LY, UK

    William O. C. M. Cookson, Michael J. Cox & Miriam F. Moffatt

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  1. William O. C. M. Cookson
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  2. Michael J. Cox
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  3. Miriam F. Moffatt
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W.O.C.M.C. carried out research, wrote the article and contributed to discussions, review and editing of the manuscript. M.J.C. and M.F.M. carried out research and contributed to discussions, review and editing of the manuscript. The authors gratefully acknowledge the considerable input of two anonymous reviewers.

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Correspondence to William O. C. M. Cookson.

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Cookson, W., Cox, M. & Moffatt, M. New opportunities for managing acute and chronic lung infections. Nat Rev Microbiol 16, 111–120 (2018). https://doi.org/10.1038/nrmicro.2017.122

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