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The Role of the Lung’s Microbiome in the Pathogenesis and Progression of Idiopathic Pulmonary Fibrosis

1
Respiratory Disease Unit, Department of Cardiac Thoracic, Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Paolo, Italy
2
NIHR Respiratory Clinical Research Facility, Royal Brompton Hospital, London SW3 6LR, UK
3
National Heart and Lung Institute, Imperial College, Sir Alexander Fleming Building, London SW7 2AZ, UK
4
Respiratory Disease and Lung Function Unit, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
*
Author to whom correspondence should be addressed.
Int. J. Mol. Sci. 2019, 20(22), 5618; https://doi.org/10.3390/ijms20225618
Received: 22 October 2019 / Revised: 4 November 2019 / Accepted: 8 November 2019 / Published: 10 November 2019
(This article belongs to the Special Issue Lung Diseases and Infections in the New Era)
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial lung disease that commonly affects older adults and is associated with the histopathological and/or radiological patterns of usual interstitial pneumonia (UIP). Despite significant advances in our understanding of disease pathobiology and natural history, what causes IPF remains unknown. A potential role for infection in the disease’s pathogenesis and progression or as a trigger of acute exacerbation has long been postulated, but initial studies based on traditional culture methods have yielded inconsistent results. The recent application to IPF of culture-independent techniques for microbiological analysis has revealed previously unappreciated alterations of the lung microbiome, as well as an increased bacterial burden in the bronchoalveolar lavage (BAL) of IPF patients, although correlation does not necessarily entail causation. In addition, the lung microbiome remains only partially characterized and further research should investigate organisms other than bacteria and viruses, including fungi. The clarification of the role of the microbiome in the pathogenesis and progression of IPF may potentially allow its manipulation, providing an opportunity for targeted therapeutic intervention. View Full-Text
Keywords: idiopathic pulmonary fibrosis; interstitial lung disease; microbiome; pathogenesis; acute exacerbation; infection idiopathic pulmonary fibrosis; interstitial lung disease; microbiome; pathogenesis; acute exacerbation; infection
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Spagnolo, P.; Molyneaux, P.L.; Bernardinello, N.; Cocconcelli, E.; Biondini, D.; Fracasso, F.; Tiné, M.; Saetta, M.; Maher, T.M.; Balestro, E. The Role of the Lung’s Microbiome in the Pathogenesis and Progression of Idiopathic Pulmonary Fibrosis. Int. J. Mol. Sci. 2019, 20, 5618.

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