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首页> 外文期刊>Journal of Clinical Medicine Research >Influence of the Lung Microbiota Dysbiosis in Chronic Obstructive Pulmonary Disease Exacerbations: The Controversial Use of Corticosteroid and Antibiotic Treatments and the Role of Eosinophils as a Disease Marker
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Influence of the Lung Microbiota Dysbiosis in Chronic Obstructive Pulmonary Disease Exacerbations: The Controversial Use of Corticosteroid and Antibiotic Treatments and the Role of Eosinophils as a Disease Marker

机译：肺部微生物症失效在慢性阻塞性肺病的影响：皮质类固醇和抗生素治疗的争议使用以及嗜酸性粒细胞作为疾病标记的作用

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Chronic obstructive pulmonary disease (COPD) is a debilitating lung disease associated with loss of lung function, poorer quality of life, co-morbidities, significant mortality, and higher health care costs. Frequent acute exacerbations of COPD are sudden worsening of symptoms, the nature of which is associated with bacterial or viral infections. However, one-third of exacerbations remain of undetermined origin. Although it is largely discussed and controversial, current guidelines recommend treatment of exacerbations with bronchodilators, antibiotics, and systemic corticosteroids; this is despite being associated with limited benefits in term of reducing mortality, side effects and without paying attention to the heterogeneity of these exacerbations. Increasing evidence suggests that the lung microbiota plays an important role in COPD and numerous studies have reported differences in the microbiota between healthy and disease states, as well as between exacerbations and stable COPD, leading to the hypothesis that frequent acute exacerbation is more likely to experience significant changes in lung microbiota composition. These findings will need further examination to explain the causes of lung dysbiosis, namely microbial composition, the host response, including the recruitment of eosinophils, lifestyle, diet, cigarette smoking and the use of antibiotics and corticosteroids. It is now important to assess: 1) Whether alterations in the lung microbiota contribute to disease pathogenesis, especially in exacerbations of unknown origin; 2) The role of eosinophils; and 3) Whether the microbiota of the lung can be manipulated therapeutically to improve COPD exacerbation event and disease progression. In summary, we hypothesize that the alterations of the lung microbiota may explain the undetermined origins of exacerbations and that there is an urgent need to facilitate the design of intervention studies that aim at conserving the lung microbial flora.Copyright 2019, Toraldo et al.
机译：慢性阻塞性肺病（COPD）是一种衰弱的肺病，与肺功能丧失相关，生活质量较差，生命性，严重的死亡率，以及更高的医疗费用。频繁的COPD急剧恶化是症状的突然恶化，其性质与细菌或病毒感染有关。然而，三分之一的恶化仍然是未确定的起源。虽然主要讨论和争议，但目前的指导方针建议使用支气管扩张剂，抗生素和全身皮质类固醇治疗恶化;尽管在减少死亡率，副作用和不关注这些恶化的异质性的情况下，这是与有限的益处相关。越来越多的证据表明，肺部微生物群在COPD中发挥着重要作用，许多研究报告了健康和疾病状态之间微生物群的差异，以及加剧和稳定的COPD之间，导致频繁急剧加剧的假设更容易发白肺部微生物群组成的显着变化。这些调查结果将需要进一步检查来解释肺失血症的原因，即微生物组合物，宿主反应，包括嗜酸性粒细胞募集，生活方式，饮食，吸烟和抗生素和皮质类固醇的使用。评估现在是重要的：1）肺部微生物群的改变是否有助于疾病发病机制，特别是在未知起源的恶化; 2）嗜酸性粒细胞的作用; 3）可以治疗肺部的微生物群，以改善COPD恶化事件和疾病进展。总之，我们假设肺部微生物群的改变可以解释未确定的恶化的起源，并且迫切需要促进旨在节约肺部微生物植物植物的干预研究的设计.Popystight 2019，Toraldo等人。

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