Respiratory Microbiome

Since the beginning of the 2000s, gene sequencing technology with high data output has been widely used, and its routine use in the fields of proteomics, metabolomics, and epigenomics has led to the historical microbiology term “microbiota.” The entire gene summation of all microbes (bacteria, bacteriophage, fungi, protozoa, and viruses) belonging to the microbiota of a specific environment is termed the “microbiome.” Since the discovery of microbiota, the role of the respiratory microbiome in the pathogenesis of various lung diseases has been investigated and study results showed that respiratory microbiota may play a key modulatory role in immune, metabolic, and cellular functions, activating disease-related inflammatory signals, increasing airway disease susceptibility and disease severity, as well as directing different phenotypes. This chapter aims to summarize the current literature on respiratory microbiota, with a main focus on pediatric asthma studies, to provide a comprehensive approach to the respiratory microbiome and its relationship with airway disease. The microbiome represents a new frontier in respiratory medicine, and further research is needed to elucidate the potential mechanisms underlying the pathophysiological processes of airway disease by investigating bacteria, fungi, and viruses which are collectively linked to clinical outcomes, including periods of exacerbation, severity of disease, and response to treatment. In the future, microbiota-based approaches may help deeply to understand clinical symptoms in airway diseases and decelerate the progression of airway disease.