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The role of acute and chronic respiratory colonization and infections in the pathogenesis of COPD.
Leung, Janice M; Tiew, Pei Yee; Mac Aogáin, Micheál; Budden, Kurtis F; Yong, Valerie Fei Lee; Thomas, Sangeeta S; Pethe, Kevin; Hansbro, Philip M; Chotirmall, Sanjay H.
Afiliação
  • Leung JM; Centre for Heart Lung Innovation, Vancouver, British Columbia, Canada.
  • Tiew PY; Division of Respiratory Medicine, St Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
  • Mac Aogáin M; Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Singapore.
  • Budden KF; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
  • Yong VF; Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia.
  • Thomas SS; Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
  • Pethe K; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
  • Hansbro PM; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
  • Chotirmall SH; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Respirology ; 22(4): 634-650, 2017 05.
Article em En | MEDLINE | ID: mdl-28342288
COPD is a major global concern, increasingly so in the context of ageing populations. The role of infections in disease pathogenesis and progression is known to be important, yet the mechanisms involved remain to be fully elucidated. While COPD pathogens such as Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae are strongly associated with acute exacerbations of COPD (AECOPD), the clinical relevance of these pathogens in stable COPD patients remains unclear. Immune responses in stable and colonized COPD patients are comparable to those detected in AECOPD, supporting a role for chronic colonization in COPD pathogenesis through perpetuation of deleterious immune responses. Advances in molecular diagnostics and metagenomics now allow the assessment of microbe-COPD interactions with unprecedented personalization and precision, revealing changes in microbiota associated with the COPD disease state. As microbial changes associated with AECOPD, disease severity and therapeutic intervention become apparent, a renewed focus has been placed on the microbiology of COPD and the characterization of the lung microbiome in both its acute and chronic states. Characterization of bacterial, viral and fungal microbiota as part of the lung microbiome has the potential to reveal previously unrecognized prognostic markers of COPD that predict disease outcome or infection susceptibility. Addressing such knowledge gaps will ultimately lead to a more complete understanding of the microbe-host interplay in COPD. This will permit clearer distinctions between acute and chronic infections and more granular patient stratification that will enable better management of these features and of COPD.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Sistema Respiratório / Infecções Respiratórias / Bactérias / Infecções Bacterianas / Doença Pulmonar Obstrutiva Crônica Tipo de estudo: Etiology_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Sistema Respiratório / Infecções Respiratórias / Bactérias / Infecções Bacterianas / Doença Pulmonar Obstrutiva Crônica Tipo de estudo: Etiology_studies / Prognostic_studies Limite: Humans Idioma: En Ano de publicação: 2017 Tipo de documento: Article