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Modern sequencing approaches have overturned the older view that healthy lungs are sterile. Reviews of the lung microbiome describe how 16S rRNA sequencing, metagenomics and related molecular methods have identified microbial communities and host–microbe interactions relevant to respiratory health and disease. The evidence is still evolving, and interpretation is complicated by low microbial biomass, contamination risk and differences in sampling and analytical methods. For internists, the important shift is conceptual: respiratory disease may reflect not only individual pathogens but also changes in microbial ecology, mucosal immunity and interactions along the gut–lung axis. This has implications for chronic airway disease, infection susceptibility and the development of microbiome-informed therapies. At present, routine clinical decisions should not be based on unvalidated microbiome signatures, but the research agenda is rapidly moving toward more precise molecular phenotyping. The topic fits APICON's translational emphasis because it links basic science to potential future diagnostics and therapeutics while also illustrating why rigorous study design is essential before promising molecular findings enter everyday practice.
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Modern sequencing approaches have overturned the older view that healthy lungs are sterile. Reviews of the lung microbiome describe how 16S rRNA sequencing, metagenomics and related molecular methods have identified microbial communities and host–microbe interactions relevant to respiratory health and disease. The evidence is still evolving, and interpretation is complicated by low microbial biomass, contamination risk and differences in sampling and analytical methods. For internists, the important shift is conceptual: respiratory disease may reflect not only individual pathogens but also changes in microbial ecology, mucosal immunity and interactions along the gut–lung axis. This has implications for chronic airway disease, infection susceptibility and the development of microbiome-informed therapies. At present, routine clinical decisions should not be based on unvalidated microbiome signatures, but the research agenda is rapidly moving toward more precise molecular phenotyping. The topic fits APICON's translational emphasis because it links basic science to potential future diagnostics and therapeutics while also illustrating why rigorous study design is essential before promising molecular findings enter everyday practice.
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