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Prof. Mike Surette - The Good and the Bad of Commensal-Pathogen Interactions in the Airways
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Descriptif
The airways arecolonized by a complex microbiota that varies in composition and density spatiallythroughout the respiratory tract, as well as temporally through the life-course. While the lower respiratory tract hastraditionally been considered sterile in healthy individuals, it is now clearthat the lower airways are continuously seeded with microbiota from oral andupper respiratory tract. This may represent a transient community that iscleared and reseeded in healthy individuals; however, it is clear that inchronic airway disease, members of this commensal microbiota thrive in thelower airways. Here they are often inthe presence of the pathogens traditionally associated with chronic lunginfections. These may simply representopportunistic colonizers with little contribution to disease, or they maycontribute to disease as part of polymicrobial infections, or more directly aspathogens themselves. The pathogenicpotential of many commensal microbiota is under appreciated. Conversely, the commensal microbiota plays anintegral role in colonization resistance, and the ability of commensalmicrobiota to inhibit the growth of common pathogens is widespread. The dichotomy in ‘good vs bad’ behaviour ofcommensal microbiota is often a ‘strain’ rather than species specificproperty. While the complexity of thesecommensal-pathogen Interactions pose a challenge in standard diagnostic andmicrobiome profiling approaches to respiratory disease, they do represent opportunitiesfor novel interventions in managing chronic airway disease and reducingsusceptibility to respiratory infections in vulnerable populations.
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