Abstract

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity andmortality worldwide. The lower airways contain a rich and diverse microbiome, whichmay play a significant regulatory role in both health and disease. In COPD, the microbiomebecomes perturbed, causing dysbiosis. Increased representation of membersin the Proteobacteria phylum and certain members in the Firmicutes phylum has beenassociated with increased risk of exacerbations and mortality. Therapies such as inhaledcorticosteroids and azithromycin may modulate the airway microbiome or itsmetabolites in patients with COPD. This paper provides an up-to-date overview of theairway microbiome and its importance in the pathophysiology of COPD and as potentialtherapeutic target in the future.