📝 Article 2: The Lung Microbiome – More Than Just Aspergillus

🌱 What is the lung microbiome?

The lung microbiome is the collection of bacteria, fungi, and viruses that naturally live in your respiratory system. For a long time, lungs were thought to be sterile — we now know that they host complex microbial communities, even in healthy people.

In people with chronic lung conditions like CPA, ABPA, asthma, bronchiectasis, and cystic fibrosis, the lung microbiome can become unbalanced. Certain harmful microbes may overgrow, while beneficial ones disappear.

🤝 Why is this important?

The balance of microbes in your lungs affects:

• How your immune system responds

• Whether inflammation is triggered or controlled

• How easily infections take hold

In aspergillosis patients:

• Disruption of the microbiome may encourage fungal growth

• Frequent antibiotics (for chest infections) can kill good bacteria, giving fungi and drug-resistant bacteria an advantage

• Some microbes may protect against Aspergillus or help modulate inflammation

This is particularly important during flare-ups and exacerbations.

🧪 What are researchers doing?

Lung microbiome research is growing rapidly. Scientists are:

• Identifying “protective” microbes that might reduce disease severity

• Studying how antibiotics, steroids, and antifungals alter the microbiome

• Investigating faecal or airway microbiota transplants in severe lung disease

• Developing tests that detect imbalances in lung flora before symptoms worsen

💡 What can you do as a patient?

• Avoid unnecessary or repeated broad-spectrum antibiotics unless clearly needed

• Use airway clearance techniques to keep mucus and debris low

• Ask your clinician if your sputum cultures test for both bacteria and fungi

• Consider probiotics cautiously, though evidence for lung benefit is still limited