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Comment
. 2015 Sep 15;192(6):648-51.
doi: 10.1164/rccm.201506-1230ED.

"B" for Bad, Beneficial, or Both? Lung Lymphoid Neogenesis in Chronic Obstructive Pulmonary Disease

Jeffrey L Curtis  1   2   3 , Christine M Freeman  4   5 , Gary B Huffnagle  2   6
Affiliations
Comment

"B" for Bad, Beneficial, or Both? Lung Lymphoid Neogenesis in Chronic Obstructive Pulmonary Disease

Jeffrey L Curtis et al. Am J Respir Crit Care Med. .
No abstract available

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Figures

Figure 1.
Figure 1.
Relationship between lung microbiome community structure and intrapulmonary lymphoid tissue abundance in cigarette smoking–induced chronic obstructive pulmonary disease (COPD). In never-smokers and smokers without airflow obstruction, lung bacterial communities are diverse and shaped by repeated elimination of bacteria derived from the upper airway. Lung bacteria are detectable only by sequencing, and some may be nonviable. In mild to moderate COPD, although sequencing indicates that microbe numbers are not necessarily greater, they become variably detectable by culture (indicating viability). Whether this change (transition 1) causes obstruction or is a marker of shared underlying causes is undefined. A further change occurs in moderate to severe COPD (transition 2), with reduced diversity and predominance of opportunistic and even pathogenic species. The relationship of this transition to spirometric severity differs between COPD phenotypes, and whether it drives progression outside exacerbations is unproven. Importantly, expansion of lung lymphoid follicles occurs relatively late during pathogenesis and parallels altered microbial community structure.
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