Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Editorial
. 2021 Nov 15;204(10):1117-1119.
doi: 10.1164/rccm.202109-2024ED.

Balancing Benefits and Risks: Do Inhaled Corticosteroids Modify the Lung Microbiome?

Shivani Singh  1 , Alexa A Pragman  2 , Leopoldo N Segal  1
Affiliations
Editorial

Balancing Benefits and Risks: Do Inhaled Corticosteroids Modify the Lung Microbiome?

Shivani Singh et al. Am J Respir Crit Care Med. .
No abstract available

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Schematic representation of the potentially dichotomous role of inhaled corticosteroids (ICS) in the lower airway microbial host interphase in chronic obstructive pulmonary disease. On the left, ICS use reduces host susceptibility to microbes by reducing mucus secretion and bacterial nutrients, which can lead to a decrease in microbial burden and a more diverse microbiota. On the right, ICS affects the immune response with suppression of antimicrobial molecules, macrophage phagocytosis, and blunting IFN responses. These effects can collectively lead to the “blooming” of certain microbes within the lung microbiota (thus reducing diversity) and increase the risk of infection.
See this image and copyright information in PMC

Comment on

References

    1. Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease: the GOLD science committee report 2019. Eur Respir J . 2019;53:1900164. - PubMed
    1. Stolberg VR, McCubbrey AL, Freeman CM, Brown JP, Crudgington SW, Taitano SH, et al. Glucocorticoid-augmented efferocytosis inhibits pulmonary pneumococcal clearance in mice by reducing alveolar macrophage bactericidal function. J Immunol . 2015;195:174–184. - PMC - PubMed
    1. van de Garde MD, Martinez FO, Melgert BN, Hylkema MN, Jonkers RE, Hamann J. Chronic exposure to glucocorticoids shapes gene expression and modulates innate and adaptive activation pathways in macrophages with distinct changes in leukocyte attraction. J Immunol . 2014;192:1196–1208. - PubMed
    1. Singanayagam A, Glanville N, Cuthbertson L, Bartlett NW, Finney LJ, Turek E, et al. Inhaled corticosteroid suppression of cathelicidin drives dysbiosis and bacterial infection in chronic obstructive pulmonary disease. Sci Transl Med . 2019;11:eaav3879. - PMC - PubMed
    1. Garcha DS, Thurston SJ, Patel AR, Mackay AJ, Goldring JJ, Donaldson GC, et al. Changes in prevalence and load of airway bacteria using quantitative PCR in stable and exacerbated COPD. Thorax . 2012;67:1075–1080. - PubMed

Substances