---
title: "Dynamic Balance of the Lung Microbiome in Health and Respiratory Diseases"
id: "pubmed-40693591"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-40693591"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/40693591/"
doi: "10.1097/CM9.0000000000003712"
published_at: "2026-08-05T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Dynamic Balance of the Lung Microbiome in Health and Respiratory Diseases
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-40693591
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/40693591/)
- **DOI:** [10.1097/CM9.0000000000003712](https://doi.org/10.1097%2FCM9.0000000000003712)
- **Published At:** 2026-08-05T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Recent research rejects the idea that healthy human lungs are sterile, revealing a **dynamic lung microbiome** that interacts with the host and external factors. - The review summarizes differences in microbial composition between healthy individuals and those with **respiratory diseases**, and details how composition varies across disease states. - The lung microbiome plays a crucial role in maintaining respiratory homeostasis and influences immune responses and disease susceptibility. - Microbial changes are associated with disease severity and progression in conditions including **chronic obstructive pulmonary disease (COPD)**, **cystic fibrosis**, **lung cancer**, **asthma**, **COVID-19**, and **tuberculosis**. - The review discusses pathogenic mechanisms by which lung microbes contribute to or exacerbate disease, citing interactions with host immunity and local lung environment. - Systemic impacts of lung microbiome alterations are explored, highlighting emerging concepts of the **gut-lung axis** and **brain-lung axis** and their potential roles in modulating lung health. - Understanding microbial dynamics in the lung suggests new directions for targeted diagnostics and therapeutic strategies for respiratory diseases. - The article frames these findings as a comprehensive synthesis aimed at clinicians and researchers to inform future translational work in respiratory medicine.
## Clinical Analysis & Structured Key Points
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Epub 2025 Jul 21. # Dynamic balance of the lung microbiome in health and respiratory diseases [Xin Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+X&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China."), [Lingfeng Bi](https://pubmed.ncbi.nlm.nih.gov/?term=Bi+L&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China."), [Jiayi Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+J&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China."), [Dan Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+D&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-2 "Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-3 "The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China."), [Weimin Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+W&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-2 "Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-3 "The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China."), [Zhoufeng Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+Z&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#full-view-affiliation-2 "Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.") Affiliations Expand ### Affiliations * 1 Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. * 2 Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. * 3 The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. * PMID: **40693591** * DOI: [ 10.1097/CM9.0000000000003712 ](https://doi.org/10.1097/cm9.0000000000003712) Item in Clipboard Review # Dynamic balance of the lung microbiome in health and respiratory diseases Xin Wang et al. Chin Med J (Engl). 2026. Show details Display options Display options Format Abstract PubMed PMID Chin Med J (Engl) Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Chin+Med+J+%28Engl%29%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Chin+Med+J+%28Engl%29%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/40693591/) . 2026 Aug 5;139(15):2280-2298. doi: 10.1097/CM9.0000000000003712. Epub 2025 Jul 21. ### Authors [Xin Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+X&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China."), [Lingfeng Bi](https://pubmed.ncbi.nlm.nih.gov/?term=Bi+L&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China."), [Jiayi Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+J&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China."), [Dan Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+D&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-2 "Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-3 "The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China."), [Weimin Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+W&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-2 "Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-3 "The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China."), [Zhoufeng Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+Z&cauthor_id=40693591)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-1 "Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/40693591/#short-view-affiliation-2 "Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.") ### Affiliations * 1 Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, State Key Laboratory of Respiratory Health and Multimorbidity, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. * 2 Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. * 3 The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China. * PMID: **40693591** * DOI: [ 10.1097/CM9.0000000000003712 ](https://doi.org/10.1097/cm9.0000000000003712) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract Recent studies have challenged the once prevalent notion that the human lungs are sterile, instead unveiling a dynamic microbial environment that interacts intricately with both the host and external factors. This review describes the distinct microbial compositions between healthy individuals and those with respiratory diseases, as well as discussing the variations in microbial composition across different disease states. We explore the crucial role of the lung microbiome in maintaining respiratory health and describe its implications in various respiratory diseases. We discuss how these microbial differences correlate with the severity and progression of respiratory diseases, including chronic obstructive pulmonary disease, cystic fibrosis, lung cancer, asthma, coronavirus disease 2019, and tuberculosis. Furthermore, we analyze the pathogenic mechanisms of the lung microbiome, as well as the associations between changes in the lung microbiome and systemic effects, including the emerging concepts of the gut-lung axis and brain-lung axis, which highlight the interconnected influence of the microbiota on lung health. This review aims to provide a comprehensive understanding of the profound impact of microbial dynamics on respiratory health and disease, suggesting new avenues for targeted diagnostic and therapeutic strategies. **Keywords:** Asthma; Chronic obstructive pulmonary disease; Cystic fibrosis; Health; Immune mechanism; Lung cancer; Lung disease; Respiratory diseases; Respiratory microbiome. Copyright © 2025 The Chinese Medical Association, produced by Wolters Kluwer Health, LLC. under the CC-BY-NC-ND license. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ [The lung microbiome in 2015: a window on chronic lung diseases]. ](https://pubmed.ncbi.nlm.nih.gov/26576604/) Andréjak C, Delhaes L.Andréjak C, et al.Med Sci (Paris). 2015 Nov;31(11):971-8. doi: 10.1051/medsci/20153111011. Epub 2015 Nov 17.Med Sci (Paris). 2015.PMID: 26576604Review.French. * [ The Human Respiratory Microbiome: Current Understandings and Future Directions. ](https://pubmed.ncbi.nlm.nih.gov/36476129/) Zhao L, Luo JL, Ali MK, Spiekerkoetter E, Nicolls MR.Zhao L, et al.Am J Respir Cell Mol Biol. 2023 Mar;68(3):245-255. doi: 10.1165/rcmb.2022-0208TR.Am J Respir Cell Mol Biol. 2023.PMID: 36476129Free PMC article. * [ Lung inflammation and disease: A perspective on microbial homeostasis and metabolism. ](https://pubmed.ncbi.nlm.nih.gov/30466159/) Mendez R, Banerjee S, Bhattacharya SK, Banerjee S.Mendez R, et al.IUBMB Life. 2019 Feb;71(2):152-165. doi: 10.1002/iub.1969. Epub 2018 Nov 22.IUBMB Life. 2019.PMID: 30466159Free PMC article.Review. * [ The emerging relationship between the airway microbiota and chronic respiratory disease: clinical implications. ](https://pubmed.ncbi.nlm.nih.gov/22082166/) Huang YJ, Lynch SV.Huang YJ, et al.Expert Rev Respir Med. 2011 Dec;5(6):809-21. doi: 10.1586/ers.11.76.Expert Rev Respir Med. 2011.PMID: 22082166Free PMC article.Review. * [ The Intriguing Connection Between the Gut and Lung Microbiomes. ](https://pubmed.ncbi.nlm.nih.gov/39599558/) Druszczynska M, Sadowska B, Kulesza J, Gąsienica-Gliwa N, Kulesza E, Fol M.Druszczynska M, et al.Pathogens. 2024 Nov 15;13(11):1005. doi: 10.3390/pathogens13111005.Pathogens. 2024.PMID: 39599558Free PMC article. [ See all similar articles ](https://pubmed.ncbi.nlm.nih.gov/?linkname=p
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