Toggle Main Menu Toggle Search

Open Access padlockePrints

A clinical review of the potential role of microaspiration and a dysregulated aerodigestive microbiome in lung disease

Lookup NU author(s): Abdullah Althuwaybi, Amal Alamer, Dr Matthew Wilcox, Dr Peter Chater, Professor Jeffrey Pearson, Professor Christopher WardORCiD



This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).


© Annals of Esophagus. All rights reserved.When initiated the human microbiome project did not include the lungs and airways in its sampling sites, indicating an under appreciation of the role of the human lung microbiome in health and disease. This paradigm has recently changed through the use of culture independent methods to characterise the human lung microbiome. The original thinking, that the normal lung was essentially sterile, had previously been challenged by findings of microaspiration in normal volunteers and in patients with decreased levels of consciousness. The sterile lung was also questioned by findings of clinically occult infection markers in lung allograft recipients. What is arguably a “rediscovery” of the importance of the human lung microbiome may still underappreciate physiological and patho-physiological inter-relationships between organ systems, studied in separate research disciplines. In particular, microaspiration may be an important, direct mechanism through which the lung microbiome is modulated. As well as aspiration related to gastro-oesophageal reflux and microaspiration the authors feel that the importance of dysphagia in chronic lung disease, will be increasingly recognised in frailty related microbiome exchange between the oropharynx into the lung. This review therefore discusses interconnections in the human microbiome, with a focus on the potential for aerodigestive pathophysiology and microaspiration. Potential connections with human lung disease are discussed and contextualised within a developing literature. This review therefore highlights much needed new targets for translational intervention in lung pathophysiology and underlies the importance of a mixed disciplinary team approach for the future.

Publication metadata

Author(s): Althuwaybi A, Alamer A, McDonnell MJ, Brennan M, Rutherford RM, Wilcox M, Chater P, Pearson J, Ward C

Publication type: Review

Publication status: Published

Journal: Annals of Esophagus

Year: 2023

Volume: 6

Print publication date: 25/03/2023

Online publication date: 11/11/2021

Acceptance date: 12/01/2021

ISSN (electronic): 2616-2784

Publisher: AME Publishing Company


DOI: 10.21037/aoe-20-88