dc.contributor.authorLeung, Janice M.
dc.contributor.authorTiew, Pei Yee
dc.contributor.authorMac Aogáin, Micheál
dc.contributor.authorBudden, Kurtis F.
dc.contributor.authorYong, Valerie Fei Lee
dc.contributor.authorThomas, Sangeeta Susan
dc.contributor.authorPethe, Kevin
dc.contributor.authorHansbro, Philip M.
dc.contributor.authorChotirmall, Sanjay Haresh
dc.identifier.citationLeung, J. M., Tiew, P. Y., Mac Aogáin, M., Budden, K. F., Yong, V. F. L., Thomas, S. S., et al. (2017). The role of acute and chronic respiratory colonization and infections in the pathogenesis of COPD. Respirology, 22(4), 634–650.en_US
dc.description.abstractCOPD is a major global concern, increasingly so in the context of ageing populations. The role of infections in disease pathogenesis and progression is known to be important, yet the mechanisms involved remain to be fully elucidated. While COPD pathogens such as Haemophilus influenzae, Moraxella catarrhalis and Streptococcus pneumoniae are strongly associated with acute exacerbations of COPD (AECOPD), the clinical relevance of these pathogens in stable COPD patients remains unclear. Immune responses in stable and colonized COPD patients are comparable to those detected in AECOPD, supporting a role for chronic colonization in COPD pathogenesis through perpetuation of deleterious immune responses. Advances in molecular diagnostics and metagenomics now allow the assessment of microbe-COPD interactions with unprecedented personalization and precision, revealing changes in microbiota associated with the COPD disease state. As microbial changes associated with AECOPD, disease severity and therapeutic intervention become apparent, a renewed focus has been placed on the microbiology of COPD and the characterization of the lung microbiome in both its acute and chronic states. Characterization of bacterial, viral and fungal microbiota as part of the lung microbiome has the potential to reveal previously unrecognized prognostic markers of COPD that predict disease outcome or infection susceptibility. Addressing such knowledge gaps will ultimately lead to a more complete understanding of the microbe-host interplay in COPD. This will permit clearer distinctions between acute and chronic infections and more granular patient stratification that will enable better management of these features and of COPD.en_US
dc.description.sponsorshipNMRC (Natl Medical Research Council, S’pore)en_US
dc.description.sponsorshipMOH (Min. of Health, S’pore)en_US
dc.format.extent67 p.en_US
dc.rights© 2017 Asian Pacific Society of Respirology. This is the author created version of a work that has been peer reviewed and accepted for publication by Respirology, Asian Pacific Society of Respirology. It incorporates referee’s comments but changes resulting from the publishing process, such as copyediting, structural formatting, may not be reflected in this document. The published version is available at: [http://dx.doi.org/10.1111/resp.13032].en_US
dc.subjectAcute exacerbations of chronic obstructive pulmo-nary diseaseen_US
dc.subjectChronic obstructive pulmonary diseaseen_US
dc.titleThe role of acute and chronic respiratory colonization and infections in the pathogenesis of COPDen_US
dc.typeJournal Article
dc.contributor.schoolLee Kong Chian School of Medicineen_US
dc.description.versionAccepted versionen_US

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