title: Bacterial-viral load and the immune response in stable and exacerbated COPD: significance and therapeutic prospects.
abstract: Chronic obstructive pulmonary disease (COPD) is characterized by persistent airflow limitation and an abnormal inflammatory response of the lung. Bacteria and viruses are a major cause of COPD exacerbations and may contribute to COPD progression by perpetuating the inflammatory response in the airways. Bacterial variety diminishes with increasing COPD severity. Respiratory viruses can colonize the lower respiratory tract in stable COPD, altering the respiratory microbiome and facilitating secondary bacterial infections. In this review, we present the most updated information about the role of bacteria and viruses in stable and exacerbated COPD. In our opinion, to optimize therapeutic strategies, the dynamic events involving bacterial-viral infections and related immune response in COPD phenotypes need to be better clarified. Our paper would address these points that we consider of great importance for the clinical management of COPD.
authors.affiliation: Department of Rehabilitation, Cardiorespiratory Unit, Fondazione Istituto G. Giglio di Cefalù, University of Palermo, Palermo, Italy.
authors.forename: Silvestro Ennio
authors.initials: SE
authors.lastname: D'Anna
authors.affiliation: Pneumology Unit and Laboratory of Cytoimmunopathology of Heart and Lung, Fondazione Salvatore Maugeri, IRCCS, Veruno (NO) and Cassano delle Murge (BA), University of Palermo, Palermo, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Balbi
authors.affiliation: Human Anatomy Section, Department of Experimental Biomedicine and Clinical Neuroscience, University of Palermo, Palermo, Italy; Euro-Mediterranean Institute of Science and Technology, Palermo, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cappello
authors.affiliation: Pneumology Unit and Laboratory of Cytoimmunopathology of Heart and Lung, Fondazione Salvatore Maugeri, IRCCS, Veruno (NO) and Cassano delle Murge (BA), University of Palermo, Palermo, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Carone
authors.affiliation: Pneumology Unit and Laboratory of Cytoimmunopathology of Heart and Lung, Fondazione Salvatore Maugeri, IRCCS, Veruno (NO) and Cassano delle Murge (BA), University of Palermo, Palermo, Italy.
authors.forename: Antonino
authors.initials: A
authors.lastname: Di Stefano
mesh_terms: D058491:Bacterial Load; D018450:Disease Progression; D006801:Humans; D007111:Immunity, Cellular; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000276:immunology* / Q000382:microbiology*; D019562:Viral Load
keywords: COPD phenotype; biomarkers; exacerbations; microbiome; severity of COPD