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- Title
Evaluation of the lung microbiome as a therapeutic target in the management of idiopathic pulmonary fibrosis: role of antioxidant/antibiotic combination therapy.
- Authors
VARONE, F.; GIBIINO, G.; GASBARRINI, A.; RICHELDI, L.
- Abstract
OBJECTIVE: Changes in the composition of the lung microbiome influence many lung diseases, including idiopathic pulmonary fibrosis (IPF), with a demonstrated association between the progression of IPF and the assessed pulmonary microbial community. A hypothesis to explain the pathogenesis of IPF is that an oxidant-antioxidant imbalance causes repeated epithelial cell injury and endogenous and exogenous antioxidants/ redox modulators influence fibrogenesis, protect the lung against fibrosis, and prevent its progression. MATERIALS AND METHODS: The present article is focused on Lung Microbiome in Idiopathic Pulmonary Fibrosis and the role of Antioxidant/ Antibiotic Combination Therapy. RESULTS: N-Acetylcysteine (NAC) at concentrations possibly achievable by nebulization showed an in vitro synergy with colistin against S. maltophilia isolates (a common coloniser of the respiratory tract of patients with chronic lung disease). Combined NAC plus colistin seems to have a beneficial role in restoring oxidant injury which may be related to its antioxidant effect. Progress has been made in the identification of the lung microbiome and the possible causal role of bacteria in the IPF pathogenesis. Recent studies suggest that antibacterial therapy in combination with antioxidant therapy may be a promising avenue for the treatment of this untreatable disease. Novel routes of administration are also an important area of research and studies assessing the use of inhaled NAC in patients with IPF could be considered.
- Subjects
IDIOPATHIC pulmonary fibrosis; EPITHELIAL cells; LUNGS; ANTIBIOTICS; PULMONARY fibrosis; LUNG diseases
- Publication
European Review for Medical & Pharmacological Sciences, 2019, Vol 23, Issue 14, p6379
- ISSN
1128-3602
- Publication type
Article