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Topic Overview
Complex microbial communities within the human body, constituting the microbiome, have a broad impact on human health and disease. Although the lungs were historically considered to be sterile, the development of sensitive, culture-independent technologies for study of microbes with DNA sequencing has debunked the dogma of lung sterility. The human lungs have been proven to harbor a diverse microbial community, which has low biomass in health but is severely altered in microbial burden and composition with acute respiratory illness, especially infectious pneumonia.  

Severe pneumonia complicated by acute lung injury (also known as acute respiratory distress syndrome or “ARDS”) has been a major cause of morbidity and mortality globally, often requiring admission to an intensive care unit (ICU). The COVID-19 pandemic has resulted in an unprecedented, massive presentation of critically ill patients with severe pneumonia and ARDS in ICUs around the world. Optimal care of pneumonia and ARDS depends on timely and accurate identification of the causative pathogen. However, current diagnostic methods are limited in sensitivity and timeliness, and treatment remains suboptimal. Furthermore, the role of the microbiome in ARDS remains poorly understood.  

Dr. Kitsios’ translational research has been leveraging multifaceted methodologies to simultaneously study lung microbial communities and the corresponding innate immunity responses of the critically ill host to respond to two key clinical challenges: Can we use culture-independent techniques for faster and more accurate diagnosis of the etiologic pathogen in pneumonia, and can we better stratify patients with ARDS for targeted therapies from simultaneous study of host-response and disrupted lung microbiota?