The Airway Microbiome in COPD, Bronchiectasis and Bronchiectasis-COPD Overlap

"Chronic airway diseases including COPD, bronchiectasis, and bronchiectasis–COPD overlap (BCO) are biologically heterogeneous conditions. Advances in culture-independent sequencing have transformed our understanding of airway colonization, dysbiosis, and host–microbe interactions in these diseases. This presentation will provide an overview of the airway microbiome landscape across COPD, bronchiectasis, and BCO. I will discuss differences in microbial diversity, dominant pathogen patterns, and the concept of dysbiosis state. The talk will highlight how microbiome configurations relate to inflammation, exacerbation risk, and disease progression, and whether overlapping microbial signatures support shared biological mechanisms in BCO. Emerging approaches including longitudinal profiling, resistome and gut-lung axis will be discussed, with emphasis on how microbiome-informed stratification may guide precision therapy in chronic airway disease. This session aims to synthesize current evidence, identify knowledge gaps, and explore how airway microbiome research can be translated into clinically actionable strategies. "