Pathogen Targeting in Chronic Respiratory Diseases: Prevention, Therapy and Management

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Background

The burden of chronic respiratory diseases (CRDs) are continuously rising globally. CRDs, including asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis and interstitial pulmonary fibrosis (IPF) are associated with frequent and/or recurrent microbial infections that potentially leads to exacerbations, decreased pulmonary functionality, increased risk of morbidity and mortality, and substantial loss of quality of life in patients with CRDs. Notably, microbial infections account for a significant episodes of exacerbations of these CRDs, which further increases the risk of morbidity and mortality along with substantially increasing the economic burden associated with CRDs. The currently available treatment for CRDs only focus on symptomatic relief and do not prevent and/or cure the disease fully. Despite the huge burden and crucial role of microbes in progression and deterioration of lung health in CRDs, the microbes involved and how these interact with the host is not fully understood. In addition, the therapeutic strategies do not account for the microbial characteristics, e.g., the virulence factors, that determine the extent of variability in the disease manifestation and/or clinical outcomes in the susceptible populations. In addition to bacterial inducers of exacerbations in patients with chronic airway disease, infections with viral pathogens such as Rhinovirus and Influenza Virus are key contributors to worsening of symptoms, as in COPD patients for example.

High quality research that is being conducted to counteract the impact of infection with common viruses is expected to be of interest to a broad audience. Furthermore, we are only at the beginning of our journey to understand the interactions between chronic lung diseases and emerging viral pathogens such as SARS-CoV-2. As new viral pathogens and their variants evolve, it will become increasingly important to identify how they overlap with chronic airway illnesses in terms of epidemiology and pathology, and to establish effective tools for their co-management in patients. Hence, in this topic, the role of respiratory viruses in chronic lung disease will also be explored.

This exciting research topic focuses on but is not limited to studies (including e.g. original research, perspectives, minireviews, commentaries and opinion papers) that;

1. further our understanding regarding improvement or expediting the diagnosis of microbial pathogens in laboratories along with predicting the best suited treatment regimen.

2. discusses the clinical utility of both prophylactic and treatment regimens with antibiotics, including macrolides.

3. investigates host-pathogen interactions/interplay and how this could be therapeutically targeted to impart benefits to patients and healthcare systems.

4. assesses the role of pro- and pre- biotics in targeting pathogenic microorganisms that are implicated in CRDs.

Under this research topic, we encourage authors to address the various host- and microbe- related characteristics that could be crucial to understand, develop and optimise prognostic, clinical and/or laboratory diagnosis, and therapeutic management of patients with CRDs.

Keywords: Bacterial persistence, viral infection, respiratory diseases, therapeutics, antimicrobial, lung infections

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