Abstract

The airway microbiome is a dynamic and diverse ecosystem of bacteria, viruses, and fungi that contributes 
critically to respiratory health and disease. In health, microbial communities maintain homeostasis through 
interactions with epithelial barriers and host immune responses. Dysbiosis, or imbalance of these microbial 
populations, is increasingly recognized as a central factor in the pathogenesis of respiratory diseases such as 
asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, and pneumonia. Shifts in microbial 
diversity, enrichment of pathobionts, and disruption of host–microbiome interactions contribute to inflammation, 
impaired immunity, and disease progression. Advances in sequencing and bioinformatics have enabled detailed 
characterization of airway microbiota, while environmental exposures, host genetics, and lifestyle factors have 
been identified as key determinants of microbial composition. Emerging evidence highlights the therapeutic 
potential of microbiome modulation through probiotics, prebiotics, antibiotic stewardship, and personalized 
medicine approaches. Future directions include longitudinal studies, integration of multi-omics, and well-designed 
clinical trials to better define causality and therapeutic opportunities. Understanding the airway microbiome offers 
significant promise for novel prognostic markers and targeted interventions in respiratory disease. 
Keywords: Airway microbiome, Dysbiosis, Respiratory diseases, Probiotics and prebiotics, and personalized 
medicine.