A recent open-access paper published in Critical Care investigates how the lung microbiome, inflammatory responses and metabolism evolve in patients under invasive mechanical ventilation, shedding light on factors that may predispose them to develop ventilator-associated pneumonia (VAP).
Led by Ingrid G. Bustos and colleagues, including Homi-Lung partner Robert P. Dickson from the University of Michigan, the study followed 80 critically ill patients without initial infection to monitor bronchoalveolar lavage samples over time. Half of the patients developed VAP during the study period.
The results show that mechanical ventilation itself alters the lung microbiome composition independently of VAP, but cases with pneumonia presented higher TNF-α levels and metabolic profiles suggesting a shift to anaerobic metabolism. These findings highlight a link between local immune activation and metabolic adaptation in the lung during infection.
The authors conclude that identifying early microbial and metabolic shifts may help improve diagnosis and guide new therapeutic strategies for VAP.
Read the full article in Critical Care:
Bustos IG, Serrano-Mayorga CC, Guerrero JL, Baker JM, Brown C, Falkowski N, Ranjan P, Acosta-Gonzalez A, Mendez LM, Garcia-Cordoba A, Echeverry-Gutierrez A, Bojaca DA, Chisica-Mahecha M, Guarin-Tequia N, Romero-Romero L, Gonzalez-Juarbe N, Rodriguez A, Cala MP, Martin-Loeches I, Chotirmall SH, Dickson RP, Reyes LF. Longitudinal analysis of lung microbiome, immune response, and metabolism in ventilator-associated pneumonia: a cohort study. Critical Care. 2025;29:275. doi:10.1186/s13054-025-05498-1