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  1. The Triumvirate

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A bugs life

One of the most topical current areas of research is the role of the microbiome in the pathogenesis of lung disease. While this is not exactly what Disney-Pixar were thinking when the retold Aesop’s fable ‘The Ant and the Grasshopper’ there are some parallels with the study by Mayhew et al ( see page 422 ). The basic premise of the fable is to beware of winter before it comes. In preparation for winter Mayhew and colleagues undertook a longitudinal observational study in 101 patients with COPD. They found that the lung microbiome was less stable in patients with frequent exacerbations, and that bacterial exacerbations were more likely to repeated in contrast with viral exacerbations which were not, suggesting that some exacerbation subtypes have non-random chances of repeating in the future, in essence a bug that is ‘To work today is to eat tomorrow’. Aesop would be proud.

A bugs life 2

One of the biggest surprises in the history of Disney-Pixar has been the absence of A Bugs Life Two. The failure to replicate the role of bugs in the lungs of patients with IPF is also somewhat of a surprise. In the case control study by Dr Kitsios and colleagues they could not reliably find any bacterial DNA from the lung tissue of …

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