Chronic Obstructive Pulmonary Disease (COPD) Nocturnal Desaturator patients associated with Obesity and Lung Microbiota Dynamics.

COPD is often accompanied by other chronic diseases that are also associated with systemic inflammation, such as obesity, diabetes, and arteriosclerosis. Recent data indicate that nocturnal oxygen desaturation and coexisting metabolic syndrome are related to systemic inflammation in patients with COPD. Alveolar hypoxia and consequent hypoxemia increase in prevalence as COPD severity increases. Chronic hypoxemia contributes to the development of adverse sequelae of COPD, such as pulmonary hypertension, atherosclerosis, lung microbiome diversity and systemic inflammation. COPD is a heterogeneous disease with airway inflammation driven by bacterial infections, few studies to date they examined microbiology or infection. The introduction of cultureindependent techniques for the microbiological analysis of respiratory samples confirmed that respiratory system hosts a large number of microorganisms, which include a wide range of bacteria. Regular exposure to tobacco smoke, lifestyle and food pattern can change the microbiome in healthy smokers and at-risk COPD patients, increasing the presence of a limited number of genres that reach a high relative abundance, a pattern, which can be considered as a dysbiosis. We assume that in patients with COPD and concurrent obesity and lung dysbiosis at least three factors play a role in the systemic inflammatory syndrome. Recent data showed that changes in the lung microbiome are associated with numerous exacerbations of COPD and are involved in mediating inflammatory responses of the host in some patients. Further research should elucidate the complex relationship between obstructive lung disease, obesity and lung microbiome diversity systemic inflammation accompanying these different conditions, and the causative role of systemic inflammation in obese COPD with nocturnal oxygen desaturation.