# From commensalism to pathogenesis: the hidden role of the respiratory virome

## TL;DR

This paper explores how the respiratory virome, including viruses and phages, influences health and disease, and highlights the need for further research.

## Contribution

The paper provides a comprehensive overview of the respiratory virome's role in health and disease, emphasizing its potential for diagnostics and therapies.

## Key findings

- The respiratory virome contributes to immune regulation and microbial balance in healthy individuals.
- Alterations in the virome are observed in respiratory diseases like asthma and pneumonia.
- Future studies are needed to define the baseline virome and its immunomodulatory functions.

## Abstract

The respiratory virome, encompassing both eukaryotic viruses and bacteriophages, is an essential but often overlooked component of the airway microbiome. Recent advances in metagenomics have revealed that a diverse viral community exists even in healthy individuals, contributing to immune regulation and microbial balance. However, the field faces several challenges: the baseline composition of the respiratory virome remains incompletely defined, its immunomodulatory functions are not fully understood, and its contributions to respiratory diseases are only beginning to be elucidated. This mini-review summarizes current knowledge of the respiratory virome under physiological conditions, highlights emerging insights into how resident viruses and phages shape host immunity, and discusses alterations observed in asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, and pneumonia. By integrating evidence across these conditions, we emphasize the significance of the virome in both health and disease. A deeper understanding of its dynamics may yield novel diagnostic markers and therapeutic strategies, underscoring the importance of future longitudinal and mechanistic studies in this rapidly evolving field.