Evidence map›Paper›PMID 24621685›Full record

ArticleThe Lancet. Respiratory medicine2014

Towards an ecology of the lung: new conceptual models of pulmonary microbiology and pneumonia pathogenesis.

Robert P Dickson, John R Erb-Downward, Gary B Huffnagle

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Respiratory medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02392182 (Understanding the Lung Microbiome in HIV-Infected & HIV-Uninfected Individuals), which is not on this map. Cited by 207 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
207citing papers in PubMed, 3 pooled it
10.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02392182 completednot on this map

Understanding the Lung Microbiome in HIV-Infected & HIV-Uninfected Individuals

TypeobservationalSponsorUniversity of MichiganRan2009 to 2015Enrolled59ConditionsHealthy Participants, Tobacco Use Disorder, Human MicrobiomeArmsFiberoptic bronchoscopy
3 · Its place in the literature

Who cites it

207 citing papers in PubMed, 3 syntheses or guidelines pooled it, 358 citations in OpenAlex.

  1. Pooled it
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  10. Association of dental diseases with pulmonary outcomes in a multicenter cohort of adolescents and young adults with CF.Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society · 2026
    Observational
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147 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Robert P DicksonDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA. Electronic address: rodickso@med.umich.edu.
John R Erb-DownwardDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
Gary B HuffnagleDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan MI, USA.
University of Michigan–Ann Arbor · US

Funding

PULMONARY CELLULAR AND MOLECULAR BIOLOGY TRAININGT32HL007749 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Robert Pickett Dickson · 1993 to 2026
$19.9M
Understanding the Lung Microbiome in HIV-Infected and HIV-uninfected individualsU01HL098961 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BECK, JAMES M, CURTIS, JEFFREY LOUIS · 2009 to 2013
$3.6M
Pulmonary bacterial microbiome-epithelial cell interactions in COPDR01HL114447 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HUFFNAGLE, GARY B, MARTINEZ, FERNANDO J · 2012 to 2015
$1.5M
NHLBI NIH HHS L30 HL120241NHLBI NIH HHS R01 HL114447NHLBI NIH HHS R01HL114447NHLBI NIH HHS T32 HL007749NHLBI NIH HHS T32HL00774921NHLBI NIH HHS U01 HL098961NHLBI NIH HHS U01HL098961
6 · The paper itself

Abstract

Pneumonia is a major cause of morbidity and mortality for which no new methods of treatment have entered clinical practice since the discovery of antibiotics. Innovations in the techniques of culture-independent microbial identification have shown that the lungs, previously deemed sterile in the absence of infection, contain diverse and dynamic communities of microbes. In this Personal View, we argue that these observations have shown the inadequacy of traditional conceptual models of lung microbiology and the pathogenesis of pneumonia, hampering progress in research and practice. We propose three new conceptual models to replace the traditional models of lung microbiology: an adapted island model of lung biogeography, the effect of environmental gradients on lung microbiota, and pneumonia as an emergent phenomenon propelled by unexplored positive feedback loops. We argue that the ecosystem of lung microbiota has all of the features of a complex adaptive system: diverse entities interacting with each other within a common space, showing interdependent actions and possessing the capacity to adapt to changes in conditions. Complex adaptive systems are fundamentally different in behaviour from the simple, linear systems typified by the traditional model of pneumonia pathogenesis, and need distinct analytical approaches.

Indexed as

HumansLungModels, BiologicalPneumonia

Identifiers

PMID24621685
PMCPMC4004084
OpenAlexW2156749754

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.