, Les bronches se ramifient successivement dans le poumon pour donner des bronchioles, jusqu'au stade terminal de ramification qui débouche sur des alvéoles, siège des échanges gazeux. Chaque alvéole reçoit le sang par une artériole pulmonaire

, Des fosses nasales aux bronchioles, la surface interne du conduit respiratoire porte une muqueuse de type respiratoire, tapissée d'un épithélium cilié et recouverte de mucus, sécrété par les cellules caliciformes. L'épithélium de type pseudostratifié (fosses nasales) ou pluristratifié, Dans les bronches segmentaires et les alvéoles, l'épithélium est de type cylindrique

, Rôle des microorganismes des voies respiratoires Pendant longtemps, on a cru les voies aériennes inférieures stériles du fait de leur capacité de clairance muco-ciliaire, et parce que les cultures bactériologiques utilisées restaient négatives. L'on sait aujourd'hui, grâce aux techniques d'identification moléculaire (ARN 16S)

, ). Cependant, cette « rareté » relative serait compensée par une forte biodiversité. On trouverait environ 2000 génomes bactéries par cm² de surface prélevée, ce qui serait comparable aux deux tiers de la diversité génétique du TD, La densité bactérienne des voies respiratoires est considérée comme faible, allant de 10 3 à 10 5 UFC par gramme de contenu, 2017.

. Le-microbiote-respiratoire-«-physiologique, est d'origine environnementale et intestinale, mais à la différence du MI, près de la moitié des bactéries qu'il héberge sont aérobies ou aérotolérantes, 2018.

, Le microbiote respiratoire se met en place dès la naissance et évolue rapidement au cours des premières années de vie, avant de se stabiliser, Les premières bactéries colonisatrices sont couramment Corynebacterium ou Staphylococcus, 2015.

, Les bactéries majoritaires sont issues de 2 phyla : les Protéobactéries (Neisseria spp., Haemophilus spp.) mais aussi les Bacteroidetes (Prevotella spp.). Les voies respiratoires supérieures (l'oropharynx et les fosses nasales) sont aussi porteuses d'une population bactérienne particulière, mais celle-ci diffère de celle des voies respiratoires inférieures à de nombreux égards. L'oropharynx porte les phyla Bacteroidetes (Prevotella spp.), Firmicutes (Veilonella spp.) et Proteoabcteria (Neisseria spp.). Les tonsilles palatines ont une quantité importante de Firmicutes (Lactobacillus spp., Streptococus spp, Ce microbiote varie qualitativement et quantitativement tout au long de l'arbre respiratoire. C'est dans le poumon que l'on retrouve la plus grande diversité bactérienne, avec plus de 200 taxons identifiés

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