{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T05:13:59Z","timestamp":1781759639373,"version":"3.54.5"},"reference-count":142,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Chronic obstructive pulmonary disease (COPD) is a prevalent chronic condition associated with substantial global morbidity and mortality. Primarily caused by prolonged exposure to harmful agents such as dust and gases, COPD is characterized by persistent airflow limitation, clinically manifesting as chronic cough, sputum production, and dyspnea. The disease course alternates between stable phases and exacerbations, with the latter often associated with pathogenic colonization of the respiratory tract. This review examines the immunological underpinnings of COPD, emphasizing the interplay between innate and adaptive immunity in disease pathogenesis. Dysregulated immune responses to environmental factors perpetuate chronic inflammation, resulting in progressive pulmonary epithelial damage and connective tissue hyperplasia, which compromise gas exchange. Exacerbations further exacerbate respiratory failure, aggravating patient symptoms and accelerating disease progression. Despite advances in COPD management, effective therapeutic options remain limited. Current treatments primarily aim to alleviate symptoms, reduce immune activation, and manage infections, yet many patients experience suboptimal outcomes. This review highlights the potential of novel therapeutic approaches targeting immune system cells and pathways. In particular, it explores the promise of oral bacterial vaccines as immunomodulatory agents to enhance immune responses and improve clinical outcomes in COPD, addressing critical gaps in current treatment paradigms.<\/jats:p>","DOI":"10.3390\/vaccines13020107","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T05:50:53Z","timestamp":1737525053000},"page":"107","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Immunological Insights and Therapeutic Advances in COPD: Exploring Oral Bacterial Vaccines for Immune Modulation and Clinical Improvement"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0539-0680","authenticated-orcid":false,"given":"S\u0142awomir","family":"Lewicki","sequence":"first","affiliation":[{"name":"Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Pl. \u017belaznej Bramy 10, 00-136 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara Joanna","family":"Ba\u0142an","sequence":"additional","affiliation":[{"name":"Department of Environmental Threat Prevention, Allergology and Immunology, Faculty of Health Sciences, Medical University of Warsaw, Pawi\u0144skiego 3c, 02-106 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Stelmasiak","sequence":"additional","affiliation":[{"name":"Department of Dietetics, Institute of Human Nutrition Science, Warsaw University of Life Sciences, Nowoursynowska 159c St.,  02-776 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorota Magdalena","family":"Radomska-Le\u015bniewska","sequence":"additional","affiliation":[{"name":"Department of Histology and Embryology, Medical University of Warsaw, Cha\u0142ubi\u0144skiego 5, 02-004 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0148-541X","authenticated-orcid":false,"given":"\u0141ukasz","family":"Szyma\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Molecular Biology, Institute of Genetics and Animal Biotechnology, Polish Academy of Sciences, Post\u0119pu 36A, 05-552 Magdalenka, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Rios-Turek","sequence":"additional","affiliation":[{"name":"Hull University Teaching Hospitals NHS Trust, Hull University, Anlaby Rd., Hull HU3 2JZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justyna","family":"Bie\u0144-Kalinowska","sequence":"additional","affiliation":[{"name":"Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, Pl. \u017belaznej Bramy 10, 00-136 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0973-5455","authenticated-orcid":false,"given":"\u0141ukasz","family":"Szarpak","sequence":"additional","affiliation":[{"name":"Institute of Medicine Science, Collegium Medicum, The John Paul II Catholic University of Lublin, 20-708 Lublin, Poland"},{"name":"Department of Clinical Research and Development, LUXMED Group, 02-678 Warsaw, Poland"},{"name":"Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA"},{"name":"TS Out-Patients Clinic for Cardiovascular and Pulmonary Diseases, 01-460 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bogdan","family":"Hajduk","sequence":"additional","affiliation":[{"name":"TS Out-Patients Clinic for Cardiovascular and Pulmonary Diseases, 01-460 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"ref_1","first-page":"260","article-title":"Air Pollution and Chronic Obstructive Pulmonary Disease","volume":"6","author":"Duan","year":"2020","journal-title":"Chronic Dis. 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