PATHOGENESIS AND IMMUNE RESPONSE: Edited by Dennis L. Stevens and Dimitri A. DiavatopoulosAnatomical site-specific immunomodulation by bacterial biofilmsMorra, Christina N.; Orihuela, Carlos J.Author Information Department of Microbiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA Correspondence to Carlos J. Orihuela, Department of Microbiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. Tel: +1 205 975 2536; fax: +1 205 996 4008; e-mail: firstname.lastname@example.org Current Opinion in Infectious Diseases: June 2020 - Volume 33 - Issue 3 - p 238-243 doi: 10.1097/QCO.0000000000000643 Buy Metrics Abstract Purpose of review The human body plays host to bacterial biofilms across diverse anatomical sites. The treatment of pathogenic biofilm infection is confounded by their high rate of antibiotic resistance. Therefore, it is critical to understand the interplay between these biofilms and the host immune system to develop new tactics to combat these infections. Recent findings Bacterial biofilms and the components they produce affect and are affected by the host immune system. Host anatomical sites represent distinct niches in which defined bacterial biofilms are able to form and interact with the host immune system. For persistent colonization to occur, the bacteria must either avoid or suppress the host immune system, or induce an immune response that facilitates their perpetuation. Summary Commensal bacterial biofilms form a protective barrier against colonization by pathogens. Using similar mechanisms, bacteria modulate the immune system to orchestrate persistence and sometimes disease. Clinicians must balance the need to avoid disturbing beneficial commensal biofilms with the difficulty in preventing or treating pathogenic bacterial biofilms such as those that develop on medical implants and open wounds. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.