Lynch Susan V
Division of Gastroenterology, University of California San Francisco, San Francisco, California.
Ann Am Thorac Soc. 2016 Mar;13 Suppl 1(Suppl 1):S51-4. doi: 10.1513/AnnalsATS.201507-451MG.
The rapid rise in childhood allergies (atopy) in Westernized nations has implicated associated environmental exposures and lifestyles as primary drivers of disease development. Culture-based microbiological studies indicate that atopy has demonstrable ties to altered gut microbial colonization in very early life. Infants who exhibit more severe multisensitization to food- or aero-allergens have a significantly higher risk of subsequently developing asthma in childhood. Hence an emerging hypothesis posits that environment- or lifestyle-driven aberrancies in the early-life gut microbiome composition and by extension, microbial function, represent a key mediator of childhood allergic asthma. Animal studies support this hypothesis. Environmental microbial exposures epidemiologically associated with allergy protection in humans confer protection against airway allergy in mice. In addition, gut microbiome-derived short-chain fatty acids produced from a high-fiber diet have been shown to protect against allergy via modulation of both local and remote mucosal immunity as well as hematopoietic antigen-presenting cell populations. Here we review key data supporting the concept of a gut-airway axis and its critical role in childhood atopy.
在西方化国家,儿童过敏症(特应性)的迅速增加表明,相关的环境暴露和生活方式是疾病发展的主要驱动因素。基于文化的微生物学研究表明,特应性与生命早期肠道微生物定植的改变有着明显的联系。对食物或空气过敏原表现出更严重多敏反应的婴儿,在儿童期随后患哮喘的风险显著更高。因此,一个新出现的假说是,环境或生活方式驱动的生命早期肠道微生物群组成异常,进而微生物功能异常,是儿童过敏性哮喘的关键调节因素。动物研究支持这一假说。在人类中,与过敏保护在流行病学上相关的环境微生物暴露可使小鼠免受气道过敏。此外,高纤维饮食产生的肠道微生物群衍生短链脂肪酸已被证明可通过调节局部和远端黏膜免疫以及造血抗原呈递细胞群体来预防过敏。在这里,我们综述了支持肠道-气道轴概念及其在儿童特应性中关键作用的关键数据。
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