哮喘患者的气道微生物失调:预防和治疗的新靶点?

Airway microbial dysbiosis in asthmatic patients: A target for prevention and treatment?

机构信息

National Heart & Lung Institute, Imperial College, London & Respiratory Biomedical Research Unit, Royal Brompton & Harefield NHS Trust and Imperial College London, London, United Kingdom.

出版信息

J Allergy Clin Immunol. 2017 Apr;139(4):1071-1081. doi: 10.1016/j.jaci.2017.02.004.

Abstract

There has been long-standing interest in the role of bacterial communities in the complex and heterogeneous disease of asthma. With the advent of 16s rRNA sequencing replacing traditional culture methods, a strong association between the presence of bacterial communities with asthma has emerged. These microbiota can be modulated by various environmental factors, including diet, antibiotics, and early-life microbial exposures. Microbiota in the gut and lungs can influence both the inception and progress of asthma. In babies and infants the presence of pathogenic bacteria in the lungs and gut has been associated with subsequent development of allergic sensitization and asthma. Lung microbiota are present in the airways of healthy subjects but are dysregulated in adults with asthma, with a reduced diversity and community composition that has been linked to severity and inflammatory phenotypes. Causality between certain gut microbiota and the development of allergic asthma has been shown in experiments conducted in neonatal mice. Manipulation of the airway microbiome, particularly in early life, might be a strategy to prevent or treat asthma, although the results of studies of probiotics used together with prebiotics have been overall negative. A better understanding of the regulation of both the lung and gut microbiota to derive appropriate targets for prevention or treatment of asthma is needed.

摘要

长期以来,人们一直关注细菌群落在哮喘这种复杂且异质性疾病中的作用。随着 16s rRNA 测序取代传统的培养方法,细菌群落与哮喘之间的关联已变得非常紧密。这些微生物群落可以通过各种环境因素(包括饮食、抗生素和生命早期的微生物暴露)进行调节。肠道和肺部的微生物群可以影响哮喘的发生和进展。在婴儿和幼儿中,肺部和肠道中存在致病性细菌与随后的过敏致敏和哮喘发展有关。健康受试者的气道中存在肺部微生物群,但哮喘患者的气道中存在失调,多样性和群落组成减少,与严重程度和炎症表型有关。在新生小鼠中进行的实验表明,某些肠道微生物群与过敏性哮喘的发展之间存在因果关系。气道微生物组的操纵,特别是在生命早期,可能是预防或治疗哮喘的一种策略,尽管使用益生菌和益生元的研究结果总体上是负面的。需要更好地了解肺部和肠道微生物组的调节,以确定预防或治疗哮喘的适当目标。

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