Department of Child Life and Health, University of Edinburgh, Edinburgh EH9 1UW, UK.
The University of Edinburgh/MRC Centre for Inflammation Research, The Queen's Medical Research Institute, Edinburgh EH16 4TJ, UK.
J Infect. 2017 Jun;74 Suppl 1:S84-S88. doi: 10.1016/S0163-4453(17)30196-2.
Despite advances over the past ten years lower respiratory tract infections still comprise around a fifth of all deaths worldwide in children under five years of age with the majority in low- and middle-income countries. Known risk factors for severe respiratory infections and poor chronic respiratory health do not fully explain why some children become sick and others do not. The respiratory tract hosts bacteria that can cause respiratory infections but also normal commensal bacteria. Together, this microbial population is called the microbiome. The composition of the respiratory microbiome in the first few months of life is likely influenced by external factors such as environment, mode of delivery and infant feeding practices, which are also associated with susceptibility to respiratory infections and wheezing illness/asthma. Recently, multiple studies have shown that respiratory microbiota profiles early in life are associated with an increased risk and frequency of subsequent respiratory infections, disease severity and occurrence of wheeze in later childhood. Early interactions between infectious agents such as viruses and the respiratory microbiome have shown to modulate host immune responses potentially affecting the course of the disease and future respiratory health. Deeper understanding of these interactions will help the development of new therapeutic agents or preventive measures that may modify respiratory health outcomes and help us to stratify at risk populations to better target our current interventional approaches.
尽管在过去十年中取得了进展，但下呼吸道感染仍然占全球 5 岁以下儿童所有死亡人数的五分之一左右，其中大多数发生在中低收入国家。已知的严重呼吸道感染和慢性呼吸道健康不良的风险因素并不能完全解释为什么有些儿童生病而有些儿童不生病。呼吸道宿主细菌会引起呼吸道感染，但也会有正常的共生细菌。这些微生物群体统称为微生物组。生命最初几个月的呼吸道微生物组组成可能受到环境、分娩方式和婴儿喂养方式等外部因素的影响，这些因素也与呼吸道感染和喘息性疾病/哮喘的易感性有关。最近，多项研究表明，生命早期的呼吸道微生物群特征与随后呼吸道感染的风险增加和频率增加、疾病严重程度以及后期儿童喘息的发生有关。感染因子（如病毒）与呼吸道微生物组之间的早期相互作用已被证明可以调节宿主的免疫反应，从而可能影响疾病的进程和未来的呼吸道健康。更深入地了解这些相互作用将有助于开发新的治疗药物或预防措施，从而可能改变呼吸道健康结果，并帮助我们对高危人群进行分层，以更好地针对我们目前的干预方法。
