Department of Paediatrics, The University of Melbourne, Melbourne, Parkville, Australia; Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia; Infectious Diseases & Microbiology Research Group, Murdoch Children's Research Institute, Parkville, Australia; Infectious Diseases Unit, University of Basel Children's Hospital, Basel, Switzerland.
Infectious Diseases & Microbiology Research Group, Murdoch Children's Research Institute, Parkville, Australia.
J Allergy Clin Immunol. 2019 Feb;143(2):467-485. doi: 10.1016/j.jaci.2018.09.025. Epub 2018 Dec 29.
The intestinal microbiota plays an important role in development of the immune system and regulation of immune responses. This review summarizes the association between the intestinal microbiota and the development of allergic sensitization, eczema, and asthma in neonates and children. Overall, a greater relative abundance of Bacteroidaceae, Clostridiaceae, and Enterobacteriaceae and a lower relative abundance of Bifidobacteriaceae and Lactobacillaceae is associated with the development of allergic sensitization, eczema, or asthma. Reduced bacterial diversity can be associated with the development of allergic disease. The association between the composition of the intestinal microbiota and the development of allergic disease or asthma is less consistent in older children than in neonates, suggesting that early-life microbial exposure plays a more important role. Inconsistencies in the results reported from different studies might partly be explained by heterogeneity in design, study populations, diagnostic criteria, microbiota analysis methods, and reporting on different taxonomic levels. Larger studies that better account for antenatal and postnatal factors will further help determine specific microbial intestinal signatures associated with increased risk of allergy and asthma. This will enable the early identification of infants at high risk and facilitate novel strategies and interventions to prevent and treat these conditions, including modifying the intestinal microbiota early in life.
肠道微生物群在免疫系统发育和免疫反应调节中起着重要作用。这篇综述总结了肠道微生物群与新生儿和儿童过敏致敏、特应性皮炎和哮喘发展之间的关联。总体而言，拟杆菌科、梭菌科和肠杆菌科的相对丰度增加，双歧杆菌科和乳杆菌科的相对丰度降低与过敏致敏、特应性皮炎或哮喘的发展相关。细菌多样性的减少可能与过敏疾病的发生有关。肠道微生物群组成与过敏疾病或哮喘的发展之间的关联在年龄较大的儿童中不如在新生儿中一致，这表明生命早期的微生物暴露起着更重要的作用。不同研究报告的结果不一致，部分原因可能是设计、研究人群、诊断标准、微生物分析方法以及不同分类水平报告的异质性。更好地考虑产前和产后因素的大型研究将进一步帮助确定与过敏和哮喘风险增加相关的特定微生物肠道特征。这将使能够早期识别高风险婴儿，并促进预防和治疗这些疾病的新策略和干预措施，包括在生命早期改变肠道微生物群。
