Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, 3584 CG Utrecht, The Netherlands.
Global Centre of Excellence Immunology, Danone Nutricia Research B.V., 3584 CT Utrecht, The Netherlands.
Nutrients. 2021 Nov 19;13(11):4153. doi: 10.3390/nu13114153.
The prevalence of asthma is increasing, but the cause remains under debate. Research currently focuses on environmental and dietary factors that may impact the gut-lung axis. Dietary fibers are considered to play a crucial role in supporting diversity and activity of the microbiome, as well as immune homeostasis in the gut and lung. This review discusses the current state of knowledge on how dietary fibers and their bacterial fermentation products may affect the pathophysiology of allergic asthma. Moreover, the impact of dietary fibers on early type 2 asthma management, as shown in both pre-clinical and clinical studies, is described. Short-chain fatty acids, fiber metabolites, modulate host immunity and might reduce the risk of allergic asthma development. Underlying mechanisms include G protein-coupled receptor activation and histone deacetylase inhibition. These results are supported by studies in mice, children and adults with allergic asthma. Fibers might also exert direct effects on the immune system via yet to be elucidated mechanisms. However, the effects of specific types of fiber, dosages, duration of treatment, and combination with probiotics, need to be explored. There is an urgent need to further valorize the potential of specific dietary fibers in prevention and treatment of allergic asthma by conducting more large-scale dietary intervention trials.
哮喘的发病率正在上升，但病因仍存在争议。目前的研究集中在可能影响肠-肺轴的环境和饮食因素上。膳食纤维被认为在支持微生物组的多样性和活性以及肠道和肺部的免疫稳态方面发挥着关键作用。这篇综述讨论了膳食纤维及其细菌发酵产物如何影响过敏性哮喘的病理生理学的最新知识。此外，还描述了膳食纤维对早期 2 型哮喘管理的影响，这在临床前和临床研究中都有体现。短链脂肪酸、纤维代谢产物调节宿主免疫，可能降低过敏性哮喘发展的风险。潜在的机制包括 G 蛋白偶联受体激活和组蛋白去乙酰化酶抑制。这些结果得到了在过敏性哮喘的小鼠、儿童和成人中进行的研究的支持。纤维也可能通过尚未阐明的机制对免疫系统产生直接影响。然而，需要通过开展更多的大规模饮食干预试验来探索特定纤维类型、剂量、治疗持续时间以及与益生菌的联合应用的效果。迫切需要通过开展更多的大规模饮食干预试验来进一步挖掘特定膳食纤维在预防和治疗过敏性哮喘方面的潜力。
