Institute for Global Health, University College London, London, UK.
Institute for Child Health, University College London, London, UK; John Radcliffe Hospital, University of Oxford, Oxford, UK.
Lancet Microbe. 2022 Nov;3(11):e867-e880. doi: 10.1016/S2666-5247(22)00184-7. Epub 2022 Aug 18.
Data from animal models suggest a role of early-life gut microbiota in lung immune development, and in establishing susceptibility to respiratory infections and asthma in humans. This systematic review summarises the association between infant (ages 0-12 months) gut microbiota composition measured by genomic sequencing, and childhood (ages 0-18 years) respiratory diseases (ie, respiratory infections, wheezing, or asthma). Overall, there was evidence that low α-diversity and relative abundance of particular gut-commensal bacteria genera (Bifidobacterium, Faecalibacterium, Ruminococcus, and Roseburia) are associated with childhood respiratory diseases. However, results were inconsistent and studies had important limitations, including insufficient characterisation of bacterial taxa to species level, heterogeneous outcome definitions, residual confounding, and small sample sizes. Large longitudinal studies with stool sampling during the first month of life and shotgun metagenomic approaches to improve bacterial and fungal taxa resolution are needed. Standardising follow-up times and respiratory disease definitions and optimising causal statistical approaches might identify targets for primary prevention of childhood respiratory diseases.
来自动物模型的数据表明，早期肠道微生物群在肺部免疫发育中起作用，并在人类中建立对呼吸道感染和哮喘的易感性方面起作用。本系统综述总结了通过基因组测序测量的婴儿（0-12 个月龄）肠道微生物群组成与儿童（0-18 岁）呼吸道疾病（即呼吸道感染、喘息或哮喘）之间的关联。总的来说，有证据表明，低α多样性和特定肠道共生菌属（双歧杆菌、粪杆菌、瘤胃球菌和罗氏菌）的相对丰度与儿童呼吸道疾病有关。然而，结果不一致，研究存在重要的局限性，包括对细菌分类群到种水平的特征描述不足、结果定义的异质性、残留混杂和样本量小。需要进行具有生命第一个月粪便采样的大型纵向研究和 shotgun 宏基因组方法来提高细菌和真菌分类群的分辨率。标准化随访时间和呼吸道疾病定义并优化因果统计方法可能会确定儿童呼吸道疾病一级预防的目标。
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