Capponi Martina, Gori Alessandra, De Castro Giovanna, Ciprandi Giorgio, Anania Caterina, Brindisi Giulia, Tosca Mariangela, Cinicola Bianca Laura, Salvatori Alessandra, Loffredo Lorenzo, Spalice Alberto, Zicari Anna Maria
Department of Maternal Infantile and Urological Sciences, Sapienza University of Rome, 00185 Rome, Italy.
Allergy Clinic, Casa di Cura Villa Serena, 65013 Genoa, Italy.
J Clin Med. 2022 Aug 31;11(17):5154. doi: 10.3390/jcm11175154.
Starting from the "Hygiene Hypothesis" to the "Microflora hypothesis" we provided an overview of the symbiotic and dynamic equilibrium between microbiota and the immune system, focusing on the role of dysbiosis in atopic march, particularly on allergic rhinitis. The advent of deep sequencing technologies and metabolomics allowed us to better characterize the microbiota diversity between individuals and body sites. Each body site, with its own specific environmental niches, shapes the microbiota conditioning colonization and its metabolic functionalities. The analysis of the metabolic pathways provides a mechanistic explanation of the remote mode of communication with systems, organs, and microflora of other body sites, including the ecosystem of the upper respiratory tract. This axis may have a role in the development of respiratory allergic disease. Notably, the microbiota is significant in the development and maintenance of barrier function; influences hematopoiesis and innate immunity; and shows its critical roles in Th1, Th2, and Treg production, which are necessary to maintain immunological balance and promote tolerance, taking part in every single step of the inflammatory cascade. These are microbial biotherapy foundations, starting from probiotics up to postbiotics and parabiotics, in a still-ongoing process. When considering the various determinants that can shape microbiota, there are several factors to consider: genetic factors, environment, mode of delivery, exposure to antibiotics, and other allergy-unrelated diseases. These factors hinder the engraftment of probiotic strains but may be upgradable with postbiotic and parabiotic administration directly on molecular targets. Supplementation with postbiotics and parabiotics could represent a very exciting perspective of treatment, bypassing probiotic limitations. At present, this avenue remains theoretical and to be explored, but it will certainly be a fascinating path to follow.
从“卫生假说”到“微生物群假说”，我们概述了微生物群与免疫系统之间的共生和动态平衡，重点关注生态失调在特应性进程中的作用，尤其是在过敏性鼻炎方面。深度测序技术和代谢组学的出现使我们能够更好地表征个体之间以及身体部位之间的微生物群多样性。每个身体部位都有其特定的环境生态位，塑造了决定定殖及其代谢功能的微生物群。对代谢途径的分析为与其他身体部位的系统、器官和微生物群（包括上呼吸道生态系统）的远程通信模式提供了机制解释。该轴可能在呼吸道过敏性疾病的发展中起作用。值得注意的是，微生物群在屏障功能的发育和维持中具有重要意义；影响造血和先天免疫；并在Th1、Th2和Treg产生中发挥关键作用，这些对于维持免疫平衡和促进耐受性是必要的，参与炎症级联反应的每一个步骤。这些都是微生物生物疗法的基础，从益生菌到后生元和共生元，这一过程仍在进行中。在考虑可以塑造微生物群的各种决定因素时，有几个因素需要考虑：遗传因素、环境、分娩方式、接触抗生素以及其他与过敏无关的疾病。这些因素阻碍了益生菌菌株的植入，但通过直接针对分子靶点的后生元和共生元给药可能会得到改善。补充后生元和共生元可能代表了一种非常令人兴奋的治疗前景，绕过了益生菌的局限性。目前，这条途径仍然停留在理论层面有待探索，但它肯定会是一条值得追寻的迷人道路。
