Infectious Diseases Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy.
Front Immunol. 2023 Mar 8;14:1080043. doi: 10.3389/fimmu.2023.1080043. eCollection 2023.
The gut microbiota plays a crucial role in human health and disease. Gut dysbiosis is known to be associated with increased susceptibility to respiratory diseases and modifications in the immune response and homeostasis of the lungs (the so-called gut-lung axis). Furthermore, recent studies have highlighted the possible role of dysbiosis in neurological disturbances, introducing the notion of the "gut-brain axis." During the last 2 years, several studies have described the presence of gut dysbiosis during coronavirus disease 2019 (COVID-19) and its relationship with disease severity, SARS-CoV-2 gastrointestinal replication, and immune inflammation. Moreover, the possible persistence of gut dysbiosis after disease resolution may be linked to long-COVID syndrome and particularly to its neurological manifestations. We reviewed recent evidence on the association between dysbiosis and COVID-19, investigating the possible epidemiologic confounding factors like age, location, sex, sample size, the severity of disease, comorbidities, therapy, and vaccination status on gut and airway microbial dysbiosis in selected studies on both COVID-19 and long-COVID. Moreover, we analyzed the confounding factors strictly related to microbiota, specifically diet investigation and previous use of antibiotics/probiotics, and the methodology used to study the microbiota (α- and β-diversity parameters and relative abundance tools). Of note, only a few studies focused on longitudinal analyses, especially for long-term observation in long-COVID. Lastly, there is a lack of knowledge regarding the role of microbiota transplantation and other therapeutic approaches and their possible impact on disease progression and severity. Preliminary data seem to suggest that gut and airway dysbiosis might play a role in COVID-19 and in long-COVID neurological symptoms. Indeed, the development and interpretation of these data could have important implications for future preventive and therapeutic strategies.
肠道微生物群在人类健康和疾病中起着至关重要的作用。众所周知,肠道菌群失调与呼吸道疾病的易感性增加以及肺部免疫反应和内稳态的改变(所谓的“肠-肺轴”)有关。此外,最近的研究强调了失调在神经紊乱中的可能作用,引入了“肠-脑轴”的概念。在过去的两年中,几项研究描述了在 2019 年冠状病毒病(COVID-19)期间存在肠道菌群失调及其与疾病严重程度、SARS-CoV-2 胃肠道复制和免疫炎症的关系。此外,疾病缓解后肠道菌群失调的持续存在可能与长 COVID 综合征有关,特别是与它的神经表现有关。我们回顾了最近关于失调与 COVID-19 之间关联的证据,研究了可能的流行病学混杂因素,如年龄、地理位置、性别、样本量、疾病严重程度、合并症、治疗和疫苗接种状态,这些因素可能影响了选定的 COVID-19 和长 COVID 研究中的肠道和气道微生物失调。此外,我们分析了与微生物组密切相关的混杂因素,特别是饮食调查和以前使用抗生素/益生菌,以及用于研究微生物组的方法(α-和β多样性参数和相对丰度工具)。值得注意的是,只有少数研究关注纵向分析,特别是长 COVID 的长期观察。最后,对于微生物组移植和其他治疗方法的作用及其对疾病进展和严重程度的可能影响,人们知之甚少。初步数据似乎表明,肠道和气道菌群失调可能在 COVID-19 和长 COVID 神经症状中发挥作用。事实上,这些数据的发展和解释可能对未来的预防和治疗策略具有重要意义。
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