Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, 13496, Republic of Korea.
Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea.
J Microbiol. 2024 Mar;62(3):201-216. doi: 10.1007/s12275-024-00124-1. Epub 2024 Apr 18.
The application of microbiome-based therapies in various areas of human disease has recently increased. In chronic respiratory disease, microbiome-based clinical applications are considered compelling options due to the limitations of current treatments. The lung microbiome is ecologically dynamic and affected by various conditions, and dysbiosis is associated with disease severity, exacerbation, and phenotype as well as with chronic respiratory disease endotype. However, it is not easy to directly modulate the lung microbiome. Additionally, studies have shown that chronic respiratory diseases can be improved by modulating gut microbiome and administrating metabolites. Although the composition, diversity, and abundance of the microbiome between the gut and lung are considerably different, modulation of the gut microbiome could improve lung dysbiosis. The gut microbiome influences that of the lung via bacterial-derived components and metabolic degradation products, including short-chain fatty acids. This phenomenon might be associated with the cross-talk between the gut microbiome and lung, called gut-lung axis. There are multiple alternatives to modulate the gut microbiome, such as prebiotics, probiotics, and postbiotics ingestion and fecal material transplantation. Several studies have shown that high-fiber diets, for example, present beneficial effects through the production of short-chain fatty acids. Additionally, genetically modified probiotics to secrete some beneficial molecules might also be utilized to treat chronic respiratory diseases. Further studies on microbial modulation to regulate immunity and potentiate conventional pharmacotherapy will improve microbiome modulation techniques, which will develop as a new therapeutic area in chronic respiratory diseases.
近年来，基于微生物组的疗法在人类疾病的各个领域中的应用不断增加。在慢性呼吸道疾病中，由于当前治疗方法的局限性，基于微生物组的临床应用被认为是极具吸引力的选择。肺部微生物组具有生态动态性，并受多种条件影响，而微生物失调与疾病严重程度、恶化和表型以及慢性呼吸道疾病的终末类型有关。然而，直接调节肺部微生物组并不容易。此外，研究表明，通过调节肠道微生物组和施用代谢物可以改善慢性呼吸道疾病。尽管肠道和肺部的微生物组在组成、多样性和丰度上有很大的不同，但调节肠道微生物组可以改善肺部微生物失调。肠道微生物组通过细菌衍生成分和代谢降解产物（包括短链脂肪酸）影响肺部微生物组。这种现象可能与肠道微生物组和肺部之间的相互作用有关，称为肠-肺轴。有多种调节肠道微生物组的方法，例如摄入益生元、益生菌和后生元以及粪便移植。几项研究表明，高纤维饮食通过产生短链脂肪酸表现出有益的作用。此外，分泌某些有益分子的基因修饰益生菌也可用于治疗慢性呼吸道疾病。进一步研究微生物调节以调节免疫和增强传统药物治疗将改善微生物调节技术，这将作为慢性呼吸道疾病的一个新的治疗领域发展。
