Pirr Sabine, Willers Maike, Viemann Dorothee
Department of Pediatric Pneumology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany.
Cluster of Excellence RESIST 2155-Resolving Infection Susceptibility, Hannover Medical School, Hannover, Germany.
Acta Physiol (Oxf). 2025 Feb;241(2):e14266. doi: 10.1111/apha.14266.
Over the past two decades, it has become clear that against earlier assumptions, the respiratory tract is regularly populated by a variety of microbiota even down to the lowest parts of the lungs. New methods and technologies revealed distinct microbiome compositions and developmental trajectories in the differing parts of the respiratory tract of neonates and infants. In this review, we describe the current understanding of respiratory microbiota development in human neonates and highlight multiple factors that have been identified to impact human respiratory microbiome development including gestational age, mode of delivery, diet, antibiotic treatment, and early infections. Moreover, we discuss to date revealed respiratory microbiome-disease associations in infants and children that may indicate a potentially imprinting cross talk between microbial communities and the host immune system in the respiratory tract. It becomes obvious how insufficient our knowledge still is regarding the exact mechanisms underlying such cross talk in humans. Lastly, we highlight strong findings that emphasize the important role of the gut-lung axis in educating and driving pulmonary immunity. Further research is needed to better understand the host - respiratory microbiome interaction in order to enable the translation into microbiome-based strategies to protect and improve human respiratory health from early childhood.
在过去二十年中，有一点已经很清楚，与早期的假设相反，呼吸道中经常存在着各种各样的微生物群，甚至在肺部最深处也是如此。新的方法和技术揭示了新生儿和婴儿呼吸道不同部位独特的微生物群组成和发育轨迹。在这篇综述中，我们描述了目前对人类新生儿呼吸道微生物群发育的理解，并强调了已确定的影响人类呼吸道微生物群发育的多个因素，包括胎龄、分娩方式、饮食、抗生素治疗和早期感染。此外，我们还讨论了迄今为止在婴儿和儿童中发现的呼吸道微生物群与疾病的关联，这些关联可能表明微生物群落与呼吸道宿主免疫系统之间存在潜在的印记相互作用。很明显，我们对人类这种相互作用的确切机制的了解仍然非常不足。最后，我们强调了一些有力的研究结果，这些结果强调了肠-肺轴在塑造和驱动肺部免疫方面的重要作用。需要进一步研究以更好地理解宿主与呼吸道微生物群的相互作用，从而能够将其转化为基于微生物群的策略，从幼儿期开始保护和改善人类呼吸道健康。
