Kim Young Jin, Bunyavanich Supinda
Division of Allergy and Immunology, Department of Pediatrics, and.
Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
J Clin Invest. 2025 Feb 17;135(4):e184316. doi: 10.1172/JCI184316.
Asthma is a common chronic respiratory disease affecting people of all ages globally. The airway hosts diverse microbial communities increasingly recognized as influential in the development and disease course of asthma. Here, we review recent findings on the airway microbiome in asthma. As relationships between the airway microbiome and respiratory health take root early in life, we first provide an overview of the early-life airway microbiome and asthma development, where multiple cohort studies have identified bacterial genera in the infant airway associated with risk of future wheeze and asthma. We then address current understandings of interactions between environmental factors, the airway microbiome, and asthma, including the effects of rural/urban environments, pet ownership, smoking, viral illness, and antibiotics. Next, we delve into what has been observed about the airway microbiome and asthma phenotypes and endotypes, as airway microbiota have been associated with asthma control, severity, obesity-related asthma, and treatment effects as well as with type 2 high, type 2 low, and more newly described multi-omic asthma endotypes. We then discuss emerging approaches to shape the microbiome for asthma therapy and conclude the Review with perspectives on future research directions.
哮喘是一种常见的慢性呼吸道疾病,全球各年龄段的人都可能患病。气道中存在着多样的微生物群落,它们在哮喘的发生发展过程中的影响日益受到认可。在此,我们综述了近期关于哮喘气道微生物群的研究发现。由于气道微生物群与呼吸健康之间的关系在生命早期就已确立,我们首先概述生命早期的气道微生物群与哮喘的发展,多项队列研究已在婴儿气道中确定了与未来喘息和哮喘风险相关的细菌属。然后,我们阐述目前对环境因素、气道微生物群和哮喘之间相互作用的理解,包括农村/城市环境、养宠物、吸烟、病毒感染和抗生素的影响。接下来,我们深入探讨关于气道微生物群与哮喘表型和内型的观察结果,因为气道微生物群与哮喘控制、严重程度、肥胖相关性哮喘、治疗效果以及2型高、2型低和最新描述的多组学哮喘内型有关。然后,我们讨论为哮喘治疗而塑造微生物群的新方法,并以对未来研究方向的展望作为本综述的结语。
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