Huang Yvonne J
Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA.
Immunol Rev. 2025 Mar;330(1):e70015. doi: 10.1111/imr.70015.
Asthma is one of the most prevalent and extensively studied chronic respiratory conditions, yet the heterogeneity of asthma remains biologically puzzling. Established factors like exogenous exposures and treatment adherence contribute to variability in asthma risk and clinical outcomes. It is also clear that the endogenous factors of genetics and immune system response patterns play key roles in asthma. Despite significant existing knowledge in the above, divergent clinical trajectories and outcomes are still observed, even among individuals with similar risk profiles, biomarkers, and optimal medical management. This suggests uncaptured biological interactions that contribute to asthma's heterogeneity, for which the role of host microbiota has lately attracted much research attention. This review will highlight recent evidence in this area, focusing on bedside-to-bench investigations that have leveraged omic technologies to uncover microbiome links to asthma outcomes and immunobiology. Studies centered on the respiratory system and the use of multi-omics are noted in particular. These represent a new generation of reverse-translational investigations revealing potential functional crosstalk in host microbiomes that may drive phenotypic heterogeneity in chronic diseases like asthma. Multi-omic data offer a wide lens into ecosystem interactions within a host. This informs new hypotheses and experimental work to elucidate mechanistic pathways for unresolved asthma endotypes. Further incorporation of multi-omics into patient-centered investigations can yield new insights that hopefully lead to even more precise, microbiome-informed strategies to reduce asthma burden.
哮喘是最常见且研究广泛的慢性呼吸道疾病之一，然而哮喘的异质性在生物学上仍然令人困惑。诸如外部暴露和治疗依从性等既定因素会导致哮喘风险和临床结果的差异。同样明显的是，遗传和免疫系统反应模式等内源性因素在哮喘中起关键作用。尽管在上述方面已有大量现有知识，但即使在具有相似风险特征、生物标志物和最佳医疗管理的个体中，仍观察到不同的临床轨迹和结果。这表明存在未被发现的导致哮喘异质性的生物相互作用，宿主微生物群的作用最近已引起众多研究关注。本综述将重点介绍该领域的最新证据，重点关注利用组学技术揭示微生物群与哮喘结果及免疫生物学联系的床边到实验台的研究。特别值得注意的是以呼吸系统为中心的研究以及多组学的应用。这些代表了新一代的反向转化研究，揭示了宿主微生物群中可能驱动哮喘等慢性疾病表型异质性的潜在功能相互作用。多组学数据为宿主内的生态系统相互作用提供了广阔视角。这为新的假设和实验工作提供了依据，以阐明未解决的哮喘内型的机制途径。将多组学进一步纳入以患者为中心的研究可以产生新的见解，有望带来更精确的、基于微生物群的策略来减轻哮喘负担。
