Dasgupta Sanjukta
Department of Biotechnology, Center for Multidisciplinary Research & Innovations, Brainware University, Kolkata, India.
OMICS. 2025 Aug;29(8):374-383. doi: 10.1177/15578100251358958. Epub 2025 Jul 10.
Asthma is a heterogeneous respiratory disease with complex pathogenesis involving immune dysregulation, environmental triggers, and increasingly recognized to have contributions from the human microbiome. Emerging evidence from longitudinal birth cohorts and multi-omics studies reveals that early-life microbial colonization patterns in both the gastrointestinal and respiratory tracts play a crucial role in shaping immune trajectories and influencing asthma susceptibility. This expert review highlights the findings from pivotal studies that associate dysbiosis in the gut and airway microbiota with asthma development and its diverse phenotypic manifestations. Reduced abundance of immunomodulatory genera such as , , and in the gut has been consistently associated with increased asthma risk. In the airways, increased colonization by potentially pathogenic taxa, including , , and , correlates with viral respiratory infections and persistent wheezing. Microbiome diversity patterns also differ between asthma phenotypes: eosinophilic asthma typically features a community profile closer to healthy individuals, while neutrophilic asthma is marked by enrichment of pro-inflammatory bacterial species. Moreover, protective genera such as and in the upper airways are associated with lower risk of asthma and reduced respiratory infections. Elucidating these microbiome-mediated mechanisms holds promise for the development of targeted microbiota-based strategies for asthma prevention and phenotype-specific therapeutic interventions. The present review unpacks these localized microbial patterns and their mechanistic implications for asthma development, severity, and endotypic variation. Finally, unraveling the microbiome-asthma axis from airway and gut microbial communities also has implications for new ways of thinking personalized medicine in the future.
哮喘是一种异质性呼吸系统疾病，其发病机制复杂，涉及免疫失调、环境触发因素，并且越来越认识到人类微生物群也有影响。来自纵向出生队列和多组学研究的新证据表明，胃肠道和呼吸道的早期微生物定植模式在塑造免疫轨迹和影响哮喘易感性方面起着关键作用。这篇专家综述强调了关键研究的结果，这些研究将肠道和气道微生物群的生态失调与哮喘发展及其多种表型表现联系起来。肠道中免疫调节菌属（如 、 和 ）丰度的降低一直与哮喘风险增加相关。在气道中，包括 、 和 在内的潜在致病菌群的定植增加与病毒性呼吸道感染和持续性喘息相关。哮喘表型之间的微生物群多样性模式也有所不同：嗜酸性粒细胞性哮喘的群落特征通常更接近健康个体，而中性粒细胞性哮喘的特征是促炎细菌种类富集。此外，上呼吸道中的保护性菌属（如 和 ）与较低的哮喘风险和减少的呼吸道感染相关。阐明这些微生物群介导的机制有望开发出基于微生物群的针对性哮喘预防策略和表型特异性治疗干预措施。本综述剖析了这些局部微生物模式及其对哮喘发展、严重程度和内型变异的机制影响。最后，从气道和肠道微生物群落中揭示微生物群 - 哮喘轴也对未来个性化医学的新思维方式具有启示意义。
