Abstract
Asthma is one of the most common chronic respiratory diseases worldwide. It affects all ages but frequently begins in childhood. Initiation and exacerbations may depend on individual susceptibility, viral infections, allergen exposure, tobacco smoke exposure, and outdoor air pollution. The aim of this review was to analyze the role of the gut–lung axis in asthma development, considering all asthma phenotypes, and to evaluate whether microbe-based therapies may be used for asthma prevention. Several studies have confirmed the role of microbiota in the regulation of immune function and the development of atopy and asthma. These clinical conditions have apparent roots in an insufficiency of early life exposure to the diverse environmental microbiota necessary to ensure colonization of the gastrointestinal and/or respiratory tracts. Commensal microbes are necessary for the induction of a balanced, tolerogenic immune system. The identification of commensal bacteria in both the gastroenteric and respiratory tracts could be an innovative and important issue. In conclusion, the function of microbiota in healthy immune response is generally acknowledged, and gut dysbacteriosis might result in chronic inflammatory respiratory disorders, particularly asthma. Further investigations are needed to improve our understanding of the role of the microbiome in inflammation and its influence on important risk factors for asthma, including tobacco smoke and host genetic features.
Highlights
Asthma is one of the most common chronic respiratory diseases worldwide
The differing composition of the lung microbiome between asthmatic and healthy people suggests that bacteria may contribute to the initiation of asthma, indicating a possible important role in influencing the immune responses for microbiota residing in other sites, such as the gut [51]
The individual opposing shift in the abundance of Lachnospira and Clostridium neonatale in the first three months of life suggests that these specific gut bacteria play a role in protecting or promoting development of a preschool age asthmatic phenotype, in addition to the previously identified roles in other atopic disorders. This bacterial dysbiosis was confirmed in other studies of the same group of authors, in which they showed the relative abundance of the bacterial genera Lachnospira and the decrease of Veillonella, Faecalibacterium, and Rothia in children at risk of asthma [53]
Summary
Asthma is one of the most common chronic respiratory diseases worldwide. It affects all ages but frequently begins in childhood. The study evaluated 60 Amish and Hutterite children; levels of allergens and endotoxins were measured, and an assessment of the microbiome composition of indoor dust samples was performed. These U.S farming populations have a similar lifestyle but different agricultural practices. Albeit comparable in genetic heritage and standard of living, it was found that in the Amish the prevalence of asthma and allergies is four and six times lower than in Hutterites, respectively This is associated with the occurrence in Amish dwellings of average endotoxin levels approximately seven times higher. The aim of this review was to analyze the role of the gut–lung axis in asthma development considering all asthma phenotypes and to evaluate whether microbe-based therapies may be used for asthma prevention
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