Bronchial asthma: influence of the lung microbiome

While the microbiome has received significant attention due to its impact on digestive health in recent years, its impact on lung disease remains largely unexplored. According to experts, this is a big omission. The
microbiome is the ecosystem of “good” and “bad” bacteria living in the body. Because the lungs continuously take in air and environmental substances, the composition and balance of microbes in the lungs can have a profound effect on many respiratory conditions. New research suggests that the lung microbiome plays a significant role in asthma severity and response to treatment.
Asthma is a chronic disease in which the airways narrow, making it difficult for air to move out of and into the lungs. As people with asthma develop inflammation in their airways, they experience a range of symptoms, including shortness of breath, coughing, wheezing, and seizures. In a group of asthma patients, researchers identified two disease phenotypes by assessing the microbiome and airway inflammation. Patients aged 18-30 had mild or moderate atopic asthma.
This suggests that the microbiome matters beyond the gut and is a potential biomarker for asthma treatment, the authors say. These two phenotypes, called asthma phenotype one and two, or AP1 and AP2, are due to the abundance and predominance of different bacteria in the lungs. When compared, patients showed different results when passing functional tests.
AP1 was associated with less severe asthma; there is a decrease in T – helper cytokines and an increase in enterococcal bacteria, normal results of pulmonary function tests. In contrast, AP2 was associated with increased pro- inflammatory cytokines, taxa, and streptococcal bacteria, as well as worsened lung test scores.
In both AP1 and AP2, associations between microbiome composition and specific inflammatory cytokines decreased after inhaled corticosteroid treatment.
The data suggest that further study of the microbiome may help develop more personalized treatment recommendations for patients with asthma, the authors note. Asthma research is increasingly focusing on the differences between seemingly similar patients, and this study adds to the growing body of evidence that patients are benefiting from precise medical approaches to common chronic conditions like asthma.
If we can better understand how the human lung microbiome affects asthma, it will be possible to predict and control the development and severity of asthma by influencing the microbiome early in life.
A second study showed that even before birth, exposure to specific bacterial compounds can trigger an inflammatory immune response that may predispose people to asthma. The lung microbiome potentially plays a role in many parts of the body, including cord blood cells, which may influence the onset of the disease or its symptoms.

event_note February 14, 2022

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