气道微生态与哮喘气道免疫反应研究进展

支气管哮喘（简称哮喘）是最常见的慢性气道疾病之一,全球3亿多人患有哮喘。近年来,有研究表明,与健康人相比,哮喘患者的气道微生态结构以及各菌群的相对丰度均发生了改变,且与哮喘气道炎症表型相关。气道微生态可以通过免疫反应影响哮喘的发生发展。气道微生态与哮喘相互作用的机制可以为哮喘精准治疗提供新的思路。本文主要对目前气道微生...     

下呼吸道微生物菌群对宿主免疫的影响

随着细菌鉴定技术的发展,健康成年人下呼吸道存在常驻微生物菌群的观点逐渐受到认可.这类微生物菌群具有调节天然免疫和获得性免疫反应的作用.在呼吸道疾病如哮喘、COPD的发生发展过程中,宿主下呼吸道微生态环境发生改变,免疫状态也发生了改变,但两者之间的关系尚不明确.我们将围绕下呼吸道微生物菌群对宿主免疫系统的影响进行阐述,以探讨影响呼吸道疾病发生发展的因素.     

慢性气道炎症性疾病的下呼吸道细菌负荷

近年来,由于慢性气道和肺部疾病患者生存率的提高、痰监测频率增加以及新的分子技术应用于微生物的鉴定,人们发现既往认为无菌的下呼吸道竟然寄居着大量微生物.这些微生物不仅出现在慢性气道和肺部疾病的急性加重期或急性发作期,稳定期甚至正常健康人群也可检测到.微生态多样性和构成的改变与某些慢性气道和肺部疾病密切相关.本文着重介绍COPD、支气管哮喘、支气管扩张症及特发性肺纤维化的菌群多样性及构成变化.     

微生态与肺癌相关研究进展

人类微生物研究已经成为一个重要领域,更多的证据表明微生物在肿瘤发生、发展的过程中起关键作用.正常呼吸道微生物保持动态平衡,进一步研究呼吸道疾病的微生物变化,可能为肺癌的病因、发病机制、治疗及与预后等提供更加丰富的理论基础及证据.本文对呼吸系统微生态及具体微生物与肺癌发生、发展过程之间的可能联系及作用进行综述.     

脑损伤后长期留置气管套管患者呼吸道定植菌状况分析

目的 分析脑损伤后长期留置气管套管患者呼吸道定植菌状况,探讨可行的治疗方式.方法 对156例脑损伤患者留置气管套管后1、3、6个月的下呼吸道468份痰标本进行细菌、真菌培养.比较患者不同时期呼吸道定植菌的变化.结果 患者留置气管套管后1、3、6个月呼吸道定植菌检出率分别为89.7%、91.0%、96.5%,其中真菌的检出率及多重呼吸道定植菌阳性率均逐渐降低(P均<0.05).结论 脑损伤后长期留置气管套管患者呼吸道定植菌检出率在1个月后趋于稳定,但多重呼吸道定植菌阳性率、真菌检出率逐渐下降;呼吸道定植菌阳性患者在无明确临床感染症状的情况下可停止使用抗生素.     

儿童百日咳与支气管哮喘关系的研究进展

支气管哮喘(哮喘)是一种多因素异质性疾病,严重影响儿童的身心健康。对于其发病原因及机制的研究一直是学者们关注的重点。近年来,呼吸道合胞病毒、鼻病毒、肺炎支原体等病原体感染与哮喘的关系逐渐明确,但是百日咳与哮喘之间的关系尚不明确。有研究认为百日咳杆菌感染后可诱导IgE的产生、激活Th2细胞并诱导Th17免疫应答,加强中性粒细胞对气道的炎症浸润、促进气道重塑、破坏气道纤毛结构引起呼吸道微生态失衡而导致哮喘,也可能通过Toll样受体9途径抑制气道高反应。但也有研究认为百日咳感染与哮喘无关。为了更好地了解百日咳感染与哮喘的关系,本文通过检索近期的文献加以阐述,以期提高认识,合理防控哮喘的发生、发展。     

肠道菌群在过敏性支气管哮喘发生和发展中的作用

过敏性支气管哮喘(简称哮喘)是临床上最常见的过敏性疾病之一,主要与免疫紊乱相关.随着“卫生假说”的提出以及微生态学的发展,近年来肠道正常菌群在过敏性哮喘发生、发展中所发挥的作用逐渐为人们所重视.人们在肠道菌群与免疫调节、菌群失调与哮喘发病风险以及利用微生态制剂预防、治疗哮喘等多方面进行了研究,为治疗并预防哮喘开辟了新的空间.     

胃肠道微生态与胃癌关系的研究进展

胃肠道微生态平衡在消化、吸收、代谢、免疫以及抑制病原菌定植中起重要作用,胃肠道微生态紊乱与胃肠道多种疾病密切相关。目前研究表明胃肠道微生态参与了胃癌的发生、发展,本文就胃肠道微生态与胃癌关系的研究进展作一综述。     

呼吸道菌群失调在支气管哮喘中的作用

呼吸道菌群研究是一个相对较新的领域,随着16S rRNA序列分析检测技术在临床研究中的广泛应用,人们对呼吸道菌群失调与支气管哮喘发生发展之间的关系有了新的认识,研究发现呼吸道有着远比之前认识要多样化的菌群.呼吸道菌群异常可能是支气管哮喘发生及加重的潜在原因之一.     

气道微生态在慢性阻塞性肺疾病中的研究进展

慢性阻塞性肺疾病（COPD）是一种慢性气道炎症性疾病,其特征为慢性呼吸道症状（呼吸困难、咳嗽、咳痰、急性加重）。感染是COPD恶化以及肺功能下降的主要原因,呼吸道微生态以及其所带来的免疫调节功能在其中发挥重要作用。新一代基因测序技术使得更清楚地了解呼吸道微生态组成及其与呼吸系统疾病相关性,不仅揭示了健康人群肺部拥有丰富的微生物群落,而且与健康人群相比,COPD患者的气道微生态结构和各菌群的相对丰度均发生了改变。本文对气道微生态在COPD中的研究进展作一综述。     

Microbiome in the primary prevention of allergic diseases and bronchial asthma

Tremendous progress in the ability to identify and test the function of microorganisms in recent years has led to a much better understanding of the role of environmental and host microbiome in the development of immune function, allergic sensitization and asthma. In this review, the most recent findings on the relationships between environmental microbiota, respiratory, intestinal microbiome, the consequences of early-life microbial exposure type and gut–lung microbial axis and the development of asthma and atopy are summarized. The current perspective on gut and airway microbiome manipulation for the primary prevention of allergic diseases and asthma is also discussed.     

The role of respiratory tract infections and the microbiome in the development of asthma: A narrative review

Asthma is a common disease in childhood, and might predispose for chronic obstructive respiratory morbidity in adolescence and adulthood. Various early‐life risk factors might influence the risk of wheezing, asthma, and lower lung function in childhood. Cohort studies demonstrated that lower respiratory tract infections in the first years of life are associated with an increased risk of wheezing and asthma, while the association with lung function is less clear. Additionally, the gut and airway microbiome might influence the risk of wheezing and asthma. The interaction between respiratory tract infections and the microbiome complicates studies of their associations with wheezing, asthma, and lung function. Furthermore, the causality behind these observations is still unclear, and several other factors such as genetic susceptibility and the immune system might be of importance. This review is focused on the association of early‐life respiratory tract infections and the microbiome with wheezing, asthma, and lung function, it is possible influencing factors and perspectives for future studies.

     

The complex interplay between inflammation,the microbiota and colorectal cancer

The microbiome has captured the attention of scientists from multiple research fields including ecology, immunology, microbiology and cancer biology. The microbial community living in the gastrointestinal tract is the most abundant and diverse niche of the human body and it is not surprising that microbiome research has predominantly focused upon this organ system. In this addendum, we summarize the latest developments in microbiome research on inflammatory bowel diseases and colorectal cancer. In addition, we highlight our recent findings that chronic intestinal inflammation modulates microbial community composition and the development of colorectal cancer. Our findings redefine the paradigm of inflammation-associated cancer by illuminating the key role of bacteria in development of colorectal cancer.     

The contribution of respiratory microbiome analysis to a treatable traits model of care

The composition of the airway microbiome in patients with chronic airway diseases, such as severe asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and cystic fibrosis (CF), has the potential to inform a precision model of clinical care. Patients with these conditions share overlapping disease characteristics, including airway inflammation and airflow limitation. The clinical management of chronic respiratory conditions is increasingly moving away from a one‐size‐fits‐all model based on primary diagnosis, towards care targeting individual disease traits, and is particularly useful for subgroups of patients who respond poorly to conventional therapies. Respiratory microbiome analysis is an important potential contributor to such a ‘treatable traits’ approach, providing insight into both microbial drivers of airways disease, and the selective characteristics of the changing lower airway environment. We explore the potential to integrate respiratory microbiome analysis into a treatable traits model of clinical care and provide a practical guide to the application and clinical interpretation of respiratory microbiome analysis.     

The microbiome in the lower respiratory tract

With the advent of new technologies evaluating the microbiome in the sample such as next-generation sequencer (NGS), current increase of an interest in understanding of the lung microbiome and its roles in lung diseases are marked. Gathering the data of bacterial flora in the lung and their changes during disease courses is unraveling the pathogenesis and the mechanism of disease progression particularly in patients with bronchial asthma, chronic obstructive pulmonary disease and infectious lung diseases. To clarify the relationship between the lung microbiome and pulmonary diseases, new information may help us to create new treatment and prevention strategies of some pulmonary diseases by controlling the lung microbiome.Using bacterial 16S ribosomal RNA gene sequence, NGS can rapidly estimate large amount of bacterial sequences in the phylum and genus levels, and some of them in species levels in a very short period of time. In addition to new information of the microbiome using NGS in the respiratory tract, other techniques using basically Sanger method in combination with the clone library construction can also be useful to identify pathogenic bacterial species with their ratio in the respiratory samples such as bacterial pneumonia, lung abscess and nontuberculous mycobacteriosis. These modalities to identify and semi-quantify bacterial burden in the respiratory tract have revealed new bacterial information in each infectious lung disease.This review describes current understanding of the lung microbiome in several representative lung diseases.     

Indoor Water and Dampness and the Health Effects on Children: A Review

Exposure to dampness and mold in indoor environments has received significant attention in recent research. This review focuses on studies looking at the impact of dampness, moisture and microbial agents on children’s health. We then look more broadly at how research studies have tried to describe dampness and exposure to moisture. Papers published from 2010 onwards were reviewed and are briefly summarized. Most of the papers using dampness as a proxy for microbial exposure focused on respiratory tract infections, especially asthma. This review highlights new findings and also discusses the variety of approaches used to assess dampness in indoor environments.     

Human behavior,not race or geography,is the strongest predictor of microbial succession in the gut bacteriome of infants

ABSTRACT

Colonization of the gastrointestinal tract with microorganisms during infancy represents a critical control point for shaping life-long immune-mediated disease susceptibility. Abnormal colonization or an imbalance of microbes, termed dysbiosis, is implicated in several diseases. Consequently, recent research has aimed at understanding ways to manipulate a dysbiotic microbiome during infancy to resemble a normal, healthy microbiome. However, one of the fundamental issues in microbiome research is characterizing what a “normal” infant microbiome is based on geography, ethnicity and cultural variations. This review provides a comprehensive account of what is currently known about the infant microbiome from a global context. In general, this review shows that the influence of cultural variations in feeding practices, delivery modes and hygiene are the biggest contributors to microbial variability. Despite geography or race, all humans have similar microbial succession during infancy.     

Emerging science of the human microbiome

The human gastrointestinal tract hosts a large number of microbial cells which exceed their mammalian counterparts by approximately 3-fold. The genes expressed by these microorganisms constitute the gut microbiome and may participate in diverse functions that are essential to the host, including digestion, regulation of energy metabolism, and modulation of inflammation and immunity. The gut microbiome can be modulated by dietary changes, antibiotic use, or disease. Different ailments have distinct associated microbiomes in which certain species or genes are present in different relative quantities. Thus, identifying specific disease-associated signatures in the microbiome as well as the factors that alter microbial populations and gene expression will lead to the development of new products such as prebiotics, probiotics, antimicrobials, live biotherapeutic products, or more traditional drugs to treat these disorders. Gained knowledge on the microbiome may result in molecular lab tests that may serve as personalized tools to guide the use of the aforementioned products and monitor interventional progress.     

Is Asthma an Infectious Disease? New Evidence

The pathogenetic mechanisms leading to asthma are likely to be diverse, influenced by multiple genetic polymorphisms as well as elements of the environment. Recent data on the microbiome of the airway have revealed intriguing differences between the number and diversity of microbial populations in healthy persons and asthmatics. There is convincing evidence that early viral infections, particularly with human rhinovirus and respiratory syncytial virus, are often associated with the development of chronic asthma and with exacerbations. Recent studies suggest that two unrelated types of atypical bacteria, Mycoplasma pneumoniae (Mpn) and Chlamydia pneumoniae, are present in the airways of a substantial proportion of the population, bringing up the possibility that the persistent presence of the organism may contribute to the asthmatic phenotype in a subset of patients. This review will examine the current data regarding a possible role for infection in chronic asthma with a particular focus on atypical bacterial infections.