The microbiome in asthma - 06/01/15

Doi : 10.1016/j.jaci.2014.11.011

Yvonne J. Huang, MD ^a, Homer A. Boushey, MD ^b,^⁎
^a Division of Pulmonary and Critical Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Mich
^b Division of Pulmonary, Critical Care, Allergy & Sleep Medicine, Department of Medicine, University of California, San Francisco, Calif

^∗Corresponding author: Homer A. Boushey, MD, Department of Medicine, University of California, San Francisco, Medicine–Allergy & Immunology Division, 505 Parnassus Ave, Rm M-1292, Box 0130, San Francisco, CA 94143-0130.

Abstract

The application of recently developed sensitive, specific, culture-independent tools for identification of microbes is transforming concepts of microbial ecology, including concepts of the relationships between the vast complex populations of microbes associated with ourselves and with states of health and disease. Although most work initially focused on the community of microbes (microbiome) in the gastrointestinal tract and its relationship to gastrointestinal disease, interest has expanded to include study of the relationships of the airway microbiome to asthma and its phenotypes and to the relationships between the gastrointestinal microbiome, development of immune function, and predisposition to allergic sensitization and asthma. Here we provide our perspective on the findings of studies of differences in the airway microbiome between asthmatic patients and healthy subjects and of studies of relationships between environmental microbiota, gut microbiota, immune function, and asthma development. In addition, we provide our perspective on how these findings suggest the broad outline of a rationale for approaches involving directed manipulation of the gut and airway microbiome for the treatment and prevention of allergic asthma.

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Key words : Microbiome, microbiota, bacterial community composition, immune function, allergy, asthma

Abbreviations used : ICS, OVA, Treg

Plan

The airway microbiome in asthma

The role of environmental and gut microbiota in asthma

Relationships of gut microbiota to response to viral respiratory tract infection

Interaction of exposures to environmental allergens and microbes

Microbiome-host relationships in asthma: Key concepts and future challenges

Disclosure of potential conflict of interest: Y. J. Huang's and H. A. Boushey's institutions have received funding for studies of the microbiome in asthma from the National Institutes of Health (Y. J. Huang from the National Heart, Lung, and Blood Institute [NHLBI; 105572] and H. A. Boushey from NHLBI U10 HL098115 and the National Institute of Allergy and Infectious Disease [1 UM1 AI114271-01 and P01 AI089473]). Within the past 3 years, H. A. Boushey has received a consultancy fee from Janssen; a grant from Genentech for study of “The Airway Microbiome of Severe Asthma” (A118451); payment for delivering lectures from the Allergy, Asthma, and Immunology Foundation of Northern California; and royalties from McGraw-Hill.