Role of the Microbiome in Allergic Disease Development

Abstract

Purpose of review: Evidence suggests that the microbiome of the skin, gastrointestinal tract, and airway contribute to health and disease. As we learn more about the role that the microbiota plays in allergic disease development, we can develop therapeutics to alter this pathway.

Recent findings: Epidemiologic studies reveal that an association exists between environmental exposures, which alter the microbiota, and developing atopic dermatitis, food allergy, and/or asthma. In fact, samples from the skin, gastrointestinal tract, and respiratory tract reveal distinct microbiotas compared with healthy controls, with microbial changes (dysbiosis) often preceding the development of allergic disease. Mechanistic studies have confirmed that microbes can either promote skin, gut, and airway health by strengthening barrier integrity, or they can alter skin integrity and damage gut and airway epithelium. In this review, we will discuss recent studies that reveal the link between the microbiota and immune development, and we will discuss ways to influence these changes.

Keywords: Asthma; Atopic dermatitis; Food allergy; Immune development; Microbiome.

Figure 1:

An increase in pathogenic bacteria is associated with a decrease in innate immune responses including a decrease in mucosal protection and an upregulation of inflammatory cytokines leading to an increase in allergic sensitization. In contrast, an increase in commensal bacteria is associated with activation of innate immunity and prevention of allergic sensitization.