Microbiome and Asthma: Microbial Dysbiosis and the Origins, Phenotypes, Persistence, and Severity of Asthma

Abstract

The importance of the microbiome, and of the gut-lung axis in the origin and persistence of asthma, is an ongoing field of investigation. The process of microbial colonisation in the first three years of life is fundamental for health, with the first hundred days of life being critical. Different factors are associated with early microbial dysbiosis, such as caesarean delivery, artificial lactation and antibiotic therapy, among others. Longitudinal cohort studies on gut and airway microbiome in children have found an association between microbial dysbiosis and asthma at later ages of life. A low α-diversity and relative abundance of certain commensal gut bacterial genera in the first year of life are associated with the development of asthma. Gut microbial dysbiosis, with a lower abundance of Phylum Firmicutes, could be related with increased risk of asthma. Upper airway microbial dysbiosis, especially early colonisation by Moraxella spp., is associated with recurrent viral infections and the development of asthma. Moreover, the bacteria in the respiratory system produce metabolites that may modify the inception of asthma and is progression. The role of the lung microbiome in asthma development has yet to be fully elucidated. Nevertheless, the most consistent finding in studies on lung microbiome is the increased bacterial load and the predominance of proteobacteria, especially Haemophilus spp. and Moraxella catarrhalis. In this review we shall update the knowledge on the association between microbial dysbiosis and the origins of asthma, as well as its persistence, phenotypes, and severity.

Keywords: asthma; dysbiosis; microbiome; microbiota.

Figure 1

Microbial dysbiosis as an early origin of asthma. Modified and with permission from Valverde-Molina J [22].

Figure 2

Main studies on intestinal microbiome and its relationship with childhood asthma. Modified and with permission from Valverde-Molina J. [22]. NF: Nasopharyngeal; Sp: Streptococcus pneumoniae; Hi: Haemophilus influenzae; Mc: Moraxella catarrhalis; Cd: Clostridium difficile; FLVR: Faecalibacterium, Lachnospira, Veillonella, and Rothia; L/C: Lachnospira/Clostridium ratio; LCC: Lachnobacterium, Lachnospira, Dialister. Arrieta et al. [71]; Fujimura et al. [73]; Galazzo et al. [78]; Lee-Sarwar et al. [86]; Stiemsma et al. [72]; Stokholm et al. [36]; Van Nimwegen et al. [69].

Figure 3

Main studies on respiratory microbiome and risk of asthma in children. Modified and with permission from Valverde-Molina J. [22]. NF: Nasopharyngeal; Sp: Streptococcus pneumoniae; Hi: Haemophilus influenzae; Mc: Moraxella catarrhalis. Bisgaard et al. [74]; Chiu et al. [76]; Dzdic et al. [81]; Mansbach et al. [85]; Powell et al. [83]; Ta et al. [77]; Tang et al. [87].; Teo et al [75,79]; Thorsen et al. [82]; Zhang et al. [84].

Figure 4

Main studies on intestinal or respiratory microbiome and asthma in children, adolescent and adult patients. Pb: Prevotella buccalis; Di: Dialister invisus; Gv: Gardnerella vaginalis; Ak: Alkanindiges hongkongensis. Abdel-Aziz et al. [118]; Chung et al. [54]; Davis et al. [99]; De Shutter et al. [124]; Denner et al. [114]; Fazlollahi [106]; Goldman et al. [129]; Goleva et al. [127]; Green et al. [125]; Ham et al. [132]; Huang et al. [104]; Kozik et al. [120]; Li et al. [123]; Mannion et al. [121]; McCauley [107]; Simpson et al. [119]; Sverrild et al. [110]; Taylor et al. [113]; Yang et al. [105]; Yang et al. [122]; Zhang et al. [102]; Zhou et al. [101].

Figure 5

Strategies for prevention and/or treatment of microbial dysbiosis.