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Review
. 2024 Jun;10(2):171-182.
doi: 10.1007/s41030-024-00261-3. Epub 2024 May 30.

Exploring the Impact of Airway Microbiome on Asthma Morbidity: A Focus on the "Constructing a 'Eubiosis Reinstatement Therapy' for Asthma-CURE" Project

Paraskevi Xepapadaki  1 , Spyridon Megremis  2 , Nikoletta Rovina  3 , Aleksandra Wardzyńska  4 , Maria Pasioti  5 , Maria Kritikou  5 , Nikolaos G Papadopoulos  5 ; CURE Consortium
Collaborators, Affiliations
Review

Exploring the Impact of Airway Microbiome on Asthma Morbidity: A Focus on the "Constructing a 'Eubiosis Reinstatement Therapy' for Asthma-CURE" Project

Paraskevi Xepapadaki et al. Pulm Ther. 2024 Jun.

Abstract

The asthma pandemic imposes a huge burden on patients and health systems in both developed and developing countries. Despite available treatments, symptom control is generally suboptimal, and hospitalizations and deaths remain at unacceptably high levels. A pivotal aspect of asthma that warrants further exploration is the influence of the respiratory microbiome and virome in modulating disease activity. A plethora of studies report that the respiratory microbiome is characteristically dysbiotic in asthma. In addition, our data suggest that dysbiosis is also observed on the respiratory virome, partly characterized by the reduced abundance of bacteriophages (phages). Even though phages can naturally infect and control their bacterial prey, phage therapy has been grossly neglected in the Western world, although more recently it is more widely used as a novel tool against bacterial infections. However, it has never been used for tackling microbiome dysbiosis in human non-communicable diseases. This review provides an up-to-date understanding of the microbiome and virome's role within the airways in relation to asthma morbidity. It also advances the rationale and hypothesis for the CURE project. Specifically, the CURE project suggests that managing the respiratory microbiome through phage therapy is viable and may result in restoring eubiosis within the asthmatic airway. This entails controlling immune dysregulation and the clinical manifestation of the disease. To accomplish this goal, it is crucial to predict the effects of introducing specific phage mixtures into the intricate ecology of the airways and devise suitable interventions.

Keywords: Asthma; Bacteriophages; CURE concept; Microbiome; Virome; Virus.

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Conflict of interest statement

Paraskevi Xepapadaki reports outside the submitted work payment or honoraria for lectures, presentations, speakers’ bureaus, Galenica, GlaxoSmithKline, Menarini, Novartis, Uriach, Nestle, Nutricia. Nikoloas G. Papadopoulos reports grants or contracts from any entity Capricare, Nestle, Numil, Vianex, consulting fees from Abbott, AbbVie, Astra Zeneca, GSK, HAL, Medscape, Menarini/Faes Farma, Mylan, Novartis, Nutricia, OM Pharma, Regeneron/Sanofi, outside the submitted work. NGP is an Editorial Board member of Pulmonary Therapy. Nikos Papadopoulos was not involved in the selection of peer reviewers for the manuscript nor any of the subsequent editorial decisions. Spyridon Megremis, Nikoletta Rovina, Aleksandra Wardzynska, Maria Pasioti, Maria Kritikou have nothing to declare.

Figures

Fig. 1
Fig. 1
The CURE hypothesis is based on the concept that phage therapy could restore the dysbiotic system, thus facilitating the return of the lung microbiome to a healthy state
See this image and copyright information in PMC

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