呼吸道及肠道微生物群对小儿呼吸道健康的临床意义

Clinical significance of respiratory and intestinal microbiota on respiratory health in children

人类呼吸道定植着微生物群落,近年高通量DNA测序技术颠覆了肺部无菌的传统认识,实际上肺部是有细菌的。随着研究的深入,发现肠道与呼吸道微生物群之间存在着某种联系,称为"肠-肺轴"。肠道微生物群可以影响肺部免疫,肺部炎症可以影响肠道微生物群并引起疾病。对"肠-肺轴"的深入了解,使我们对黏膜免疫有了更深入的认识。呼吸道微生物群可能在宿主呼吸道结构成熟、局部免疫形成和系统发育中发挥重要作用,对儿童呼吸道疾病的发生和发展也有重要影响。近年围绕呼吸道疾病方面,微生物学研究取得了许多成果。人们试图应用微生物导向疗法(包括益生菌、益生元和抗生素甚至疫苗)恢复疾病状态下呼吸道微生物群的健康动态平衡,这可能是未来防治呼吸系统疾病的重要靶点。进一步设想应用"组学"如宏基因组学、代谢组学、宏转录组学和宏蛋白质组学实验研究,更深入认识呼吸道微生物群对呼吸道健康和疾病的影响,更好地了解呼吸道微生物群的功能和因果关系。积极寻找具有抗炎特性的新型益生菌或微生物群将是未来改善呼吸道炎症的潜在候选方法;进一步发现具有免疫调节潜力的新型代谢物,纯化微生物的代谢物(如短链脂肪酸)是治疗呼吸系统疾病的一个有希望的目标,本文就近年取得的研究成果进行综述。

Human respiratory tract is colonized with microbial communities.In recent years,high-throughput DNA sequencing technology has subverted the traditional understanding of pulmonary sterility by proving that there are bacteria in the lungs.As research progresses,it is discovered that there is a connection between the gut and respiratory microbiota,known as the"gut-lung axis".The gut microbiota can influence lung immunity,and lung inflammation can affect the gut microbiota and cause disease.An in-depth understanding of the"gut-lung axis"has given us a deeper understanding of mucosal immunity.The respiratory microbiota may play an important role in the structural maturation of the host airway,the formation of local immunity and the development of the system,and also has an important impact on the occurrence and development of respiratory diseases in children.In recent years,many achievements have been made in microbiological research around respiratory diseases.Attempts to apply microbe-directed therapies(including probiotics,prebiotics and antibiotics and even vaccines)to restore the healthy homeostasis of the respiratory microbiota in diseased states may be an important target for the prevention and treatment of respiratory diseases in the future.The assumption of applying"omics"such as metagenomics,metabolomics,metatranscriptomics and metaproteomics for experimental research may help to gain a deeper understanding of the impact of the respiratory microbiota on respiratory health and disease,and to better understand the function of the respiratory microbiota and causality.Actively searching for novel probiotics or microbiota with anti-inflammatory properties will be a potential candidate approach for improving airway inflammation in the future;further discovery of novel metabolites with immunomodulatory potential as well as the metabolites of purified microorganisms(such as short-chain fatty acids)will provide promising candidates for the treatment of respiratory diseases.This article summarized the progress in this field in recent years.