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The human respiratory tract, comprising the upper and lower segments, serves as a critical interface with the external environment. The upper respiratory tract (URT)—including the nostrils, sinuses, pharynx, and oropharynx—is heavily colonized by microbes, while the lower respiratory tract (LRT), composed of the larynx, trachea, bronchi, and lungs, was long thought to be sterile. However, recent molecular studies have revealed that the lungs are not devoid of microbes but act more...
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Microbes and asthma: Opportunities for intervention.

Hermelijn H Smits1, Pieter S Hiemstra2, Clarissa Prazeres da Costa3

  • 1Department of Parasitology, Leiden University Medical Center, Leiden, The Netherlands.

The Journal of Allergy and Clinical Immunology
|March 8, 2016
PubMed
Summary

Rising asthma rates may be linked to reduced early-life exposure to microbes, as suggested by the hygiene hypothesis. Understanding immune system modulation by infections is crucial for developing new asthma treatments.

Keywords:
Hygiene hypothesisasthmahelminthsimmune regulationmicrobesmicrobiomesensitizationviruses

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Area of Science:

  • Immunology
  • Epidemiology
  • Respiratory Medicine

Background:

  • Global asthma incidence and prevalence are increasing.
  • Asthma is recognized as a complex condition with diverse phenotypes and endotypes.
  • The hygiene hypothesis proposes reduced microbial exposure in early life contributes to allergy development.

Purpose of the Study:

  • To explore how immune system modulation by infections influences asthma development.
  • To identify novel therapeutic targets for specific asthma phenotypes.
  • To outline future research directions for asthma interventions.

Main Methods:

  • Discussion and conclusion synthesis from a Netherlands Lung Foundation workshop.
  • Review of existing literature on the hygiene hypothesis and asthma.
  • Analysis of microbial interactions with the human immune system.

Main Results:

  • The workshop highlighted the importance of understanding pathophysiologic pathways in asthma.
  • Evidence suggests microbial manipulation of the immune system plays a role in allergic diseases.
  • Improved asthma models and clinical trial endpoints are needed.

Conclusions:

  • Further investigation into the impact of bacterial, parasitic, and viral infections on asthma is warranted.
  • Understanding immune modulation by microbes can lead to primary and secondary asthma interventions.
  • Identifying new molecular targets is essential for treating specific asthma phenotypes.