The intestinal and pulmonary microbiota may be involved in the onset of asthma. Research is in progress.
Asthma is a chronic inflammation of the bronchi that causes them to become hyperresponsive when exposed to certain substances or in certain situations. Around 235 million people are affected throughout the world.1
Asthma attacks are characterized by bronchial obstruction leading to breathing problems. They can be triggered by contact with an allergen, an irritant (pollution, smoke, paint, etc.), a respiratory virus, by certain medications, or even by physical activity.2
Role of the microbiota
Several studies suggest that there is a connection with intestinal microbiota dysbiosis.3-6 For instance, low diversity in the latter in the first months of life3 or fecal colonization at three months with Bacteroides fragilis or Clostridium coccoides XIVa4 are risks factors for asthma . Furthermore, the use of antibiotics by the mother during pregnancy or by the child in the first year of life is associated with an increase in the risk of developing asthma for the child.7 Dysbiosis brought on by antibiotics –occurring in the first weeks or even the first months of life, when the intestinal microbiota is being established8– may be related to an increased risk of developing asthma. The role of the pulmonary microbiota9 has also been identified. The discovery of a distinct and specific pulmonary flora suggests it plays a role in the development of asthma.10-12 Conversely, exposure to microorganisms during early infancy may be beneficial in preventing asthma: it seems that there a reduced risk of developing asthma in children born vaginally,13, 14 or who are in contact with pets15 or farmanimals16.
The primary measures consist of eliminating triggers, if possible. Long-term and quick-relief treatments also reduce the frequency of attacks and control their severity. Furthermore, for allergic asthma, preclinical studies show that GOS and FOS prebiotics, as well as certain probiotics,17,18 have a beneficial effect in modulating the immune response.
1- OMS, avril 2017 http://www.who.int/mediacentre/factsheets/fs307/fr/
2- Recommandations GINA (2017) : Guide for asthma management and prevention. http://ginasthma.org/2017-pocket-guide-for-asthma-management-and-prevention/
3- Abrahamsson TR, Jakobsson HE, Andersson AF, Björkstén B, Engstrand L, Jenmalm MC. Low gut microbiota diversity in early infancy precedes asthma at school age. Clin Exp Allergy 2013. doi: https://www.ncbi.nlm.nih.gov/pubmed/24330256 https://pdfs.semanticscholar.org/4421/476df50d20ba512ad954eb9867b6b10f3801.pdf
4- Vael C, Nelen V, Verhulst S, Goossens H, Desager K. Early intestinal Bacteroides fragilis colonisation and development of asthma. BMC Pulm Med 2008: 8: 19 https://www.ncbi.nlm.nih.gov/pubmed/18822123
5- Songjinda P, Nakayama J, Tateyama A, et al. Differences in developing intestinal microbiota between allergic and nonallergic infants: a pilot study in Japan. Biosci Biotechnol Biochem 2007 ; 71 : 2338-42 https://www.ncbi.nlm.nih.gov/pubmed/17827672
6- Vael C, Vanheirstraeten L, Desager KN, Goossens H. Denaturing gradient gel electrophoresis of neonatal intestinal microbiota in relation to the development of asthma. BMC Microbiol 2011 ; 11 : 68 https://www.ncbi.nlm.nih.gov/pubmed/21477358
7- Murk W et al. Prenatal or early-life exposure to anti- biotics and risk of childhood asthma: a systematic review. Pediatrics 2011 ; 127 : 1125-38.
8- Azad MB, Kozyrskyj AL. Perinatal programming of asthma: the role of gut microbiota. Clin Dev Immunol 2012 ; 2012 : 932072.
9- Hilty M, Conor Burke et al. Disordered Microbial Communities in Asthmatic Airways. PLOS One. 2010 http://dx.doi.org/10.1371/journal.pone.0008578
10- Sullivan A et al. The Microbiome and the Pathophysiology of Asthma. Respir Res. 2016 Dec 5;17(1):163. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5139145/
11- Hauptmann M et al. Linking microbiota and respiratory disease. FEBS Lett. 2016 Nov;590(21):3721-3738. https://www.ncbi.nlm.nih.gov/pubmed/27637588
12- Michon AL et al. Revue francophone des laboratoires.Février 2015 N°469 p37-49
13- Huang L, Chen Q, Zhao Y, Wang W, Fang F, Bao Y. Is elective cesarean section associated with a higher risk of asthma? A meta-analysis. J Asthma 2015;52:16-25.
14- Azad MB, Konya T, Maughan H, et al. Gut microbiota of healthy Canadian infants: profiles by mode of delivery and infant diet at 4 months. CMAJ 2013;185:385-94.
15- Ownby DR, Johnson CC, Peterson EL. Exposure to dogs and cats in the first year of life and risk of allergic sensitization at 6 to 7 years of age. JAMA 2002;288:963-72.
16- Riedler J, Braun-Fahrlander C, Eder W, et al. Exposure to farming in early life and development of asthma and allergy: a cross-sectional survey. Lancet 2001;358:1129-33.
17- Juan Z, Zhao-Ling S, Ming-Hua Z, Chun W, Hai-Xia W, Meng-Yun L, Jian-Qiong H, Yue-Jie Z, Xin S. Oral administration of Clostridium butyricum CGMCC0313-1 reduces ovalbumin-induced allergic airway inflammation in mice. Respirology. 2017 Jan 25. https://www.ncbi.nlm.nih.gov/pubmed/28122397
18- Fonseca VM, Milani TM, Prado R, Bonato VL, Ramos SG, Martins FS, Vianna EO, Borges MC . Oral administration of Saccharomyces cerevisiae UFMG A-905 prevents allergic asthma in mice. Respirology. 2017 Feb 6. https://www.ncbi.nlm.nih.gov/pubmed/28166610