| Abstract | Astma je heterogena, upalna bolest dišnog sustava uzrokovana nizom genetičkih i okolišnih faktora kao što su prehrambene navike, stil života, izloženost patogenima u djetinjstvu te ljudskom mikrobiotom, zajednicom svih mikrobnih organizama u i na ljudskom tijelu. Razvoj metoda sekvenciranja nove generacije je omogućio bržu i jeftiniju analizu mikrobiote nego ikada prije što je u novije vrijeme generiralo veliki interes za otkrivanjem njenog utjecaja na zdravlje. Postoje indikacije o postojanju "kritičnog okvira" u ranom djetinjstvu gdje okolišni uvjeti imaju posebice jak utjecaj na pravilno sazrijevanje imunološkog sustava s mnogim rizičnim faktorima uključujući izostanak dojenja, nisku izloženost patogenima i toksinima, antibiotike, rođenje carskim rezom i specifične infekcije. Najznačajniju ulogu u razvoju astme imaju mikrobiota crijeva i pluća. Uočene su mnoge razlike u bogatstvu i raznolikosti između zdrave i astmatične mikrobiote tih dvaju sustava. Generalizacije o povezanosti nekih većih taksonomskih skupina s mikrobiotom zdravih ljudi ili astmatičara je teško za izreći pošto se čini da je utjecaj na astmu uglavnom ograničen na razini vrste i roda. Najbolje ustanovljeni mehanizam utjecaja mikrobiote na astmu uključuje utjecaj na gensku regulaciju, staničnu signalizaciju i aktivaciju ili inhibiciju određenih grana imunološkog odgovora preko proizvodnje različitih imunomodulatornih metabolita kao što su masne kiseline kratkog lanca. Postoji potencijal za razvojem novih terapeutika i terapeutskih metoda koje utječu na sastav mikrobiote administracijom probiotika, prebiotika, simbiotika, makrolidnih antibiotika i fekalnih transplantata. Ipak, za razvoj ovih metoda potrebno je puno temeljitije proučiti utjecaj pojedinih mikrobnih vrsta na astmu te jasnije definirati njihove molekularne mehanizme utjecaja na astmu. |
| Abstract (english) | Asthma is a heterogenous, inflammatory disease of the respiratory system caused by a number of genetic and environmental factors such as dietary habits, lifestyle, childhood exposure to pathogens, and the human microbiota, a community of all microbial organisms in and on the human body. The rise of next-generation sequencing methods has enabled faster and cheaper analysis of the microbiota than ever before which has, in recent times, generated great interest in discovering its influence on human health. There are indications on the existence of a “critical window” in early childhood, in which environmental conditions have an especially strong influence on proper maturation of the immune system. There are many environmental risk factors including a lack of breastfeeding, low exposure to pathogens and toxins, antibiotics, cesarian birth and specific infections. The microbiota of the lung and gut have the most significant influence on asthma development. Many differences in the richness and diversity of microbiota between healthy and asthmatic subjects have been observed. Any generalisations linking higher taxonomic ranks with the microbiota of healthy or asthmatic subjects are hard to make as the microbiota’s influence on asthma seems to be mostly determined at the species and genus level. The most established mechanisms by which the microbiota influence asthma include influences on gene regulation, cellular signalization and activation or inhibition of certain branches of the immune response by way of production of various immunomodulatory metabolites such as short chain fatty acids. There is potential for development of new therapeutics and therapeutic methods which affect the composition of the microbiota by administering probiotics, prebiotics, synbiotics, macrolide antibiotics or fecal transplants. Nevertheless, developing these methods will require a more thorough look at the influence of individual microbial species on asthma, and a clearer understanding of their molecular mechanism of influence on asthma. |
