Editorial: Microbiota and asthma
Brandon Bautista-Becerril
Kurtis F. Budden
Ramcés Falfán-Valencia- 1HLA Laboratory, Instituto Nacional de Enfermedades Respiratorias Ismael Cosio Villegas, Mexico City, Mexico
- 2Hunter Medical Research Institute, New Lambton Heights and The University of Newcastle, Callaghan, NSW, Australia
Editorial on the Research Topic
Microbiota and asthma
The human microbiome has emerged as a critical determinant of human health, mainly due to the multiple complementary mechanisms by which microbes tune and train host immunity. Microbiomes, particularly those in early life, are shaped by extrinsic and intrinsic factors, including many exposures that influence asthma risk (1). In this Research Topic, we present several emerging pieces of research that expand our knowledge of the role of microbiomes in asthma.
Severe eosinophilic asthma (SEA) is recognized as one of the most common severe asthma phenotypes. Post-hoc analysis from a clinical trial involving benralizumab demonstrated its increased efficacy on asthma outcomes in patients with comorbid SEA (2).
D'Amato et al. analyzed data from 205 patients with SEA receiving Benralizumab treatment recruited in the Italian ANANKE multicenter observational retrospective cohort study from 2019 to 2021 from 201 Italian hospital centers. Benralizumab administration reduced eosinophil count, annualized asthma exacerbation rate and use of oral corticosteroids, and improved asthma control and lung function in patients with and without the presence of chronic rhinosinusitis with nasal polyps.
In severe refractory acute asthma, some guidelines recommend add-on intravenous infusion and/or nebulized magnesium sulfate (MgSO4) (3). Nevertheless, in contrast to the standard treatment of asthma exacerbations, the clinical effect of MgSO4 has been much debated.
Rovsing et al. performed a systematic review and meta-analysis to provide an update on the efficacy of MgSO4 in asthma exacerbations in adults refractory to standard treatment. The study included 17 randomized controlled trials, eight evaluated treatments with intravenous MgSO4, eight with nebulized MgSO4, and one with intravenous and nebulized MgSO4. MgSO4 has a beneficial effect on lung function and reduces the admission rate in patients with acute asthma; none of the studies identified serious side effects. Therefore, it could be used as a last resort in patients with refractory symptoms after standard treatment.
The microbiota in the bronchial tree is characteristic and is disturbed in asthma subjects’ airways. The structure of the bacterial community in the airway might differ between different asthma phenotypes.
Cardenas et al. aimed to study age-related microbiome changes and their relationship with wheezing in asthma by amplicon sequencing of the bacterial 16S rRNA gene in oropharyngeal samples from 225 subjects aged 7 to 24 months (91 cases with recurrent episodic wheezing and 134 controls) in a rural district of Ecuador. The authors concluded that the upper respiratory tract microbiome differs between groups, with significantly increased Streptococcus and decreased Veillonella dispar and Prevotella in cases compared to controls. Likewise, microbiome changes could influence asthma development pathophysiology later in life and could contribute to chronic inflammation in the airway mucosa.
On the other hand, Ramos-Tapia et al. compared the variations of oral and nasal microbiota in terms of composition, structure, and function between healthy and asthmatic children from Santiago de Chile, sequencing the 16S rRNA amplicon of the nasal and oral mucosa of 63 asthmatic children and 89 healthy children. The oral microbiota diversity did not show significant differences in any diversity index evaluated, indicating no significant variation between asthmatic subjects and healthy individuals. However, the genera Moraxella, Dolosigranulum, Haemophilus, Corynebacterium, Streptococcus, and Staphylococcus dominated most asthmatic nasal mucosa samples.
The present Research Topic contributes novel information to better understand the implementation of biological and pharmacological treatments in asthma, as well as microbiome participation in asthma pathogenesis, particularly during early life exposures.
Author contributions
BB: Investigation, Methodology, Resources, Writing – original draft, Writing – review & editing. KB: Data curation, Investigation, Methodology, Supervision, Writing – review & editing. RF: Conceptualization, Formal Analysis, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing.
Funding
The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.
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References
1. Steininger H, Moltzau-Anderson J, Lynch S V. Contributions of the early-life microbiome to childhood atopy and asthma development. Semin Immunol. (2023) 69:101795. doi: 10.1016/j.smim.2023.101795
2. Bleecker ER, Wechsler ME, Mark FitzGerald J, Menzies-Gow A, Wu Y, Hirsch I, et al. Baseline patient factors impact on the clinical efficacy of benralizumab for severe asthma. Eur Respir J. (2018) 52(4):1–13. doi: 10.1183/13993003.00936-2018
3. Global Initiative for Asthma - Global Initiative for Asthma - GINA. Available at: https://ginasthma.org/ (Accessed September 1, 2023)
Keywords: microbiota, asthma, microbiome, inflammation, exacerbation
Citation: Bautista-Becerril B, Budden KF and Falfán-Valencia R (2023) Editorial: Microbiota and asthma. Front. Allergy 4:1297425. doi: 10.3389/falgy.2023.1297425
Received: 20 September 2023; Accepted: 31 October 2023;
Published: 14 November 2023.
Edited and Reviewed by: Nikolaos (Nikos) G. Papadopoulos, National and Kapodistrian University of Athens, Greece
© 2023 Bautista-Becerril, Budden and Falfán-Valencia. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Ramcés Falfán-Valencia rfalfanv@iner.gob.mx