Asthma severity is associated with upper respiratory tract microbiome_Scientific invention

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A new study led by Washington University School of Medicine in St. Louis shows a link between upper respiratory tract bacteria and the severity of asthma symptoms in children with mild to moderate asthma.

This study raises the possibility that the airway microbiome may play a causal role in asthma symptom severity. The study paves the way for future research to discover whether changing the types of bacteria that live in the upper respiratory tract can help people with asthma.

The research results were published in the journal "Nature Communications" on December 16.

There is an urgent need to develop better asthma treatments for these patients, said Avraham Beigelman, MD, associate professor of pediatrics at the University of Washington. Although our study cannot prove cause and effect, it raises interesting questions that we plan to pursue. If we somehow supplement these patients with bacteria that appear to be good, do they do better? We're interested in studying whether we can deliberately change the cause of the bacteria. Airway microbiome to reduce the risk of asthma symptom exacerbations.

In the United States, more than 6 million children under the age of 18 have asthma, or about 1 in 12 children, according to the Asthma and Allergy Foundation. It is a leading chronic pediatric disease and the number one cause of missed school days.

Researchers found that children who had warning signs of an impending asthma attack were more likely to have disease-associated bacteria in their upper airways, including Staphylococcus, Streptococcus and Moraxella. In contrast, airway microbes dominated by Corynebacterium and Dolosigranulum bacteria were associated with healthy periods when asthma was well controlled.

Beigelman and colleagues also found that children whose airway microbiomes shifted from being dominated by Corynebacterium and Dolosigranulum bacteria to being dominated by Moraxella spp. of children are at the highest risk of developing asthma symptoms.

Our data demonstrate rapid changes in the airway microbiome in children who transition from respiratory health to disease, said first author Yanjiao Zhou, MD, who was a postdoctoral fellow at the University of Washington before joining the faculty. Microbiome and bioinformatics research. Connecticut. It is also interesting to note that patterns of changes in the microbiome may play an important role in acute asthma exacerbations. We are planning further studies to explore this possibility.

The upper respiratory microbiome study was conducted in conjunction with a clinical trial involving 214 children aged 5 to 11 years with mild to moderate asthma. The trial, Stepped Yellow Zone Inhaled Corticosteroids for Acute Exacerbation Prevention, was conducted as part of AsthmaNet, a network of national medical centers conducting asthma research funded by the National Heart, Lung, and Blood Institute of the U.S. National Institutes of Health. Institute. UW is an AsthmaNet site, and Leonard B. Bachalier, M.D., professor of pediatrics at UW, an asthma expert and co-author of the current microbiome study, led the pediatric portion of the UW STICS trial.

The purpose of this clinical trial is to determine whether increasing the dose of inhaled corticosteroids fivefold at the first signs of asthma exacerbation is better than keeping the same drug at a low dose. The trial found no benefit from higher doses, and those results were published in the New England Journal of Medicine in 2018.

During the trial, researchers also collected nasal mucus samples from the children to study their upper respiratory tract microbes. Samples were collected at the beginning of the trial and at the first early signs of asthma control beginning to weaken.

Based on these findings, Begelman and Zhou said they plan to conduct studies in mice with tightly controlled airway microbiota to see if the researchers can uncover the bacterial causes of asthma severity. Additionally, such experiments could allow them to test different interventions that might intentionally alter upper respiratory tract bacteria in a protective way.

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