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Cross-Talk between Gut and Lung Microbiomes: Implications for Chronic Respiratory Disease

Hansbro PM, Budden KF, Shukla SD, Alemao CA, Keely S, Bowerman K, Hugenholtz P.

RDD Europe 2019. Volume 1, 2019: 17-26.

Abstract:

Chronic respiratory diseases including asthma and chronic obstructive pulmonary disease (COPD) are major clinical issues. Current therapies are ineffective in severe asthma and only alleviate some symptoms but neither reverse nor cure COPD. Asthma results from aberrant responses to innocuous antigens, allergens and infections while cigarette smoking is the commonest cause of COPD. In both diseases, chronic inflammation results in tissue damage leading to airway remodeling, that combine to impair lung function. Alveolar destruction and emphysema also occur in COPD.

The microbiome encompasses all the microorganisms that inhabit the body, and recent studies show that a healthy microbiome is essential for maintaining homeostasis and health. Changes in the respiratory microbiome and the metabolites they produce may contribute to the pathogenesis of asthma and COPD. Deleterious bacteria may promote inflammation whereas beneficial bacteria may suppress inflammation and disease. All these bacteria may be altered by immune responses to allergens and cigarette smoke. Alterations in gut microbiomes may induce or suppress local and systemic inflammation. Substantial immune and inflammatory cross-talk occurs between the lung and gut, and so it is possible that changing gut microbiomes may be beneficial in lung disease. Microbiome profiling assesses changes that are associated with disease. Transfer of microbiomes, e.g., by fecal transfers, can modify microbiomes or microbial metabolites can be used instead. This can identify deleterious and beneficial bacteria and the potential for therapeutic manipulation as treatments for chronic respiratory diseases.