Probiotics and Lung Diseases
Probiotics and Lung Diseases
复制标题
DOI：
10.1378/chest.10-1861
复制
发表时间：
2011-04-01
期刊：
影响因子：
9.6
通讯作者：
Forsythe, Paul
中科院分区：
文献类型：
--
作者：
Forsythe, Paul
随着人们对肠道共生菌在免疫系统发育和调节中的作用的认识不断提高，人们对益生菌和其他基于细菌的策略治疗一系列免疫相关疾病的潜力产生了极大的兴趣。动物模型研究发现，许多非致病性细菌具有很强的免疫调节作用，并提供证据表明，肠道微生物可以激活共同的粘膜免疫反应，从而影响远至肠道的部位，包括呼吸道。在动物模型中，益生菌的呼吸作用包括减轻气道过敏反应和保护呼吸道病原体。树突状细胞在引导对益生菌的有益免疫反应和将微生物信号从先天免疫系统转化为适应性免疫系统方面发挥着核心作用，而调节性T细胞正在成为益生菌介导反应的潜在关键效应体，特别是在减少过敏性炎症方面。尽管基础研究取得了进展，但益生菌在过敏/哮喘和呼吸道感染中的临床试验充其量是高度可变的，导致对这种潜在治疗策略的信心受到破坏。很明显，关于由不同菌株引起的不同免疫反应的决定因素，还有很多东西需要学习。我们需要更深入地了解益生菌与现有微生物群之间的相互作用，以及微生物与先天免疫系统之间的对话如何转化为有益/保护反应，才能实现临床有效的基于细菌的策略，以维持和促进呼吸系统健康。胸部2011;39 (4): 901 - 908
Increasing awareness of the role of intestinal commensal bacteria in the development and modulation of the immune system has led to great interest in the therapeutic potential of probiotics and other bacteria-based strategies for a range of immune-related disorders. Studies in animal models have identified strong immumomodulatory effects of many nonpathogenic bacteria and provided evidence that intestinal microbes can activate a common mucosal immune response and, thus, influence sites distant to the intestine, including the respiratory tract. Respiratory effects of probiotics in animal models have included attenuating allergic airway responses and protecting against respiratory pathogens. Dendritic cells appear central to directing the beneficial immune response to probiotic bacteria and in translating microbial signals from the innate to the adaptive immune system, whereas regulatory T cells are emerging as potentially key effectors of probiotic-mediated responses, particularly in the reduction of allergic inflammation. Despite progress in basic research, clinical trials of probiotics in allergy/asthma and respiratory infection have been highly variable at best, leading to an undermining of confidence in this potential therapeutic strategy. It is clear that there is still much to learn regarding the determinants of the diverse immune responses elicited by different bacterial strains. A deeper knowledge of the interactions between administered probiotics and the existing microbiota, together with an understanding of how the dialogue between microbes and the innate immune system is translated into beneficial/protective responses, will be required before we can achieve clinically effective bacteria-based strategies that maintain and promote respiratory health. CHEST 2011; 39(4):901-908