La disbiosis microbiana como origen precoz del asma.
Resumen
Existe creciente evidencia de la importancia del microbioma intestinal y del eje intestino-pulmón en el origen del asma. El proceso de colonización microbiana en los primeros 3 años de vida es fundamental para la salud, describiéndose como ventana crítica las alteraciones que se producen y generan disbiosis microbiana en los primeros 100 días de vida. Distintos factores producen esta disbiosis microbiana precoz, como el parto por cesárea, la lactancia artificial o de fórmula y el uso de antibioterapia, entre otros. Estudios realizados en modelos de ratones libres de gérmenes han demostrado la repercusión de la disbiosis microbiana precoz en el desarrollo y homeostasis del sistema inmune generando un disbalance a respuesta proinflamatoria y Th2. Estudios de cohortes longitudinales en niños sobre microbiota intestinal y de vías respiratorias han encontrado asociación entre disbiosis microbiana y asma en edades posteriores de la vida. Una reducida diversidad en la microbiota intestinal en la infancia temprana se asocia a un riesgo aumentado de diagnostico de atopia y asma, mientras una elevada diversidad ha mostrado ser beneficioso para la salud. El objetivo de esta revisión es actualizar los conocimientos sobre el proceso de colonización intestinal normal durante lo primeros 3 años de vida, los factores que pueden modificarlo, así como la posible relación entre la disbiosis microbiana precoz y el asma en edades posteriores de la vida.
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