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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In 2016&#44; a group of scientists from the University of D&#252;sseldorf published a genetic portrait of the ancestor of all living beings which they called LUCA&#44; the last universal common ancestor&#46; This ancestor was a unicellular organism similar to bacteria&#44; which&#44; according to these researchers&#44; might have been the original common point of all bacteria&#44; archaea&#44; and eukaryotes&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> It therefore seems reasonable to think that the relationship between humans and bacteria is not one that has developed over time&#44; but instead dates back to a common ancestral nexus&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Since the 1980s&#44; the prevalence of diseases in developed countries has changed&#46; A decrease in the incidence of infectious diseases&#44; due to the use of antibiotics and vaccines&#44; has been accompanied by an alarming increase in the incidence of diseases with an autoimmune component&#44; such as inflammatory bowel disease&#44; type 1 diabetes&#44; and asthma&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> This inverse relationship appears to be caused by changes in the intestinal microbial colonization that occurs in the first few weeks of human life&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The development of massive sequencing platforms capable of analyzing entire metagenomes by rapidly and inexpensively amassing DNA sequencing data has solved the problems inherent to conventional methods of culture-based diagnosis&#46; This has enabled scientists to determine which types of microorganisms&#44; not just bacteria&#44; are present in the different organs of the human body&#44; and how they interact with the host&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">It is estimated that the gut microbiome contains 150 genes more than the human being&#44; and that there is a constant interaction between the two which&#44; under normal circumstances&#44; thrive in symbiosis&#46; Circumstances such as country of origin&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">5</span></a> manner of birth &#40;vaginal or cesarean&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> the use of antibiotics&#44; or feeding with breast milk or formula&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> can influence the establishment of the intestinal microbiota&#46; This first contact of our intestines with bacteria will mark the development of the immune system&#44; and may predispose us to or protect us from the appearance of some diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> Thus&#44; a lower intestinal microbial diversity in childhood is associated with an increased risk of allergic diseases&#44; such as atopic dermatitis&#44; eczema&#44; or asthma&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> In contrast&#44; greater exposure to certain microorganisms reduces the likelihood of developing these entities&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> This is known today as the microflora hypothesis&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> and is a variant of the hygiene hypothesis proposed by Strachan in 1989&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The intestinal microbiota&#44; which is initially unstable&#44; undergoes dynamic changes up to the age of 3 years&#44; when it stabilizes&#44; creating an intestinal microbiota similar to that of the adult&#46; It plays a leading role in human health&#44; helping to maintain intestinal homeostasis and adequate protection against certain pathogens&#44; while exercising a nutritional and metabolic effect and physiological and immunological activity&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The lower airway is one of the least populated surfaces in the human body in terms of bacteria&#46; Both the intestinal and respiratory microbiota develop simultaneously after birth&#46; There is a constant cross-communication between these 2 compartments&#44; and fluctuations in the populations of certain bacteria occur in a similar manner in both&#46; Diet has also been shown to have an impact not only on the composition of the intestinal microbiota&#44; but also on the respiratory microbiota&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In patients with chronic respiratory diseases&#44; the respiratory microbiota presents some specific phenotypes that differ from those of healthy individuals&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> and there is a close relationship between low microbial diversity in the gut during childhood and allergic asthma&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> Various studies have also shown that contact with certain environmental microorganisms and the habitat of farms are associated with a decreased risk of developing asthma and atopy&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Although we know less about how viral or bacterial infections that cause many of the exacerbations of chronic respiratory diseases modify the respiratory microbiota of diseases such as COPD&#44; recent studies in this area have highlighted the relationship between infections by certain respiratory viruses in childhood and predisposition to asthma&#46; This relationship is stronger when the infections were caused by respiratory syncytial virus and less when caused by human rhinovirus&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> Very recent data show that the inflammatory response triggered by respiratory syncytial virus infection in childhood varies depends on the composition of the nasopharyngeal microbiome&#46; This produces 2 different clusters of immune response&#44; which are associated with a greater probability of wheezing during the first and second year of life&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> Modifying the composition of the nasopharyngeal microbiome to reduce the inflammatory response provoked by exposure to respiratory syncytial virus is a promising hypothesis that has yet to be tested&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The same occurs with a high-fiber diet&#44; which we know to be important for maintaining intestinal health&#44; since it fosters favorable colonization and the production of short-chain fatty acids&#46; However&#44; there is no sound evidence that increased consumption of fiber reduces the incidence of asthma&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">All these data point toward a window of therapeutic opportunity in the first few weeks of life that could modify the subsequent appearance of allergic diseases&#44; including asthma&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Despite all this rapid progress&#44; our understanding of &#8220;healthy&#8221; intestinal microbiota&#44; the optimal intestinal colonization patterns that help to establish tolerance&#44; and the numerous and complex interactions between the host and the microbiota is still incomplete&#46; This may explain the inconsistencies in studies that have aimed to manipulate the microbiota in the treatment and prevention of different allergic diseases&#46; Microbiota and&#44; in particular&#44; markers of microbiota activity must still be identified&#46; In the near future&#44; we should be able to use these markers in the diagnosis&#44; treatment&#44; and prevention of chronic diseases such as asthma&#46;</p></span>"
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Editorial
The Microbiome and Asthma
Microbioma y asma
Juan Luis García-Rivero
Servicio de Neumología, Hospital de Laredo, Laredo, Cantabria, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In 2016&#44; a group of scientists from the University of D&#252;sseldorf published a genetic portrait of the ancestor of all living beings which they called LUCA&#44; the last universal common ancestor&#46; This ancestor was a unicellular organism similar to bacteria&#44; which&#44; according to these researchers&#44; might have been the original common point of all bacteria&#44; archaea&#44; and eukaryotes&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">1</span></a> It therefore seems reasonable to think that the relationship between humans and bacteria is not one that has developed over time&#44; but instead dates back to a common ancestral nexus&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Since the 1980s&#44; the prevalence of diseases in developed countries has changed&#46; A decrease in the incidence of infectious diseases&#44; due to the use of antibiotics and vaccines&#44; has been accompanied by an alarming increase in the incidence of diseases with an autoimmune component&#44; such as inflammatory bowel disease&#44; type 1 diabetes&#44; and asthma&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">2</span></a> This inverse relationship appears to be caused by changes in the intestinal microbial colonization that occurs in the first few weeks of human life&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The development of massive sequencing platforms capable of analyzing entire metagenomes by rapidly and inexpensively amassing DNA sequencing data has solved the problems inherent to conventional methods of culture-based diagnosis&#46; This has enabled scientists to determine which types of microorganisms&#44; not just bacteria&#44; are present in the different organs of the human body&#44; and how they interact with the host&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">It is estimated that the gut microbiome contains 150 genes more than the human being&#44; and that there is a constant interaction between the two which&#44; under normal circumstances&#44; thrive in symbiosis&#46; Circumstances such as country of origin&#44;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">5</span></a> manner of birth &#40;vaginal or cesarean&#41;&#44;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">6</span></a> the use of antibiotics&#44; or feeding with breast milk or formula&#44;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">7</span></a> can influence the establishment of the intestinal microbiota&#46; This first contact of our intestines with bacteria will mark the development of the immune system&#44; and may predispose us to or protect us from the appearance of some diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">8</span></a> Thus&#44; a lower intestinal microbial diversity in childhood is associated with an increased risk of allergic diseases&#44; such as atopic dermatitis&#44; eczema&#44; or asthma&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> In contrast&#44; greater exposure to certain microorganisms reduces the likelihood of developing these entities&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a> This is known today as the microflora hypothesis&#44;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">11</span></a> and is a variant of the hygiene hypothesis proposed by Strachan in 1989&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">12</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The intestinal microbiota&#44; which is initially unstable&#44; undergoes dynamic changes up to the age of 3 years&#44; when it stabilizes&#44; creating an intestinal microbiota similar to that of the adult&#46; It plays a leading role in human health&#44; helping to maintain intestinal homeostasis and adequate protection against certain pathogens&#44; while exercising a nutritional and metabolic effect and physiological and immunological activity&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">13</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The lower airway is one of the least populated surfaces in the human body in terms of bacteria&#46; Both the intestinal and respiratory microbiota develop simultaneously after birth&#46; There is a constant cross-communication between these 2 compartments&#44; and fluctuations in the populations of certain bacteria occur in a similar manner in both&#46; Diet has also been shown to have an impact not only on the composition of the intestinal microbiota&#44; but also on the respiratory microbiota&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">In patients with chronic respiratory diseases&#44; the respiratory microbiota presents some specific phenotypes that differ from those of healthy individuals&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">14</span></a> and there is a close relationship between low microbial diversity in the gut during childhood and allergic asthma&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">9</span></a> Various studies have also shown that contact with certain environmental microorganisms and the habitat of farms are associated with a decreased risk of developing asthma and atopy&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Although we know less about how viral or bacterial infections that cause many of the exacerbations of chronic respiratory diseases modify the respiratory microbiota of diseases such as COPD&#44; recent studies in this area have highlighted the relationship between infections by certain respiratory viruses in childhood and predisposition to asthma&#46; This relationship is stronger when the infections were caused by respiratory syncytial virus and less when caused by human rhinovirus&#46;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">15</span></a> Very recent data show that the inflammatory response triggered by respiratory syncytial virus infection in childhood varies depends on the composition of the nasopharyngeal microbiome&#46; This produces 2 different clusters of immune response&#44; which are associated with a greater probability of wheezing during the first and second year of life&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">16</span></a> Modifying the composition of the nasopharyngeal microbiome to reduce the inflammatory response provoked by exposure to respiratory syncytial virus is a promising hypothesis that has yet to be tested&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The same occurs with a high-fiber diet&#44; which we know to be important for maintaining intestinal health&#44; since it fosters favorable colonization and the production of short-chain fatty acids&#46; However&#44; there is no sound evidence that increased consumption of fiber reduces the incidence of asthma&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">All these data point toward a window of therapeutic opportunity in the first few weeks of life that could modify the subsequent appearance of allergic diseases&#44; including asthma&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Despite all this rapid progress&#44; our understanding of &#8220;healthy&#8221; intestinal microbiota&#44; the optimal intestinal colonization patterns that help to establish tolerance&#44; and the numerous and complex interactions between the host and the microbiota is still incomplete&#46; This may explain the inconsistencies in studies that have aimed to manipulate the microbiota in the treatment and prevention of different allergic diseases&#46; Microbiota and&#44; in particular&#44; markers of microbiota activity must still be identified&#46; In the near future&#44; we should be able to use these markers in the diagnosis&#44; treatment&#44; and prevention of chronic diseases such as asthma&#46;</p></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Garc&#237;a-Rivero JL&#46; Microbioma y asma&#46; Arch Bronconeumol&#46; 2020&#59;56&#58;1&#8211;2&#46;</p>"
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Article information
ISSN: 15792129
Original language: English
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