Clinical Reviews in Allergy & Immunology

, Volume 57, Issue 3, pp 350–363 | Cite as

The Human Microbiota and Asthma

  • Aaron Ver Heul
  • Joseph Planer
  • Andrew L. KauEmail author


Over the last few decades, advances in our understanding of microbial ecology have allowed us to appreciate the important role of microbial communities in maintaining human health. While much of this research has focused on gut microbes, microbial communities in other body sites and from the environment are increasingly recognized in human disease. Here, we discuss recent advances in our understanding of host–microbiota interactions in the development and manifestation of asthma focusing on three distinct microbial compartments. First, environmental microbes originating from house dust, pets, and farm animals have been linked to asthma pathogenesis, which is often connected to their production of bioactive molecules such as lipopolysaccharide. Second, respiratory microbial communities, including newly appreciated populations of microbes in the lung have been associated with allergic airway inflammation. Current evidence suggests that the presence of particular microbes, especially Streptococcus, Haemophilus, and Morexella species within the airway may shape local immune responses and alter the severity and manifestations of airway inflammation. Third, the gut microbiota has been implicated in both experimental models and clinical studies in predisposing to asthma. There appears to be a “critical window” of colonization that occurs during early infancy in which gut microbial communities shape immune maturation and confer susceptibility to allergic airway inflammation. The mechanisms by which gut microbial communities influence lung immune responses and physiology, the “gut–lung axis,” are still being defined but include the altered differentiation of immune cell populations important in asthma and the local production of metabolites that affect distal sites. Together, these findings suggest an intimate association of microbial communities with host immune development and the development of allergic airway inflammation. Improved understanding of these relationships raises the possibility of microbiota-directed therapies to improve or prevent asthma.


Asthma Allergy Microbiota Microbiome Gut–lung axis 



The authors would like to thank Anne Rosen for her helpful input during the writing of this review.

Compliance with Ethical Standards

Conflict of Interest

Aaron Ver Heul, MD, PhD has received research support from the National Institutes of Health (5T32DK077653–27).

Joseph Planer, MD/PhD is a resident in internal medicine at Massachusetts General Hospital. He has no other conflicts of interest to declare.

Andrew L. Kau, MD/PhD has received research support from the National Institutes of Health (K08AI113184) and the AAAAI Foundation. Dr. Kau also reports equity interest in Gilead Sciences, Inc.

Research Involving Human Participants and/or Animals

This article does not contain any studies with human participants performed by any of the authors.

Informed Consent

This is a review article. Informed consent is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of Allergy and Immunology, Department of MedicineWashington University School of MedicineSt. LouisUSA
  2. 2.Department of MedicineMassachusetts General HospitalBostonUSA
  3. 3.Center for Women’s Infectious Disease ResearchWashington University School of MedicineSt. LouisUSA

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