There are ample data to suggest that early‐life dysbiosis of both the gut and/or airway microbiome can predispose a child to develop along a trajectory toward asthma. Although individual studies show clear associations between dysbiosis and asthma development, it is less clear what (collection of) bacterial species is mechanistically responsible for the observed effects. This is partly due to issues related to the asthma diagnosis and the broad spectrum of anatomical sites, sample techniques, and analysis protocols that are used in different studies. Moreover, there is limited attention for potential differences in the genetics of individuals that would affect the outcome of the interaction between the environment and that individual. Despite these challenges, the first bacterial components were identified that are able to affect the transcriptional state of human cells, ergo the immune system. Such molecules could in the future be the basis for intervention studies that are now (necessarily) restricted to a limited number of bacterial species. For this transition, it might be prudent to develop an ex vivo human model of a local mucosal immune system to better and safer explore the impact of such molecules. With this approach, we might move beyond association toward understanding of causality.

中文翻译：

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肠道和气道微生物组对哮喘发展和疾病的影响

有大量数据表明，生命早期肠道和/或气道微生物群的菌群失调可能使儿童容易患上哮喘。尽管个别研究表明菌群失调与哮喘发展之间存在明确的关联，但尚不清楚哪种细菌（集合）在机制上对观察到的影响负责。这部分是由于与哮喘诊断以及不同研究中使用的广泛解剖部位、采样技术和分析方案相关的问题。此外，人们对个体遗传学中可能影响环境与个体之间相互作用结果的潜在差异的关注有限。尽管存在这些挑战，我们还是发现了第一个能够影响人类细胞转录状态（从而影响免疫系统）的细菌成分。这些分子将来可能成为干预研究的基础，而这些研究现在（必然）仅限于有限数量的细菌物种。对于这一转变，谨慎的做法可能是开发局部粘膜免疫系统的离体人体模型，以更好、更安全地探索此类分子的影响。通过这种方法，我们可能会超越关联而理解因果关系。