Gut Microbiome in Children with Bronchial Asthma Against the Background of Mycoplasma and Chlamydial Infection: Features and Clinical Significance

Аннотация

Asthma is the most common chronic inflammatory disease of the airways, characterized by episodes of obstruction. The aim of the study is to assess the state of the gut microbiome in children with bronchial asthma and to investigate its interaction with Chlamydia pneumoniae and Mycoplasma pneumoniae infections in the course of the disease. Materials and methods. All patients were examined at the Department of Pediatric Allergology of the Tashkent Medical Academy. The study included 14 children with severe, 23 with moderate, and 31 with mild forms of BA. Age distribution: 7–10 years – 23 children (34%), 11–14 years – 20 children (30%), 15–17 years – 25 children (36%). Duration of the disease: 1–3 years — 34 children (50%), 3–6 years — 34 children (50%). Gender distribution: 43 boys (63%) and 25 girls (36%). Results. All children with BA experienced breathing difficulties, mainly at night. In 82.3% of cases, bronchial asthma attacks (shortness of breath, dry cough) occurred 1–3 times per month, lasting 5–10 minutes. In patients infected with M. pneumoniae and C. pneumoniae, significant alterations in the gut microbiota were The American Journal of Medical Sciences and Pharmaceutical Research 42 https://www.theamericanjournals.com/index.php/tajmspr The American Journal of Medical Sciences and Pharmaceutical Research observed. These changes manifested as a decrease in system, modulating inflammation, and maintaining beneficial bacteria — Bifidobacterium and mucosal barrier function. Disruption of the microbiota Lactobacillus. In infected children, the number of balance—dysbiosis—has been linked not only to Bifidobacterium decreased by an average of 48% gastrointestinal diseases but also to systemic immune- (p<0.05), while Lactobacillus decreased by 42% mediated disorders, including allergic diseases such as (p<0.01). Additionally, an increase in conditionally asthma. In pediatric patients, the microbiota is more pathogenic bacteria — Escherichia coli, Clostridium, dynamic and sensitive to external influences, making and Bacteroides — was detected: Clostridium early childhood a critical period for the formation of increased by 35% (p<0.01), Bacteroides by 29% immune tolerance and stable respiratory health [5, 8, 9]. (p<0.05), and E. coli by 33% (p<0.01). These infectious Of particular interest is the interaction between gut agents contribute to the development of dysbiosis, microbiota alterations and respiratory tract infections. characterized by a reduction in beneficial Mycoplasma and Chlamydia species are known for their microorganisms (Bifidobacterium, Lactobacillus) and ability to cause persistent infections with a pro- an increase in conditionally pathogenic bacteria inflammatory effect. In children with asthma, chronic or (Escherichia coli, Clostridium, Bacteroides). Such recurrent infections with these pathogens can lead to changes are associated with an enhanced systemic prolonged inflammation and remodeling of the airways. inflammatory response and a higher susceptibility to Moreover, these infections may influence the allergic reactions, which aggravate the clinical course composition and function of the gut microbiome of the disease. Conclusion: Mycoplasma pneumoniae through systemic immune responses and antibiotic use, and Chlamydia pneumoniae significantly affect the further exacerbating immune dysregulation [2, 4, 10]. composition of the gut microbiome in children with Understanding the characteristics of the gut bronchial asthma. These infectious agents contribute microbiome in children with bronchial asthma to the development of dysbiosis, characterized by a associated with Mycoplasma and Chlamydia infections decrease in beneficial microorganisms (such as could open new prospects for individualized treatment Bifidobacterium and Lactobacillus) and an increase in approaches. This includes the use of probiotics, conditionally pathogenic microorganisms (such as prebiotics, and microbiota-targeted therapies, which Escherichia coli, Clostridium, and Bacteroides). These may help to restore microbial balance, improve the alterations in the intestinal microbiota are associated course of asthma, and reduce the frequency of with enhanced systemic inflammatory processes and exacerbations. Additionally, microbiome-based increased susceptibility to allergic reactions, which in biomarkers could assist in predicting disease severity turn aggravate the clinical course of the disease. and response to therapy [6, 7]. Given the increasing prevalence of antibiotic-resistant Keywords: Bronchial asthma, children, atypical strains of atypical bacteria and the limitations of microflora, gut microbiota. standard asthma treatment in cases with infectious components, the exploration of the gut-lung axis is both timely and clinically significant. It contributes not only to Introduction: In recent years, growing attention has a deeper understanding of the pathophysiological been paid to the role of the gut microbiome in the m