title: Asthma and the microbiome:defining the critical window in early life.
abstract: Asthma is a chronic inflammatory immune disorder of the airways affecting one in ten children in westernized countries. The geographical disparity combined with a generational rise in prevalence, emphasizes that changing environmental exposures play a significant role in the etiology of this disease. The microflora hypothesis suggests that early life exposures are disrupting the composition of the microbiota and consequently, promoting immune dysregulation in the form of hypersensitivity disorders. Animal model research supports a role of the microbiota in asthma and atopic disease development. Further, these model systems have identified an early life critical window, during which gut microbial dysbiosis is most influential in promoting hypersensitivity disorders. Until recently this critical window had not been characterized in humans, but now studies suggest that the ideal time to use microbes as preventative treatments or diagnostics for asthma in humans is within the first 100 days of life. This review outlines the major mouse-model and human studies leading to characterization of the early life critical window, emphasizing studies analyzing the intestinal and airway microbiotas in asthma and atopic disease. This research has promising future implications regarding childhood immune health, as ultimately it may be possible to therapeutically administer specific microbes in early life to prevent the development of asthma in children.
authors.affiliation: Department of Microbiology & Immunology, University of British Columbia, Vancouver, BC Canada ; BC Children's Hospital, Vancouver, BC Canada.
authors.forename: Leah T
authors.initials: LT
authors.lastname: Stiemsma
authors.affiliation: BC Children's Hospital, Vancouver, BC Canada ; Department of Pediatrics, University of British Columbia, Vancouver, BC Canada ; Department of Pediatrics, BC Children's Hospital, 950 West 28th Avenue, Vancouver, BC V5Z 4H4 Canada.
authors.forename: Stuart E
authors.initials: SE
authors.lastname: Turvey
keywords: Asthma; Critical window; Early life; Hygiene hypothesis; Microbiota; Microflora hypothesis