Inter-Organ Relationships among Gut, Lung and Skin beyond the Pathogenesis of Allergies: Relevance to the Zang-Fu Theory in Chinese Medicine — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Inter-Organ Relationships among Gut, Lung and Skin beyond the Pathogenesis of Allergies: Relevance to the Zang-Fu Theory in Chinese Medicine
Division of Life Science, Hong Kong University of Science & Technology, Hong Kong, China
,
Division of Life Science, Hong Kong University of Science & Technology, Hong Kong, China
,
Division of Life Science, Hong Kong University of Science & Technology, Hong Kong, China
,
Division of Life Science, Hong Kong University of Science & Technology, Hong Kong, China
1 Division of Life Science, Hong Kong University of Science & Technology, Hong Kong, China
2 Division of Life Science, Hong Kong University of Science & Technology, Hong Kong, China
3 Division of Life Science, Hong Kong University of Science & Technology, Hong Kong, China
4 Division of Life Science, Hong Kong University of Science & Technology, Hong Kong, China
Research on allergy has recently uncovered an apparent co-occurrence of allergies in skin and the lungs, a phenomenon that has been coined “atopic march”. A positive correlation has been found between gut microbiota at birth and the development of asthma and skin eczema later in life. Chinese medicine has long described a functional relationship between the large intestine and the lungs, and between the lungs and skin. In this short article, we examined the evidence in support of these inter-organ physiological/pathological relationships. In addition to the clinical observation of the relationship between the composition of gut microbiota at birth and the development of asthma later in childhood, gut microorganisms have also been shown to exert a protective effect on bacteria-induced pneumonia in experimental animals. Genetic predisposition was also found to play an important role in the co-existence of certain diseases of lung and skin. Despite the fact that the mechanism(s) underlying the connection of immune systems between two organs (such as the large intestine and the lungs) is still not clearly understood, it is the first time to correlate the relationship among gut, lung and skin based on recent clinical studies in relation to the Zang-Fu Theory in Chinese medicine. Future investigation of the gut-lung and lung-skin axes in terms of physiological/pathological relationships may help to provide a greater understanding of the pathogenesis of allergies, possibly establishing relevance to the Zang-Fu Theory in Chinese medicine.
KeywordsGutLungSkinZang-Fu Theory
Bantz, S.K., Zhu, Z. and Zheng, T. (2014) The Atopic March: Progression from Atopic Dermatitis to Allergic Rhinitis and Asthma. Journal of Clinical and Cellular Immunology, 5, 202.
Penders, J., Gerhold, K., Stobberingh, E.E., Thijs, C., Zimmermann, K., Lau, S. and Hamelmann, E. (2013) Establishment of the Intestinal Microbiota and Its Role for Atopic Dermatitis in Early Childhood. Journal of Allergy and Clinical Immunology, 132, 601-607. https://doi.org/10.1016/j.jaci.2013.05.043
Abrahamsson, T.R., Jakobsson, H.E., Andersson, A.F., Bjorkstén, B., Engstrand, L. and Jenmalm MC. (2014) Low Gut Microbiota Diversity in Early Infancy Precedes Asthma at School Age. Clinical & Experimental Allergy, 44, 842-850. https://doi.org/10.1111/cea.12253
Shaykhiev, R. and Bals, R. (2007) Interactions between Epithelial Cells and Leukocytes in Immunity and Tissue Homeostasis. Journal of Leukocyte Biology, 82, 1-15. https://doi.org/10.1189/jlb.0207096
Lozupone, C.A., Stombaugh, J.I., Gordon, J.I., Jansson, J.K. and Knight, R. (2012) Diversity, Stability and Resilience of the Human Gut Microbiota. Nature, 489, 220-230. https://doi.org/10.1038/nature11550
Marsland, B.J., Trompette, A. and Gollwitzer, E.S. (2015) The Gut-Lung Axis in Respiratory Disease. Annals of the American Thoracic Society, 12, S150-S156.
Yang, F., Wang, J. and Wang Q. (2015) Allergic Diseases and Intestinal Flora Imbalance for Allergic Constitution Research. Journal of Beijing University of Traditional Chinese Medicine, 38, 509-514.
Russell, S.L., Gold, M.J., Hartmann, M., Willing, B.P., Thorson, L., Wlodarska, M., Gill, N., Blanchet, M., Mohn, W.W., McNagny, K.M. and Finlay, B.B. (2012) Early Life Antibiotic-Driven Changes in Microbiota Enhance Susceptibility to Allergic Asthma. EMBO Reports, 13, 440-447. https://doi.org/10.1038/embor.2012.32
Nielsen, S., Needham, B., Leach, S.T., Day, A.S., Jaffe, A., Thomas, T. and Ooi, C.Y. (2016) Disrupted Progression of the Intestinal Microbiota with Age in Children with Cystic Fibrosis. Scientific Reports, 6, 24857. https://doi.org/10.1038/srep24857
Schuijt, T.J., Lankelma, J.M., Scicluna, B.P., de Sousa e Melo, F., Roelofs, J.J., de Boer, J.D., Hoogendijk, A.J., de Beer, R., de Vos, A., Belzer, C., de Vos, W.M., van der Poll, T. and Wiersinga, W.J. (2016) The Gut Microbiota Plays a Protective Role in the Host Defense against Pneumococcal Pneumonia. Gut, 65, 575-583. https://doi.org/10.1136/gutjnl-2015-309728
Trompette, A., Gollwitzer, E.S., Yadava, K., Sichelstiel, A.K., Sprenger, N., Ngom-Bru, C., Blanchard, C., Junt, T., Nicod, L.P., Harris, N.L. and Marsland, B.J. (2014) Gut Microbiota Metabolism of Dietary Fiber Influences Allergic Airway Disease and Hematopoiesis. Nature Medicine, 20, 159-166. https://doi.org/10.1038/nm.3444
Kumar, M., Prasad, S.K. and Hemalatha, S. (2014) A Current Update on the Phytopharmacological Aspects of Houttuynia Cordata Thunb. Pharmacognosy Reviews, 8, 22-35. https://doi.org/10.4103/0973-7847.125525
Mollet, T.W., Garcia, C.A. and Koester, G. (2009) Skin Metastases from Lung Cancer. Dermatol Online J, 15, 1.
Frankel, A., Penrose, C. and Emer, J. (2009) A Practical Case Report and Review for the Dermatologist. J Clin Aesthet Dermatol, 2, 19-27.
Hüls, A., Vierkotter, A., Gao, W., Kramer, U., Yang, Y., Ding, A., Stolz, S., Matsui, M., Kan, H., Wang, S., Jin, L., Krutmann, J. and Schikowski, T. (2016) Traffic-Related Air Pollution Contributes to Development of Facial Lentigines: Further Epidemiological Evidence from Caucasians and Asians. Journal of Investigative Dermatology, 136, 1053-1056. https://doi.org/10.1016/j.jid.2015.12.045
Adam, M., Schikowski, T., Carsin, A.E., Cai, Y., Jacquemin, B., Sanchez, M., Vierkotter, A., Marcon, A., Keidel, D., Sugiri, D., Al Kanani, Z., Nadif, R., Siroux, V., Hardy, R., Kuh, D., Rochat, T., Bridevaux, P.O., Eeftens, M., Tsai, M.Y., Villani, S., Phuleria, H.C., Birk, M., Cyrys, J., Cirach, M., de Nazelle, A., Nieuwenhuijsen, M.J., Forsberg, B., de Hoogh, K., Declerq, C., Bono, R., Piccioni, P., Quass, U., Heinrich, J., Jarvis, D., Pin, I., Beelen, R., Hoek, G., Brunekreef, B., Schindler, C., Sunyer, J., Kramer, U., Kauffmann, F., Hansell, A.L., Künzli, N. and Probst-Hensch, N. (2015) Adult Lung Function and Long-Term Air Pollution Exposure. ESCAPE: A Multicentre Cohort Study and Meta-Analysis. European Respiratory Journal, 45, 38-50. https://doi.org/10.1183/09031936.00130014
Chang, A.L. (2016) Expanding Our Understanding of Human Skin Aging. Journal of Investigative Dermatology, 136, 897-899. https://doi.org/10.1016/j.jid.2016.02.020
Vierkotter, A., Schikowski, T., Ranft, U., Sugiri, D., Matsui, M., Kramer, U. and Krutmann, J. (2010) Airborne Particle Exposure and Extrinsic Skin Aging. Journal of Investigative Dermatology, 130, 2719-2726. https://doi.org/10.1038/jid.2010.204
Vierkotter, A., Schikowski, T., Sugiri, D., Matsui, M.S., Kramer, U. and Krutmann, J. (2015) MMP-1 and -3 Promoter Variants Are Indicative of a Common Susceptibility for Skin and Lung Aging: Results from a Cohort of Elderly Women (SALIA). Journal of Investigative Dermatology, 135, 1268-1274. https://doi.org/10.1038/jid.2015.7
Elander, N., Soderkvist, P. and Fransén, K. (2006) Matrix Metalloproteinase (MMP) -1, -2, -3 and -9 Promoter Polymorphisms in Colorectal Cancer. Anticancer Research, 26, 791-795.
Woo, M., Park, K., Nam, J. and Kim, J.C. (2007) Clinical Implications of Matrix Metalloproteinase-1, -3, -7, -9, -12, and Plasminogen Activator Inhibitor-1 Gene Polymorphisms in Colorectal Cancer. Journal of Gastroenterology and Hepatology, 22, 1064-1070. https://doi.org/10.1111/j.1440-1746.2006.04424.x
Stokes, G.M., Milner, A.D., Hodges, I.G. and Groggins, R.C. (1981) Lung Function Abnormalities after Acute Bronchiolitis. The Journal of Pediatrics, 98, 871-874. https://doi.org/10.1016/S0022-3476(81)80577-X
Bohme, M., Lannero, E., Wickman, M., Nordvall, S.L. and Wahlgren, C.F. (2002) Atopic Dermatitis and Concomitant Disease Patterns in Children up to Two Years of Age. Acta Dermato-Venereologica, 82, 98-103. https://doi.org/10.1080/00015550252948112
O'Neill, C.A., Monteleone, G., McLaughlin, J.T. and Paus, R. (2016) The Gut-Skin Axis in Health and Disease: A Paradigm with Therapeutic Implications. BioEssays, 38, 1167-1176. https://doi.org/10.1002/bies.201600008
Marrs, T. and Flohr, C. (2016) The Role of Skin and Gut Microbiota in the Development of Atopic Eczema. British Journal of Dermatology, 2, 13-18. https://doi.org/10.1111/bjd.14907