ArticleThorax2026
Airway microbiota in young people across four continents differ by country, asthma status and inflammatory phenotype.
Article in Thorax, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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24 authors.
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Abstract
backgroundAsthma is an umbrella diagnosis encompassing distinct pathophysiological mechanisms. While a global problem, our understanding of the interplay between respiratory microbiology and airway inflammation is largely from populations in high-income settings. As a result, treatment approaches align poorly with asthma characteristics in less studied populations.
objectiveTo identify conserved and geographically distinct relationships between airway inflammation and microbiota characteristics in young people with and without asthma.
methodsWe conducted a cross-sectional study performing inflammatory phenotyping, microbiota analysis and enumeration of total bacteria,
resultsAsthma inflammatory phenotypes and microbiology differed between countries, with Uganda characterised by higher neutrophils, microbial diversity and bacterial abundance. Comparison of airway inflammation with microbiota characteristics showed conserved relationships across centres, with airway neutrophil proportion explaining variance in microbiota Bray-Curtis dissimilarity (p<0.001) and being positively associated with bacterial abundance, including
conclusionBoth airway inflammation and microbiology varied geographically in young people with asthma. Associations between microbiota characteristics and neutrophilic phenotype were conserved.
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