The Role of Intestinal Microbiota in the Development of Severe Wheezing Syndrome in Children with Acute Bronchitis

Abstract

Background: The intestinal microbiota is a key component in maintaining homeostasis and immune protection. Disruption of its normal composition reduces local enteral immunity, suppresses cytokine and antibody production, and increases the risk of infections and allergic reactions. Objective: To assess the role of intestinal microbiota in the development and severity of wheezing syndrome in children with acute bronchitis. Methods: A total of 150 children aged 1–3 years were examined: 120 with acute bronchitis and wheezing syndrome (ABWS) (33 mild, 51 moderate, 36 severe), 30 with acute bronchitis without wheezing, and 20 healthy controls. Intestinal microbiota composition was analyzed by standard bacteriological methods. Statistical significance was determined at P<0.05, P<0.01, and P<0.001. Results: Children with ABWS demonstrated significant dysbiotic changes. Counts of bifidobacteria and lactobacilli were markedly decreased (P<0.001), while opportunistic microorganisms (Staphylococcus aureus, Klebsiella pneumoniae, Proteus, Candida spp.) were significantly increased (P<0.01–0.001). The degree of microbial imbalance correlated directly with the severity of wheezing. Conclusion: Intestinal dysbiosis contributes to the pathogenesis and severity of wheezing syndrome in children with acute bronchitis. Probiotic therapy aimed at restoring intestinal microbiota may improve disease outcomes and should be considered in treatment strategies.