The gastrointestinal and respiratory systems are colonized by a complex ecosystem of microorganisms called the microbiota. These microorganisms co-evolved over millions of years with the host, creating a symbiotic relationship that is fundamental for promoting host homeostasis by producing bioactive metabolites and antimicrobial molecules, and regulating the immune and inflammatory responses. Imbalance in the abundance, diversity, and function of the gut microbiota (known as dysbiosis) have been shown to increase host susceptibility to infections in the lungs, suggesting crosstalk between these organs. This crosstalk is now referred to as the gut-lung axis. Hence, the use of probiotics, prebiotics, and synbiotics for modulation of gut microbiota has been studied based on their effectiveness in reducing the duration and severity of respiratory tract infections, mainly owing to their effects on preventing pathogen colonization and modulating the immune system. This review discusses the role and responses of probiotics, prebiotics, and synbiotics in the gut-lung axis in the face of lung infections.

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Background There is mounting evidence that SARS-CoV-2 targets tissues beyond the respiratory tract. Long-term sequelae after COVID-19 are frequent and of major concern. Prolonged virus detection in the gut has been particularly intriguing. Of note, SARS-CoV-2 infection also disturbs the gut microbiota composition, a finding linked with disease severity in patients with COVID-19. Here, we aimed to characterize the functional role of the gut microbiota in the long-term consequences of COVID-19. To this end, we characterized the gut microbiota from COVID-19 human subjects and followed the effects of human fecal transfer to germ-free mice. Results The gut microbiota of post-COVID subjects (up to 4 months from the initial positive test) revealed a remarkable predominance of Enterobacteriaceae strains with multidrug-resistance phenotype compared to healthy controls. After fecal transfer to germ-free mice, animals receiving samples from post-COVID subjects displayed higher lung inflammation and increased susceptibility to pulmonary infection caused by an antimicrobial resistant Klebsiella pneumoniae strain. These mice also showed poorer cognitive performance associated with increased expression of TNF-α, reduced levels of brain-derived neurotrophic factor-BDNF and postsynaptic density protein-PSD-95 in the brain, as well as alterations of several biochemical pathways. These alterations were observed in the absence of SARS-CoV-2, suggesting that alterations in the gut microbiota caused them. Consistent with this hypothesis, brain dysfunctions induced in a mouse model of coronavirus infection were partially prevented by modulation of the microbiota via treatment with the commensal probiotic bacteria Bifidobacterium longum 51A. Conclusions Our results show prolonged impact of SARS-CoV-2 infection in the gut microbiota that persists even after the individuals have cleared the virus. Increased Enterobacteriaceae with antimicrobial resistance phenotype were of particular concern. Moreover, microbiota transfer from post-COVID subjects induced loss of brain cognitive functions and impaired lung defense in mice. Altogether, our work emphasizes the importance of microbiota as a target for therapies to help treat post-COVID sequelae.

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Objetivo: Construir conhecimento sobre Trichomonas vaginalis/tricomoníase junto à universitários do sexo masculino das áreas de Ciências Exatas e da Natureza, Tecnologia e Geociências e Informática da Universidade Federal de Pernambuco. Metodologia: Extensão universitária realizada através da Educação em Saúde nos semestres 2017-2019. Foi montado stand com painéis sobre T. vaginalis/tricomoníase e com auxílio de bancadas expostos folders, cartilhas, preservativos, lubrificantes íntimo e material de laboratório para diagnóstico da tricomoníase. Sessenta extensionistas, estudantes de graduação das Ciências Biológicas, Saúde e Médica, atuaram na transmissão e construção do conhecimento. Resultado: As ações educativas alcançaram 3.162 estudantes com idade média entre 19,65-23,05 anos de idade. O diálogo foi consolidado, mas no início alguns demonstraram timidez e no geral, declararam não conhecer às formas de transmissão e tratamento, importância epidemiológica do sexo masculino na manutenção da tricomoníase, além dos agravos à saúde masculina. Nas ações cerca de 3.500 folders sobre T. vaginalis/tricomoníase e 15.000 folhetos/cartilhas sobre HIV/AIDS, sífilis e hepatites virais, além de 25.000 preservativos peniano, 2.000 preservativos vaginal e 40.000 sachês de lubrificante íntimo, foram distribuídos. Conclusão: As ações contribuíram no processo educativo participativo, onde os universitários do sexo masculino atuaram como sujeitos reflexivos e ativos na construção do conhecimento sobre o T. vaginalis/tricomoníase e na conquista da autonomia na adoção de prevenção, levando à sustentabilidade da vida sexual saudável e segura. A Universidade é locu estratégico para promover ações inovadoras e transformadoras em Educação em Saúde que favoreçam a formação dos seus estudantes, bem como seu vínculo com a sociedade.