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Yu M, Han K, Kim DH, Nam GE. Atopic dermatitis is associated with Caesarean sections in Korean adolescents, but asthma is not. Acta Paediatr 2015; 104:1253-8. [PMID: 26363368 DOI: 10.1111/apa.13212] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2015] [Revised: 06/29/2015] [Accepted: 09/09/2015] [Indexed: 12/31/2022]
Abstract
AIM Studies on the associations between mode of delivery and allergic diseases have produced different results, and research has rarely been conducted in Asian countries such as South Korea. This study assessed the relationship between mode of delivery and atopic dermatitis and asthma in Korean adolescents. METHODS Data collected from the Korea National Health and Nutrition Examination Survey between 2010 and 2011 were used. We included 1302 adolescents aged from 12 to 18 years, and multivariable logistic regression analysis was performed. RESULTS The odds ratio (OR) of having atopic dermatitis in adolescents born by Caesarean section compared with vaginal delivery was 1.50, with a 95% confidence interval (95% CI) of 1.01-2.22, after adjusting for age and sex. The association remained significant after further adjustments for body mass index, breastfeeding and serum 25-hydroxyvitamin D level (OR = 1.61, 95% CI = 1.05-2.47) and when fat intake was added to those variables (OR = 1.80, 95% CI = 1.14-2.85). However, asthma was not associated with mode of delivery in any of the models. CONCLUSIONS Atopic dermatitis in adolescents was associated with Caesarean delivery, which is common in South Korea. The findings suggest that the frequency of this practice should be reconsidered and that further research with longitudinal evaluation of relevant mechanisms is needed.
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Affiliation(s)
- Mi Yu
- College of Nursing; Institute of Health Science; Gyeongsang National University; Jinju-si Korea
| | - Kyungdo Han
- Department of Biostatistics; College of Medicine; Catholic University; Seoul Korea
| | - Do Hoon Kim
- Department of Family Medicine; Korea University Ansan Hospital; College of Medicine; Korea University; Ansan-si Korea
| | - Ga Eun Nam
- Department of Family Medicine; Korea University Ansan Hospital; College of Medicine; Korea University; Ansan-si Korea
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102
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van Best N, Hornef MW, Savelkoul PHM, Penders J. On the origin of species: Factors shaping the establishment of infant's gut microbiota. ACTA ACUST UNITED AC 2015; 105:240-51. [DOI: 10.1002/bdrc.21113] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/03/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Niels van Best
- Institute of Medical Microbiology, RWTH University Hospital Aachen; Aachen Germany
- Department of Medical Microbiology; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+; Maastricht The Netherlands
| | - Mathias W. Hornef
- Institute of Medical Microbiology, RWTH University Hospital Aachen; Aachen Germany
| | - Paul H. M. Savelkoul
- Department of Medical Microbiology; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+; Maastricht The Netherlands
- Department of Medical Microbiology and Infection Control; VU University Medical Center Amsterdam; The Netherlands
- Department of Medical Microbiology; Caphri School for Public Health and Primary Care, Maastricht University Medical Centre+; Maastricht The Netherlands
| | - John Penders
- Department of Medical Microbiology; NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+; Maastricht The Netherlands
- Department of Medical Microbiology; Caphri School for Public Health and Primary Care, Maastricht University Medical Centre+; Maastricht The Netherlands
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103
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Wegienka G, Havstad S, Zoratti EM, Kim H, Ownby DR, Johnson CC. Combined effects of prenatal medication use and delivery type are associated with eczema at age 2 years. Clin Exp Allergy 2015; 45:660-8. [PMID: 25469564 DOI: 10.1111/cea.12467] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 11/21/2014] [Accepted: 11/24/2014] [Indexed: 01/15/2023]
Abstract
BACKGROUND Separately, prenatal antibiotics and Caesarian delivery have been found to be associated with increased risk of allergic diseases. It is not clear whether these factors may modify the effect of each other. OBJECTIVE To assess whether the associations between delivery types and eczema, sensitization and total IgE at age 2 years were modified by maternal use of prenatal medications. METHODS Prenatal charts of women enrolled in the WHEALS birth cohort were reviewed for delivery mode and medications prescribed and administered throughout their entire pregnancy, including systemic antibiotics and vaginally applied antifungal medications. The associations between the delivery mode and select medications and, eczema, sensitization (≥ 1 of 10 allergen-specific IgE ≥ 0.35 IU/mL) and total IgE at age 2 years were assessed. RESULTS There was a lower risk of eczema among vaginally vs. c-section born children (relative risk adjusted for race = aRR = 0.77, 95% CI 0.56, 1.05). Although not statistically significantly different, this association was stronger among the subset of children born vaginally to a mother who did not use systemic antibiotics or vaginal antifungal medications (aRR = 0.69, 95% CI 0.44, 1.08) compared to those born vaginally to mothers who used systemic antibiotics or vaginal antifungals (aRR = 0.81, 95% CI 0.57, 1.14). A protective association between vaginal birth and sensitization (aRR = 0.86, 95% CI 0.72, 1.03) was similar for those children born vaginally to a mother who did not (aRR = 0.87, 95% CI 0.69, 1.10) and who did (RR = 0.85, 95% CI 0.70, 1.04) use systemic antibiotics or vaginal antifungal medications. There were no associations with total IgE. CONCLUSIONS Children born vaginally had lower risk of eczema and sensitization compared with those born via c-section; however, the protective association with eczema may be slightly weakened when mothers took systemic antibiotics or vaginally applied medications during pregnancy.
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Affiliation(s)
- G Wegienka
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
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104
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Zoch B, Karch A, Dreesman J, Monazahian M, Baillot A, Mikolajczyk RT. Feasibility of a birth cohort study dedicated to assessing acute infections using symptom diaries and parental collection of biomaterials. BMC Infect Dis 2015; 15:436. [PMID: 26493700 PMCID: PMC4618955 DOI: 10.1186/s12879-015-1189-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 10/07/2015] [Indexed: 11/23/2022] Open
Abstract
Background A birth cohort dedicated to studying infections in early childhood may be assisted by parental recording of symptoms on a daily basis and a collection of biomaterials. We aimed at testing the feasibility of this approach for use in a long-term study focusing on infections in children in Germany. Methods Parents of 1- to 3-year-old children (n = 75) were recruited in nursery schools. They were asked to complete a symptom diary on a daily basis and to take monthly and symptom-triggered nasal swabs and stool samples from their child over the study period of three months. Feasibility was measured by means of the return proportions of symptom diaries and bio samples; acceptance was assessed by a questionnaire delivered to participants at the end of the study. Results The majority of the participants filled in the symptom diary during the three months study for 75 or more days (77.3 %), and provided the monthly nasal swabs (62.7 %) and stool samples (65.3 %). The time needed for the tasks was acceptable for most participants (symptom diary: 92.3 %, nasal swabs: 98.5 %, stool samples: 100.0 %). In 64.3 % of the symptom-triggered nasal swabs, respiratory viruses were found compared to 55.5 % in throat swabs taken by health-care professionals within the “ARE surveillance Lower Saxony”, a special project by the Governmental Institute of Public Health of Lower Saxony to investigate causal pathogens for acute respiratory infections in children. Conclusions The parental assessment of symptoms and collection of biomaterials in a birth cohort dedicated to studying infections appears feasible in a middle class German population. The success of the study will depend on the ability to maintain these activities over a long time period. Electronic supplementary material The online version of this article (doi:10.1186/s12879-015-1189-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Beate Zoch
- ESME - Research Group Epidemiological and Statistical Methods, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany. .,PhD Programme "Epidemiology", Braunschweig-Hannover, Braunschweig, Germany.
| | - André Karch
- ESME - Research Group Epidemiological and Statistical Methods, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany. .,PhD Programme "Epidemiology", Braunschweig-Hannover, Braunschweig, Germany. .,German Centre for Infection Research (DZIF), Hannover-Braunschweig site, Braunschweig, Germany.
| | - Johannes Dreesman
- Governmental Institute of Public Health of Lower Saxony, Hannover, Germany.
| | - Masyar Monazahian
- Governmental Institute of Public Health of Lower Saxony, Hannover, Germany.
| | - Armin Baillot
- Governmental Institute of Public Health of Lower Saxony, Hannover, Germany.
| | - Rafael T Mikolajczyk
- ESME - Research Group Epidemiological and Statistical Methods, Helmholtz Centre for Infection Research, Inhoffenstr. 7, 38124, Braunschweig, Germany. .,German Centre for Infection Research (DZIF), Hannover-Braunschweig site, Braunschweig, Germany. .,Hannover Medical School (MHH), Hannover, Germany.
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105
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Lee EK, Ahn YT, Huh CS, Soo Kim H, Kim E, Chun YH, Yoon JS, Kim HH, Tack Kim J. The Early Intestinal Microbiota of Healthy Korean Newborns. IRANIAN JOURNAL OF PEDIATRICS 2015; 25:e2079. [PMID: 26495089 PMCID: PMC4610329 DOI: 10.5812/ijp.2079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 07/11/2015] [Accepted: 08/07/2015] [Indexed: 01/15/2023]
Abstract
Background: The microflora hypothesis may be the underlying explanation for the growth of inflammatory disease. In addition to many known affecting factors, knowing the gut microbiota of healthy newborns can help to understand the gut immunity and modulate it. Objectives: This study examined the microbiota of healthy newborns from urban regions. Patients and Methods: We enrolled 128 full-term newborns, born at Seoul St. Mary and St. Paul hospital from January 2009 to February 2010. All 143 samples of feces were cultivated in six culture plates to determine the amounts of total bacteria, anaerobes, gram-positive bacteria, coliforms, lactobacilli, and bifidobacteria. The samples were evaluated with a bivariate correlation between coliforms and lactobacilli. Terminal restriction fragment length polymorphism (T-RFLP) analysis with HhaI and MspI and a clustering analysis were performed for determination of diversity. Results: Bacteria were cultured in 61.5% of feces in the following order: anaerobes, gram-positive bacteria, lactobacilli, coliform, and bifidobacteria. The growth of total bacteria and lactobacilli increased in feces defecated after 24 hours of birth (P < 0.001, P = 0.008) and anaerobes decreased (P = 0.003). A negative correlation between the growth of lactobacilli and coliforms was found (r = -463, P < 0.001). Conclusions: This study confirms that bacterial colonization of healthy newborns born in cities is non-sterile, but has early diversification and inter-individuality.
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Affiliation(s)
- Eu Kyoung Lee
- Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Young Tae Ahn
- Research and Business Development Korea Yakult Co. Ltd, Yongin, Republic of Korea
| | - Chul Sung Huh
- Graduate of International Agricultural Technology, Pyeongchang, Republic of Korea
| | - Hwan Soo Kim
- Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Eugene Kim
- Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Yoon Hong Chun
- Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Jong-Seo Yoon
- Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
- Corresponding author: Jong-Seo Yoon, Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Tel: +82-222586190, Fax: +82-25374544, E-mail:
| | - Hyun Hee Kim
- Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Tack Kim
- Department of Pediatrics, Seoul St. Mary’s Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
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106
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The role of IL-10 in microbiome-associated immune modulation and disease tolerance. Cytokine 2015; 75:291-301. [DOI: 10.1016/j.cyto.2014.11.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Revised: 11/20/2014] [Accepted: 11/21/2014] [Indexed: 02/06/2023]
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107
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Powers CE, McShane DB, Gilligan PH, Burkhart CN, Morrell DS. Microbiome and pediatric atopic dermatitis. J Dermatol 2015; 42:1137-42. [PMID: 26388516 DOI: 10.1111/1346-8138.13072] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2015] [Accepted: 07/10/2015] [Indexed: 12/18/2022]
Abstract
Atopic dermatitis is a chronic inflammatory skin condition with drastic impacts on pediatric health. The pathogenesis of this common disease is not well understood, and the complex role of the skin microbiome in the pathogenesis and progression of atopic dermatitis is being elucidated. Skin commensal organisms promote normal immune system functions and prevent the colonization of pathogens. Alterations in the skin microbiome may lead to increased Staphylococcus aureus colonization and atopic dermatitis progression. Despite the evidence for their important role, probiotics have not been deemed efficacious for the treatment of atopic dermatitis, although studies suggest that probiotics may be effective at preventing the development of atopic dermatitis when given to young infants. This review will cover the most recent published work on the microbiome and pediatric atopic dermatitis.
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Affiliation(s)
- Claire E Powers
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Diana B McShane
- Department of Dermatology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
| | - Peter H Gilligan
- Clinical Microbiology-Immunology Laboratories, University of North Carolina Hospitals, Chapel Hill, North Carolina, USA
| | - Craig N Burkhart
- Department of Dermatology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
| | - Dean S Morrell
- Department of Dermatology, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
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108
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Rutten NBMM, Gorissen DMW, Eck A, Niers LEM, Vlieger AM, Besseling-van der Vaart I, Budding AE, Savelkoul PHM, van der Ent CK, Rijkers GT. Long Term Development of Gut Microbiota Composition in Atopic Children: Impact of Probiotics. PLoS One 2015; 10:e0137681. [PMID: 26378926 PMCID: PMC4574972 DOI: 10.1371/journal.pone.0137681] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 08/18/2015] [Indexed: 11/26/2022] Open
Abstract
Introduction Imbalance of the human gut microbiota in early childhood is suggested as a risk factor for immune-mediated disorders such as allergies. With the objective to modulate the intestinal microbiota, probiotic supplementation during infancy has been used for prevention of allergic diseases in infants, with variable success. However, not much is known about the long-term consequences of neonatal use of probiotics on the microbiota composition. The aim of this study was to assess the composition and microbial diversity in stool samples of infants at high-risk for atopic disease, from birth onwards to six years of age, who were treated with probiotics or placebo during the first year of life. Methods In a double-blind, randomized, placebo-controlled trial, a probiotic mixture consisting of B. bifidum W23, B. lactis W52 and Lc. Lactis W58 (Ecologic® Panda) was administered to pregnant women during the last 6 weeks of pregnancy and to their offspring during the first year of life. During follow-up, faecal samples were collected from 99 children over a 6-year period with the following time points: first week, second week, first month, three months, first year, eighteen months, two years and six years. Bacterial profiling was performed by IS-pro. Differences in bacterial abundance and diversity were assessed by conventional statistics. Results The presence of the supplemented probiotic strains in faecal samples was confirmed, and the probiotic strains had a higher abundance and prevalence in the probiotic group during supplementation. Only minor and short term differences in composition of microbiota were found between the probiotic and placebo group and between children with or without atopy. The diversity of Bacteroidetes was significantly higher after two weeks in the placebo group, and at the age of two years atopic children had a significantly higher Proteobacteria diversity (p < 0.05). Gut microbiota development continued between two and six years, whereby microbiota composition at phylum level evolved more and more towards an adult-like configuration. Conclusion Perinatal supplementation with Ecologic® Panda, to children at high-risk for atopic disease, had minor effects on gut microbiota composition during the supplementation period. No long lasting differences were identified. Regardless of intervention or atopic disease status, children had a shared microbiota development over time determined by age that continued to develop between two and six years.
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Affiliation(s)
- N. B. M. M. Rutten
- Department of Pediatric Pulmonology and Allergology, Wilhelmina Children’s Hospital, University Medical Centre, Utrecht, the Netherlands
- Department of Pediatrics, St Antonius Hospital, Nieuwegein, the Netherlands
- * E-mail:
| | - D. M. W. Gorissen
- Department of Pediatric Pulmonology and Allergology, Wilhelmina Children’s Hospital, University Medical Centre, Utrecht, the Netherlands
| | - A. Eck
- Department of Medical Microbiology and Infection Control, VU University Medical Centre, Amsterdam, the Netherlands
| | - L. E. M. Niers
- Department of Pediatric Pulmonology and Allergology, Wilhelmina Children’s Hospital, University Medical Centre, Utrecht, the Netherlands
| | - A. M. Vlieger
- Department of Pediatrics, St Antonius Hospital, Nieuwegein, the Netherlands
| | | | - A. E. Budding
- Department of Medical Microbiology and Infection Control, VU University Medical Centre, Amsterdam, the Netherlands
| | - P. H. M. Savelkoul
- Department of Medical Microbiology and Infection Control, VU University Medical Centre, Amsterdam, the Netherlands
- Department of Medical Microbiology, School of Nutrition & Translational Research in Metabolism (NUTRIM), Maastricht University Medical Centre, Maastricht, the Netherlands
| | - C. K. van der Ent
- Department of Pediatric Pulmonology and Allergology, Wilhelmina Children’s Hospital, University Medical Centre, Utrecht, the Netherlands
| | - G. T. Rijkers
- Department of Sciences, University College Roosevelt Academy, Middelburg and Department of Medical Microbiology and Immunology, St Antonius Hospital, Nieuwegein, the Netherlands
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109
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West CE, Rydén P, Lundin D, Engstrand L, Tulic MK, Prescott SL. Gut microbiome and innate immune response patterns in IgE-associated eczema. Clin Exp Allergy 2015; 45:1419-29. [DOI: 10.1111/cea.12566] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2014] [Revised: 04/01/2015] [Accepted: 04/29/2015] [Indexed: 02/06/2023]
Affiliation(s)
- C. E. West
- International Inflammation Network (in-FLAME) of the World Universities Network; Umeå Sweden
- Department of Clinical Sciences, Pediatrics; Umeå University; Umeå Sweden
| | - P. Rydén
- Department of Mathematics and Mathematical Statistics; Umeå University; Umeå Sweden
| | - D. Lundin
- Department of Microbiology, Tumor and Cell Biology; Science for Life Laboratory; Karolinska Institutet; Stockholm Sweden
- Bioinformatics Infrastructure for Life Sciences; Science for Life Laboratory; Stockholm Sweden
| | - L. Engstrand
- Department of Microbiology, Tumor and Cell Biology; Science for Life Laboratory; Karolinska Institutet; Stockholm Sweden
| | - M. K. Tulic
- International Inflammation Network (in-FLAME) of the World Universities Network; Umeå Sweden
- Université de Nice Sophia-Antipolis; Nice France
| | - S. L. Prescott
- International Inflammation Network (in-FLAME) of the World Universities Network; Umeå Sweden
- School of Paediatrics and Child Health; University of Western Australia; Perth Australia
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110
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Laursen MF, Zachariassen G, Bahl MI, Bergström A, Høst A, Michaelsen KF, Licht TR. Having older siblings is associated with gut microbiota development during early childhood. BMC Microbiol 2015; 15:154. [PMID: 26231752 PMCID: PMC4522135 DOI: 10.1186/s12866-015-0477-6] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 07/06/2015] [Indexed: 12/15/2022] Open
Abstract
Background Evidence suggests that early life infections, presence of older siblings and furred pets in the household affect the risk of developing allergic diseases through altered microbial exposure. Recently, low gut microbial diversity during infancy has also been linked with later development of allergies. We investigated whether presence of older siblings, furred pets and early life infections affected gut microbial communities at 9 and 18 months of age and whether these differences were associated with the cumulative prevalence of atopic symptoms of eczema and asthmatic bronchitis at 3 years of age. Bacterial compositions and diversity indices were determined in fecal samples collected from 114 infants in the SKOT I cohort at age 9 and 18 months by 16S rRNA gene sequencing. These were compared to the presence of older siblings, furred pets and early life infections and the cumulative prevalence of diagnosed asthmatic bronchitis and self-reported eczema at 3 years of age. Results The number of older siblings correlated positively with bacterial diversity (p = 0.030), diversity of the phyla Firmicutes (p = 0.013) and Bacteroidetes (p = 0.004) and bacterial richness (p = 0.006) at 18 months. Further, having older siblings was associated with increased relative abundance of several bacterial taxa at both 9 and 18 months of age. Compared to the effect of having siblings, presence of household furred pets and early life infections had less pronounced effects on the gut microbiota. Gut microbiota characteristics were not significantly associated with cumulative occurrence of eczema and asthmatic bronchitis during the first 3 years of life. Conclusions Presence of older siblings is associated with increased gut microbial diversity and richness during early childhood, which could contribute to the substantiation of the hygiene hypothesis. However, no associations were found between gut microbiota and atopic symptoms of eczema and asthmatic bronchitis during early childhood and thus further studies are required to elucidate whether sibling-associated gut microbial changes influence development of allergies later in childhood. Electronic supplementary material The online version of this article (doi:10.1186/s12866-015-0477-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Martin Frederik Laursen
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, DK-2860, Søborg, Denmark.
| | - Gitte Zachariassen
- H.C. Andersen Children's Hospital, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense C, Denmark.
| | - Martin Iain Bahl
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, DK-2860, Søborg, Denmark.
| | - Anders Bergström
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, DK-2860, Søborg, Denmark. .,Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark.
| | - Arne Høst
- H.C. Andersen Children's Hospital, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense C, Denmark.
| | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 30, DK-1958, Frederiksberg C, Denmark.
| | - Tine Rask Licht
- Division of Diet, Disease Prevention and Toxicology, National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, DK-2860, Søborg, Denmark
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111
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Zhou D, Zhang H, Bai Z, Zhang A, Bai F, Luo X, Hou Y, Ding X, Sun B, Sun X, Ma N, Wang C, Dai X, Lu Z. Exposure to soil, house dust and decaying plants increases gut microbial diversity and decreases serum immunoglobulin E levels in BALB/c mice. Environ Microbiol 2015; 18:1326-37. [DOI: 10.1111/1462-2920.12895] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 05/01/2015] [Accepted: 05/01/2015] [Indexed: 01/15/2023]
Affiliation(s)
- Dongrui Zhou
- Key Laboratory of Child Development and Learning Sciences; Southeast University; Nanjing 210096 China
- Suzhou Research Institute of Southeast University; Suzhou 215123 China
| | - Honglin Zhang
- State Key Laboratory of Bioelectronics; Southeast University; Nanjing 210096 China
- College of Food Science; Nanjing Xiaozhuang University; Nanjing 211171 China
| | - Zhimao Bai
- School of Public Health; Southeast University; Nanjing 210096 China
| | - Aidi Zhang
- Key Laboratory of Child Development and Learning Sciences; Southeast University; Nanjing 210096 China
| | - Futian Bai
- Medical School; Southeast University; Nanjing 210096 China
| | - Xing Luo
- State Key Laboratory of Bioelectronics; Southeast University; Nanjing 210096 China
| | - Yue Hou
- State Key Laboratory of Bioelectronics; Southeast University; Nanjing 210096 China
| | - Xiao Ding
- State Key Laboratory of Bioelectronics; Southeast University; Nanjing 210096 China
| | - Beili Sun
- State Key Laboratory of Bioelectronics; Southeast University; Nanjing 210096 China
| | - Xiao Sun
- State Key Laboratory of Bioelectronics; Southeast University; Nanjing 210096 China
| | - Ning Ma
- Key Laboratory of Child Development and Learning Sciences; Southeast University; Nanjing 210096 China
| | - Cuifen Wang
- Center for Diagnostic Nanosystems; Marshall University; Huntington WV 25755 USA
- School of Pharmacy; Marshall University; Huntington WV 25755 USA
| | - Xiaoniu Dai
- Medical School; Southeast University; Nanjing 210096 China
| | - Zuhong Lu
- State Key Laboratory of Bioelectronics; Southeast University; Nanjing 210096 China
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112
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Staphylococcus aureus MnhF mediates cholate efflux and facilitates survival under human colonic conditions. Infect Immun 2015; 83:2350-7. [PMID: 25824834 DOI: 10.1128/iai.00238-15] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 03/20/2015] [Indexed: 12/17/2022] Open
Abstract
Resistance to the innate defenses of the intestine is crucial for the survival and carriage of Staphylococcus aureus, a common colonizer of the human gut. Bile salts produced by the liver and secreted into the intestines are one such group of molecules with potent antimicrobial activity. The mechanisms by which S. aureus is able to resist such defenses in order to colonize and survive in the human gut are unknown. Here we show that mnhF confers resistance to bile salts, which can be abrogated by efflux pump inhibitors. MnhF mediates the efflux of radiolabeled cholic acid both in S. aureus and when heterologously expressed in Escherichia coli, rendering them resistant. Deletion of mnhF attenuated the survival of S. aureus in an anaerobic three-stage continuous-culture model of the human colon (gut model), which represents different anatomical areas of the large intestine.
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Seo JH, Kim HY, Jung YH, Lee E, Yang SI, Yu HS, Kim YJ, Kang MJ, Kim HJ, Park KS, Kwon JW, Kim BJ, Kim HB, Kim EJ, Lee JS, Lee SY, Hong SJ. Interactions between innate immunity genes and early-life risk factors in allergic rhinitis. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2015; 7:241-8. [PMID: 25840711 PMCID: PMC4397364 DOI: 10.4168/aair.2015.7.3.241] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 03/25/2014] [Accepted: 07/29/2014] [Indexed: 12/12/2022]
Abstract
PURPOSE Allergic rhinitis (AR) is a common chronic disease. Many factors could affect the development of AR. We investigated early-life factors, such as delivery mode, feeding method, and use of antibiotics during infancy, which could affect the development of AR. In addition, how interactions between these factors and innate gene polymorphisms influence the development of AR was investigated. METHODS A cross-sectional study of 1,828 children aged 9-12 years was conducted. Three early-life factors and AR were assessed by a questionnaire. Skin prick tests were done. Polymorphisms of TLR4 (rs1927911) and CD14 (rs2569190) were genotyped. RESULTS Use of antibiotics during infancy increased the risk of AR (aOR [95% CI] 1.511 [1.222-2.037]) and atopic AR (aOR [95% CI], 1.565 [1.078-2.272]). There were synergistic interactions between caesarean delivery, formula feeding, and use of antibiotics in the rate of atopic AR (aOR [95% CI], 3.038 [1.256-7.347]). Additional analyses revealed that the risk for the development of AR or atopic AR subjects with the TLR4 CC genotype were highest when all the 3 early-life factors were present (aOR [95% CI], 5.127 [1.265-20.780] for AR; 6.078 [1.499-24.649] for atopic AR). In addition, the risk for the development of AR or atopic AR in subjects with the CD14 TT genotype were highest when all the 3 early-life factors were present (aOR [95% CI], 5.960 [1.421-15.002] for AR; 6.714 [1.440-31.312] for atopic AR). CONCLUSIONS Delivery mode, feeding method, and use of antibiotics during infancy appeared to have synergistic interactions in the development of AR. Gene-environment interactions between polymorphism of innate genes and early- life risk factors might affect the development of AR.
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Affiliation(s)
- Ju Hee Seo
- Department of Pediatrics, Korean Cancer Center Hospital, Seoul, Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Young Ho Jung
- Department of Pediatrics, CHA University School of Medicine, Seongnam, Korea
| | - Eun Lee
- Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Research Center for Standardization of Allergic Diseases, University of Ulsan College of Medicine, Seoul, Korea
| | - Song I Yang
- Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Research Center for Standardization of Allergic Diseases, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho Sung Yu
- Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Young Joon Kim
- Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Mi Jin Kang
- Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Ha Jung Kim
- Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Asan Institute for Life Sciences, Asan Medical Center, Seoul, Korea
| | - Kang Seo Park
- Department of Pediatrics, Presbyterian Medical Center, Jeonju, Korea
| | - Ji Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byung Ju Kim
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Hyo Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Eun Jin Kim
- Allergy TF, Department of Immunology and Pathology, Korea National Institute of Health, Osong, Korea
| | - Joo Shil Lee
- Allergy TF, Department of Immunology and Pathology, Korea National Institute of Health, Osong, Korea
| | - So Yeon Lee
- Department of Pediatrics, Hallym Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
| | - Soo Jong Hong
- Childhood Asthma Atopy Center, Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.; Research Center for Standardization of Allergic Diseases, University of Ulsan College of Medicine, Seoul, Korea.
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Brugman S, Perdijk O, van Neerven RJJ, Savelkoul HFJ. Mucosal Immune Development in Early Life: Setting the Stage. Arch Immunol Ther Exp (Warsz) 2015; 63:251-68. [PMID: 25666708 PMCID: PMC4499104 DOI: 10.1007/s00005-015-0329-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 01/22/2015] [Indexed: 12/17/2022]
Abstract
Our environment poses a constant threat to our health. To survive, all organisms must be able to discriminate between good (food ingredients and microbes that help digest our food) and bad (pathogenic microbes, viruses and toxins). In vertebrates, discrimination between beneficial and harmful antigens mainly occurs at the mucosal surfaces of the respiratory, digestive, urinary and genital tract. Here, an extensive network of cells and organs form the basis of what we have come to know as the mucosal immune system. The mucosal immune system is composed of a single epithelial cell layer protected by a mucus layer. Different immune cells monitor the baso-lateral side of the epithelial cells and dispersed secondary lymphoid organs, such as Peyer’s patches and isolated lymphoid follicles are equipped with immune cells able to mount appropriate and specific responses. This review will focus on the current knowledge on host, dietary and bacterial-derived factors that shape the mucosal immune system before and after birth. We will discuss current knowledge on fetal immunity (both responsiveness and lymphoid organ development) as well as the impact of diet and microbial colonization on neonatal immunity and disease susceptibility. Lastly, inflammatory bowel disease will be discussed as an example of how the composition of the microbiota might predispose to disease later in life. A fundamental understanding of the mechanisms involved in mucosal immune development and tolerance will aid nutritional intervention strategies to improve health in neonatal and adult life.
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Affiliation(s)
- Sylvia Brugman
- Cell Biology and Immunology Group, Wageningen University, de Elst 1, 6708, WD, Wageningen, The Netherlands,
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115
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Rodríguez JM, Murphy K, Stanton C, Ross RP, Kober OI, Juge N, Avershina E, Rudi K, Narbad A, Jenmalm MC, Marchesi JR, Collado MC. The composition of the gut microbiota throughout life, with an emphasis on early life. MICROBIAL ECOLOGY IN HEALTH AND DISEASE 2015; 26:26050. [PMID: 25651996 PMCID: PMC4315782 DOI: 10.3402/mehd.v26.26050] [Citation(s) in RCA: 538] [Impact Index Per Article: 59.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The intestinal microbiota has become a relevant aspect of human health. Microbial colonization runs in parallel with immune system maturation and plays a role in intestinal physiology and regulation. Increasing evidence on early microbial contact suggest that human intestinal microbiota is seeded before birth. Maternal microbiota forms the first microbial inoculum, and from birth, the microbial diversity increases and converges toward an adult-like microbiota by the end of the first 3-5 years of life. Perinatal factors such as mode of delivery, diet, genetics, and intestinal mucin glycosylation all contribute to influence microbial colonization. Once established, the composition of the gut microbiota is relatively stable throughout adult life, but can be altered as a result of bacterial infections, antibiotic treatment, lifestyle, surgical, and a long-term change in diet. Shifts in this complex microbial system have been reported to increase the risk of disease. Therefore, an adequate establishment of microbiota and its maintenance throughout life would reduce the risk of disease in early and late life. This review discusses recent studies on the early colonization and factors influencing this process which impact on health.
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Affiliation(s)
- Juan Miguel Rodríguez
- Department of Nutrition, Food Science and Food Technology, Complutense University of Madrid, Madrid, Spain
| | - Kiera Murphy
- Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
- Teagasc Moorepark Food Research Centre, Fermoy, Ireland
| | - Catherine Stanton
- Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
- Teagasc Moorepark Food Research Centre, Fermoy, Ireland
| | - R Paul Ross
- Alimentary Pharmabiotic Centre, University College Cork, Cork, Ireland
- Teagasc Moorepark Food Research Centre, Fermoy, Ireland
| | - Olivia I Kober
- The Gut Health and Food Safety Institute Strategic Programme, Institute of Food Research, Norwich Research Park, Norwich, UK
| | - Nathalie Juge
- The Gut Health and Food Safety Institute Strategic Programme, Institute of Food Research, Norwich Research Park, Norwich, UK
| | - Ekaterina Avershina
- Department of Chemistry, Biotechnology and Food Sciences, Norwegian University of Life Sciences, Aas, Norway
| | - Knut Rudi
- Department of Chemistry, Biotechnology and Food Sciences, Norwegian University of Life Sciences, Aas, Norway
| | - Arjan Narbad
- The Gut Health and Food Safety Institute Strategic Programme, Institute of Food Research, Norwich Research Park, Norwich, UK
| | - Maria C Jenmalm
- Department of Clinical and Experimental Medicine, Unit of Autoimmunity and Immune Regulation, Division of Clinical Immunology, Linköping University, Linköping, Sweden
| | - Julian R Marchesi
- School of Biosciences, Cardiff University, Cardiff, UK
- Centre for Digestive and Gut Health, Imperial College London, London, UK
| | - Maria Carmen Collado
- Department of Biotechnology, Institute of Agrochemistry and Food Technology, Spanish National Research Council (IATA-CSIC), Valencia, Spain;
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Wegienka G, Zoratti E, Johnson CC. The role of the early-life environment in the development of allergic disease. Immunol Allergy Clin North Am 2015; 35:1-17. [PMID: 25459574 PMCID: PMC4427897 DOI: 10.1016/j.iac.2014.09.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
A consensus has been reached that the development of allergic disorders is strongly influenced by early life exposures. An overview of several prenatal and early life factors that have been investigated for their associations with development of childhood allergy is presented. Delivery mode, the gut microbiome, vitamin D, folate, breastfeeding, pets, antibiotics, environmental tobacco smoke, and airborne traffic pollutants are discussed. Although many studies suggest an effect, overall, no risk factors clearly increase or reduce the risk of allergic outcomes.
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Affiliation(s)
- Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA.
| | - Edward Zoratti
- Division of Allergy and Immunology, Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
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Abrahamsson TR, Wu RY, Jenmalm MC. Gut microbiota and allergy: the importance of the pregnancy period. Pediatr Res 2015; 77:214-9. [PMID: 25310761 DOI: 10.1038/pr.2014.165] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 09/15/2014] [Indexed: 12/15/2022]
Abstract
Limited microbial exposure is suggested to underlie the increase of allergic diseases in affluent countries, and bacterial diversity seems to be more important than specific bacteria taxa. Prospective studies indicate that the gut microbiota composition during the first months of life influences allergy development, and support the theory that factors influencing the early maturation of the immune system might be important for subsequent allergic disease. However, recent research indicates that microbial exposure during pregnancy may be even more important for the preventative effects against allergic disease. This review gives a background of the epidemiology, immunology, and microbiology literature in this field. It focuses on possible underlying mechanisms such as immune-regulated epigenetic imprinting and bacterial translocation during pregnancy, potentially providing the offspring with a pioneer microbiome. We suggest that a possible reason for the initial exposure of bacterial molecular patterns to the fetus in utero is to prime the immune system and/or the epithelium to respond appropriately to pathogens and commensals after birth.
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Affiliation(s)
- Thomas R Abrahamsson
- 1] Department of Clinical and Experimental Medicine, Division of Pediatrics, Linköping University, Sweden [2] Research Institute, Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Richard You Wu
- Research Institute, Hospital for Sick Children, University of Toronto, Ontario, Canada
| | - Maria C Jenmalm
- 1] Department of Clinical and Experimental Medicine, Division of Pediatrics, Linköping University, Sweden [2] Department of Clinical and Experimental Medicine, Unit of Autoimmunity and Immune Regulation, Division of Clinical Immunology, Linköping University, Sweden
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Lebel MJ, Chapdelaine H, Paradis L, Des Roches A, Alvarez F. Increase in de novo food allergies after pediatric liver transplantation: tacrolimus vs. cyclosporine immunosuppression. Pediatr Transplant 2014; 18:733-9. [PMID: 25156571 DOI: 10.1111/petr.12342] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2014] [Indexed: 01/28/2023]
Abstract
Post-TAFA is an uncommon but serious complication of organ transplantation. This study aimed to compare the incidence of FA in CsA and tacrolimus-treated children following OLT and identify risk factors. The medical charts of all patients who underwent OLT at our institution were reviewed. Between 1985 and 2010, 218 OLTs were performed on 188 pediatric recipients, of which 154 were included in the study. Three patients (3%) of the 102 receiving CsA developed FA, compared with nine (17%) in the 52 tacrolimus-treated patients, the latter exceeding general population reported FA prevalence (RR 5.88; 95% CI: 1.66-20.81). All TAFA cases underwent transplantation before the age of three with an incidence of 29% (9/31) in the tacrolimus-treated children in comparison with 7% (3/41) in the CsA group (RR 3.97; 95% CI: 1.17-13.45). Eosinophilia was present in 81% of children receiving tacrolimus compared with 54% in the CsA group (p = 0.002). We observed a statistically significant increase incidence of FA in tacrolimus-treated children following an OLT and those under the age of three are particularly vulnerable. The underlying process is still unknown and probably multifactorial.
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Affiliation(s)
- Marie-Jeanne Lebel
- Centre Hospitalier Universitaire Mère-enfant Sainte-Justine, Université de Montréal, Montreal, Quebec, Canada
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119
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Inoue Y, Shimojo N. Microbiome/microbiota and allergies. Semin Immunopathol 2014; 37:57-64. [DOI: 10.1007/s00281-014-0453-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 10/02/2014] [Indexed: 02/07/2023]
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Abstract
This thesis explores the contribution of twin studies, particularly those studies originating from the Danish Twin Registry, to the understanding of the aetiology of asthma. First, it is explored how twin studies have established the contribution of genetic and environmental factors to the variation in the susceptibility to asthma, and to the variation in several aspects of the clinical expression of the disease such as its age at onset, its symptomatology, its intermediate phenotypes, and its relationship with other atopic diseases. Next, it is explored how twin studies have corroborated theories explaining asthma's recent increase in prevalence, and last, how these fit with the explanations of the epidemiological trends in other common chronic diseases of modernity.
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121
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Huang L, Chen Q, Zhao Y, Wang W, Fang F, Bao Y. Is elective cesarean section associated with a higher risk of asthma? A meta-analysis. J Asthma 2014; 52:16-25. [PMID: 25162303 DOI: 10.3109/02770903.2014.952435] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED Abstract Background: Recent meta-analyses indicate that children delivered by cesarean section have increased risk for asthma. However, the studies included in these previous meta-analyses showed significant heterogeneity. Furthermore, no previous meta-analysis has distinguished the association of elective and emergency CS, spontaneous and instrumental vaginal deliveries (VD) with the odds of asthma. OBJECTIVE To examine the association between specific mode of delivery and the prevalence of asthma. METHODS PUBMED, Google Scholar, EMBASE, and MEDLINE were searched to identify relevant studies. Odds ratio (OR) and 95% confidence interval (CI) were calculated from the prevalence of asthma in children born by elective CS, emergent CS, instrumental VD and spontaneous VD. Meta-analysis was then used to derive a combined OR. Heterogeneity between studies was also tested in the findings. RESULTS A total of 26 studies were identified. The overall meta-analysis revealed an increase in the risk of asthma in children delivered by CS (OR=1.16, 95% CI 1.14, 1.29), and no evidence of heterogeneity was found (I(2)=24.6%). Elective and emergency CS moderately increased the risk of asthma (OR=1.21, 95% CI 1.17, 1.25; I(2)=39.9%; OR=1.23, 95% CI 1.19-1.26). The risk of asthma was also higher in the children born by instrumental VD (OR=1.07, 95% CI, 1.04-1.11) but with evidence of heterogeneity (I(2)=54.9%). CONCLUSION About 20% increase in the subsequent risk of asthma was both found in children delivered by elective and emergency CS. The increasing rates of CS worldwide might partly explain the concomitant rise in asthma during the same time period.
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Affiliation(s)
- Lisu Huang
- MOE-Shanghai Key Laboratory of Children's Environmental Health and
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Wopereis H, Oozeer R, Knipping K, Belzer C, Knol J. The first thousand days - intestinal microbiology of early life: establishing a symbiosis. Pediatr Allergy Immunol 2014; 25:428-38. [PMID: 24899389 DOI: 10.1111/pai.12232] [Citation(s) in RCA: 205] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/28/2014] [Indexed: 12/12/2022]
Abstract
The development of the intestinal microbiota in the first years of life is a dynamic process significantly influenced by early-life nutrition. Pioneer bacteria colonizing the infant intestinal tract and the gradual diversification to a stable climax ecosystem plays a crucial role in establishing host-microbe interactions essential for optimal symbiosis. This colonization process and establishment of symbiosis may profoundly influence health throughout life. Recent developments in microbiologic cultivation-independent methods allow a detailed view of the key players and factors involved in this process and may further elucidate their roles in a healthy gut and immune maturation. Aberrant patterns may lead to identifying key microbial signatures involved in developing immunologic diseases into adulthood, such as asthma and atopic diseases. The central role of early-life nutrition in the developmental human microbiota, immunity, and metabolism offers promising strategies for prevention and treatment of such diseases. This review provides an overview of the development of the intestinal microbiota, its bidirectional relationship with the immune system, and its role in impacting health and disease, with emphasis on allergy, in early life.
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Affiliation(s)
- Harm Wopereis
- Nutricia Research, Utrecht, The Netherlands; Laboratory of Microbiology, Wageningen University, Wageningen, The Netherlands
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123
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Kim BJ, Lee SY, Kim HB, Lee E, Hong SJ. Environmental changes, microbiota, and allergic diseases. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2014; 6:389-400. [PMID: 25228995 PMCID: PMC4161679 DOI: 10.4168/aair.2014.6.5.389] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 11/12/2013] [Indexed: 12/26/2022]
Abstract
During the last few decades, the prevalence of allergic disease has increased dramatically. The development of allergic diseases has been attributed to complex interactions between environmental factors and genetic factors. Of the many possible environmental factors, most research has focused on the most commonly encountered environmental factors, such as air pollution and environmental microbiota in combination with climate change. There is increasing evidence that such environmental factors play a critical role in the regulation of the immune response that is associated with allergic diseases, especially in genetically susceptible individuals. This review deals with not only these environmental factors and genetic factors but also their interactions in the development of allergic diseases. It will also emphasize the need for early interventions that can prevent the development of allergic diseases in susceptible populations and how these interventions can be identified.
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Affiliation(s)
- Byoung-Ju Kim
- Department of Pediatrics, Inje University Haeundae Paik Hospital, Busan, Korea
| | - So-Yeon Lee
- Department of Pediatrics, Hallym University Sacred Heart Hospital, University of Hallym College of Medicine, Anyang, Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
| | - Eun Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Seoul, Korea. ; Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, University of Ulsan College of Medicine, Seoul, Korea. ; Research Center for Standardization of Allergic Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Abrahamsson TR, Jakobsson HE, Andersson AF, Björkstén B, Engstrand L, Jenmalm MC. Low gut microbiota diversity in early infancy precedes asthma at school age. Clin Exp Allergy 2014; 44:842-50. [DOI: 10.1111/cea.12253] [Citation(s) in RCA: 480] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 11/02/2013] [Accepted: 12/04/2013] [Indexed: 12/11/2022]
Affiliation(s)
- T. R. Abrahamsson
- Division of Pediatrics; Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - H. E. Jakobsson
- Department of Microbiology, Tumor and Cell Biology; Karolinska Institutet; Stockholm Sweden
| | - A. F. Andersson
- Division of Gene Technology; Science for Life Laboratory; School of Biotechnology; KTH Royal Institute of Technology; Stockholm Sweden
| | - B. Björkstén
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- School of Health and Medical Sciences; Örebro University; Örebro Sweden
| | - L. Engstrand
- Department of Microbiology, Tumor and Cell Biology; Karolinska Institutet; Stockholm Sweden
- Division of Gene Technology; Science for Life Laboratory; School of Biotechnology; KTH Royal Institute of Technology; Stockholm Sweden
| | - M. C. Jenmalm
- Division of Pediatrics; Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
- Unit of Autoimmunity and Immune Regulation; Division of Clinical Immunology; Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
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Lee SY, Yu J, Ahn KM, Kim KW, Shin YH, Lee KS, Hong SA, Jung YH, Lee E, Yang SI, Seo JH, Kwon JW, Kim BJ, Kim HB, Kim WK, Song DJ, Jang GC, Shim JY, Lee SY, Kwon JY, Choi SJ, Lee KJ, Park HJ, Won HS, Yoo HS, Kang MJ, Kim HY, Hong SJ. Additive effect between IL-13 polymorphism and cesarean section delivery/prenatal antibiotics use on atopic dermatitis: a birth cohort study (COCOA). PLoS One 2014; 9:e96603. [PMID: 24848505 PMCID: PMC4029558 DOI: 10.1371/journal.pone.0096603] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 04/10/2014] [Indexed: 01/09/2023] Open
Abstract
Background Although cesarean delivery and prenatal exposure to antibiotics are likely to affect the gut microbiome in infancy, their effect on the development of atopic dermatitis (AD) in infancy is unclear. The influence of individual genotypes on these relationships is also unclear. To evaluate with a prospective birth cohort study whether cesarean section, prenatal exposure to antibiotics, and susceptible genotypes act additively to promote the development of AD in infancy. Methods The Cohort for Childhood of Asthma and Allergic Diseases (COCOA) was selected from the general Korean population. A pediatric allergist assessed 412 infants for the presence of AD at 1 year of age. Their cord blood DNA was subjected to interleukin (IL)-13 (rs20541) and cluster-of-differentiation (CD)14 (rs2569190) genotype analysis. Results The combination of cesarean delivery and prenatal exposure to antibiotics associated significantly and positively with AD (adjusted odds ratio, 5.70; 95% CI, 1.19–27.3). The association between cesarean delivery and AD was significantly modified by parental history of allergic diseases or risk-associated IL-13 (rs20541) and CD14 (rs2569190) genotypes. There was a trend of interaction between IL-13 (rs20541) and delivery mode with respect to the subsequent risk of AD. (P for interaction = 0.039) Infants who were exposed prenatally to antibiotics and were born by cesarean delivery had a lower total microbiota diversity in stool samples at 6 months of age than the control group. As the number of these risk factors increased, the AD risk rose (trend p<0.05). Conclusion Cesarean delivery and prenatal antibiotic exposure may affect the gut microbiota, which may in turn influence the risk of AD in infants. These relationships may be shaped by the genetic predisposition.
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Affiliation(s)
- So-Yeon Lee
- Department of Pediatrics, Hallym University College of Medicine, Anyang, Korea
| | - Jinho Yu
- Childhood Asthma Atopy Center, Asan Medical Center, Seoul, Korea
| | - Kang-Mo Ahn
- Department of Pediatrics, Sungkyunkwan University of School of Medicine, Seoul, Korea
| | - Kyung Won Kim
- Department of Pediatrics, College of Medicine, Yonsei University, Seoul, Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA University of School of Medicine, Seoul, Korea
| | | | - Seo Ah Hong
- Childhood Asthma Atopy Center, Asan Medical Center, Seoul, Korea
| | - Young-ho Jung
- Childhood Asthma Atopy Center, Asan Medical Center, Seoul, Korea
| | - Eun Lee
- Childhood Asthma Atopy Center, Asan Medical Center, Seoul, Korea
| | - Song-I Yang
- Childhood Asthma Atopy Center, Asan Medical Center, Seoul, Korea
| | - Ju-hee Seo
- Department of Pediatrics, Korea Cancer Center Hospital, Seoul, Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Byoung-Ju Kim
- Department of Pediatrics, Inje University College of Medicine, Seoul, Korea
| | - Hyo-Bin Kim
- Department of Pediatrics, Inje University College of Medicine, Seoul, Korea
| | - Woo-Kyung Kim
- Department of Pediatrics, Inje University College of Medicine, Seoul, Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University Guro Hospital, Seoul, Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea
| | - Jung Yeon Shim
- Department of Pediatrics, Sungkyunkwan University of School of Medicine, Seoul, Korea
| | - Soo-Young Lee
- Department of Pediatrics, Ajou University School of Medicine, Suwon, Korea
| | - Ja-Young Kwon
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Seoul, Korea
| | - Suk-Joo Choi
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Ju Lee
- Department of Obstetrics and Gynecology, Pochon CHA University College of Medicine, Seoul, Korea
| | - Hee Jin Park
- Department of Obstetrics and Gynecology, Pochon CHA University College of Medicine, Seoul, Korea
| | - Hye-Sung Won
- Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ho-Sung Yoo
- The Asan Institute for Life Science, Seoul, Korea
| | - Mi-Jin Kang
- The Asan Institute for Life Science, Seoul, Korea
| | - Hyung-Young Kim
- Department of Pediatrics, Kosin University College of Medicine, Busan, Korea
| | - Soo-Jong Hong
- Childhood Asthma Atopy Center, Asan Medical Center, Seoul, Korea
- * E-mail:
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Nakao A, Ito T, Han X, Lu YJ, Hisata K, Tsujiwaki A, Matsunaga N, Komatsu M, Hiramatsu K, Shimizu T. Intestinal carriage of methicillin-resistant Staphylococcus aureus in nasal MRSA carriers hospitalized in the neonatal intensive care unit. Antimicrob Resist Infect Control 2014; 3:14. [PMID: 24808943 PMCID: PMC4012148 DOI: 10.1186/2047-2994-3-14] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 04/09/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The current data regarding the correlation between the methicillin-resistant Staphylococcus aureus (MRSA) clones carried in the nasal cavity and digestive tract are inadequate. METHODS MRSA strains were isolated from both the feces and nasal swabs of 21 nasal-MRSA carriers ranging from 10 to 104 days of age treated at the neonatal intensive care units of two hospitals. The molecular epidemiological characteristics of the isolates were determined: multilocus sequence types, spa-types, staphylococcal cassette chromosome mec (SCCmec) types, carriage of four exotoxin genes, and genes contained in commercially available kit. RESULTS The feces of all nasal carriers contained MRSA at levels ranging from 4.0 × 10(2) to 2.8 × 10(8) colony forming units/g feces. The MRSA clones isolated from the feces and the nasal swabs of each patient were the same. Four MRSA clones, clonal complex (CC) 8-SCCmec IVl, CC8-SCCmec IVb, CC1-SCCmec IVa and CC5-SCCmec IIa were identified from 21 patients. All CC8-SCCmec IVl strains and one of three CC5-SCCmec IIa strains carried the toxic shock syndrome toxin gene. CONCLUSIONS The feces of tested MRSA carriers contained the same MRSA clones as the nasal isolates in considerable amounts, suggesting that more careful attention should be paid for the handling of excrement in the case of newborn babies or infants than that of adults.
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Affiliation(s)
- Akihiro Nakao
- Department of Pediatrics, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Teruyo Ito
- Department of Bacteriology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan ; Department of Infection Control Science, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Xiao Han
- Department of Infection Control Science, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Yu Jie Lu
- Department of Infection Control Science, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Ken Hisata
- Department of Pediatrics, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Atsushi Tsujiwaki
- Department of Pediatrics, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Nobuaki Matsunaga
- Department of Pediatrics, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Mitsutaka Komatsu
- Department of Pediatrics, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Keiichi Hiramatsu
- Department of Bacteriology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan ; Department of Infection Control Science, Graduate School of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
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Jakobsson HE, Abrahamsson TR, Jenmalm MC, Harris K, Quince C, Jernberg C, Björkstén B, Engstrand L, Andersson AF. Decreased gut microbiota diversity, delayed Bacteroidetes colonisation and reduced Th1 responses in infants delivered by caesarean section. Gut 2014; 63:559-66. [PMID: 23926244 DOI: 10.1136/gutjnl-2012-303249] [Citation(s) in RCA: 625] [Impact Index Per Article: 62.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The early intestinal microbiota exerts important stimuli for immune development, and a reduced microbial exposure as well as caesarean section (CS) has been associated with the development of allergic disease. Here we address how microbiota development in infants is affected by mode of delivery, and relate differences in colonisation patterns to the maturation of a balanced Th1/Th2 immune response. DESIGN The postnatal intestinal colonisation pattern was investigated in 24 infants, born vaginally (15) or by CS (nine). The intestinal microbiota were characterised using pyrosequencing of 16S rRNA genes at 1 week and 1, 3, 6, 12 and 24 months after birth. Venous blood levels of Th1- and Th2-associated chemokines were measured at 6, 12 and 24 months. RESULTS Infants born through CS had lower total microbiota diversity during the first 2 years of life. CS delivered infants also had a lower abundance and diversity of the Bacteroidetes phylum and were less often colonised with the Bacteroidetes phylum. Infants born through CS had significantly lower levels of the Th1-associated chemokines CXCL10 and CXCL11 in blood. CONCLUSIONS CS was associated with a lower total microbial diversity, delayed colonisation of the Bacteroidetes phylum and reduced Th1 responses during the first 2 years of life.
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Affiliation(s)
- Hedvig E Jakobsson
- Department of Preparedness, Swedish Institute for Communicable Disease Control, , Solna, Sweden
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128
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Penders J, Gerhold K, Thijs C, Zimmermann K, Wahn U, Lau S, Hamelmann E. New insights into the hygiene hypothesis in allergic diseases: mediation of sibling and birth mode effects by the gut microbiota. Gut Microbes 2014; 5:239-44. [PMID: 24637604 PMCID: PMC4063851 DOI: 10.4161/gmic.27905] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
There is convincing evidence from both human and animal studies suggesting that the infant intestinal microbiota plays an important role in regulating immune responses associated with the development of allergic diseases. To date there are, however, still no definite bacterial taxa or particular subsets of the microbiota that have been consistently associated with allergic diseases, which is mainly attributable to the methodological dissimilarities between studies. As such there is a need to apply different methodological concepts to enhance a deeper and more refined understanding of the relationship between the gut microbiota and allergies. Within our recent studies we reported that colonization by clostridia in early infancy increased the risk of atopic dermatitis. Using subsequent mediation analysis, we demonstrated that birth mode and having older siblings strongly impacted the infant microbiota which in turn affected the risk of atopic dermatitis. The results of these mediation analyses contributed stronger evidence for a causal link of birth mode and birth order on allergy risk through modulation of the microbiota composition.
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Affiliation(s)
- John Penders
- Department of Medical Microbiology; School for Nutrition, Toxicology, and Metabolism; Maastricht University Medical Centre; Maastricht, the Netherlands,Department of Epidemiology; School for Public Health and Primary Care; Maastricht University; Maastricht, the Netherlands,Correspondence to: John Penders,
| | - Kerstin Gerhold
- Department of Pediatric Pneumology and Immunology; Charité-Universitätsmedizin Berlin; Berlin, Germany
| | - Carel Thijs
- Department of Epidemiology; School for Public Health and Primary Care; Maastricht University; Maastricht, the Netherlands
| | | | - Ulrich Wahn
- Department of Pediatric Pneumology and Immunology; Charité-Universitätsmedizin Berlin; Berlin, Germany
| | - Susanne Lau
- Department of Pediatric Pneumology and Immunology; Charité-Universitätsmedizin Berlin; Berlin, Germany
| | - Eckard Hamelmann
- University Children’s Hospital St Josef; Ruhr-Universität Bochum; Bochum, Germany
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129
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Nwaru BI, Takkinen HM, Kaila M, Erkkola M, Ahonen S, Pekkanen J, Simell O, Veijola R, Ilonen J, Hyöty H, Knip M, Virtanen SM. Food diversity in infancy and the risk of childhood asthma and allergies. J Allergy Clin Immunol 2014; 133:1084-91. [PMID: 24472626 DOI: 10.1016/j.jaci.2013.12.1069] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 12/05/2013] [Accepted: 12/10/2013] [Indexed: 01/23/2023]
Abstract
BACKGROUND Recently, the bacterial diversity of the intestinal flora and the diversity of various environmental factors during infancy have been linked to the development of allergies in childhood. Food is an important environmental exposure, but the role of food diversity in the development of asthma and allergies in childhood is poorly defined. OBJECTIVE We studied the associations between food diversity during the first year of life and the development of asthma and allergies by age 5 years. METHODS In a Finnish birth cohort we analyzed data on 3142 consecutively born children. We studied food diversity at 3, 4, 6, and 12 months of age. Asthma, wheeze, atopic eczema, and allergic rhinitis were measured by using the International Study of Asthma and Allergies in Childhood questionnaire at age 5 years. RESULTS By 3 and 4 months of age, food diversity was not associated with any of the allergic end points. By 6 months of age, less food diversity was associated with increased risk of allergic rhinitis but not with the other end points. By 12 months of age, less food diversity was associated with increased risk of any asthma, atopic asthma, wheeze, and allergic rhinitis. CONCLUSION Less food diversity during the first year of life might increase the risk of asthma and allergies in childhood. The mechanisms for this association are unclear, but increased dietary antigen exposure might contribute to this link.
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Affiliation(s)
- Bright I Nwaru
- School of Health Sciences, University of Tampere, Tampere, Finland; Allergy & Respiratory Research Group, Center for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.
| | - Hanna-Mari Takkinen
- School of Health Sciences, University of Tampere, Tampere, Finland; Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland
| | - Minna Kaila
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland; Hjelt Institute, University of Helsinki, Helsinki, Finland
| | - Maijaliisa Erkkola
- Division of Nutrition, Department of Food and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Suvi Ahonen
- School of Health Sciences, University of Tampere, Tampere, Finland; Science Center of Pirkanmaa Hospital District, Tampere, Finland
| | - Juha Pekkanen
- Environmental Epidemiology Unit, National Institute for Health and Welfare, Kuopio, Finland; Unit of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Olli Simell
- Department of Pediatrics, University of Turku, Turku, Finland
| | - Riitta Veijola
- Department of Pediatrics, Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Jorma Ilonen
- Immunogenetics Laboratory, University of Turku, Turku, Finland; Department of Clinical Microbiology, University of Eastern Finland, Kuopio, Finland
| | - Heikki Hyöty
- Medical School, University of Tampere, Tampere, Finland; Fimlab Laboratories, Tampere, Finland
| | - Mikael Knip
- Department of Pediatrics, Tampere University Hospital, Tampere, Finland; Folkhälsan Research Center, Helsinki, Finland; Children's Hospital, University of Helsinki, and Helsinki University Central Hospital, Helsinki, Finland; Diabetes and Obesity Research Program, University of Helsinki, Helsinki, Finland
| | - Suvi M Virtanen
- School of Health Sciences, University of Tampere, Tampere, Finland; Nutrition Unit, Department of Lifestyle and Participation, National Institute for Health and Welfare, Helsinki, Finland; Department of Pediatrics, Tampere University Hospital, Tampere, Finland; Science Center of Pirkanmaa Hospital District, Tampere, Finland
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130
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Kuitunen M. Probiotics prevent allergic diseases in high-risk children. Expert Rev Clin Immunol 2014; 5:221-4. [DOI: 10.1586/eci.09.3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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131
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Aires J, Butel MJ. Proteomics, human gut microbiota and probiotics. Expert Rev Proteomics 2014; 8:279-88. [DOI: 10.1586/epr.11.5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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132
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Bertelsen RJ, Brantsæter AL, Magnus MC, Haugen M, Myhre R, Jacobsson B, Longnecker MP, Meltzer HM, London SJ. Probiotic milk consumption in pregnancy and infancy and subsequent childhood allergic diseases. J Allergy Clin Immunol 2014; 133:165-71.e1-8. [PMID: 24034345 PMCID: PMC3912862 DOI: 10.1016/j.jaci.2013.07.032] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Revised: 07/02/2013] [Accepted: 07/12/2013] [Indexed: 12/14/2022]
Abstract
BACKGROUND Whether probiotics, which can influence the microbiome, prevent infant eczema or allergic disease remains an open question. Most studies have focused on high-risk infants. OBJECTIVES We sought to assess whether consumption of probiotic milk products protects against atopic eczema, rhinoconjunctivitis, and asthma in early childhood in a large population-based pregnancy cohort (the Norwegian Mother and Child Cohort study). METHODS We examined associations between consumption of probiotic milk products in pregnancy and infancy with questionnaire-reported atopic eczema, rhinoconjunctivitis, and asthma in 40,614 children. Relative risks (RRs) were calculated by using general linear models adjusted for potential confounders. RESULTS Consumption of probiotic milk in pregnancy was associated with a slightly reduced relative risk (RR) of atopic eczema at 6 months (adjusted RR, 0.94; 95% CI, 0.89-0.99) and of rhinoconjunctivitis between 18 and 36 months (adjusted RR, 0.87; 95% CI, 0.78-0.98) compared with no consumption during pregnancy. Maternal history of allergic disease did not notably influence the associations. When both the mother (during pregnancy) and infant (after 6 months of age) had consumed probiotic milk, the adjusted RR of rhinoconjunctivitis was 0.80 (95% CI, 0.68-0.93) relative to no consumption by either. Probiotic milk consumption was not associated with asthma at 36 months. CONCLUSIONS In this population-based cohort consumption of probiotic milk products was related to a reduced incidence of atopic eczema and rhinoconjunctivitis, but no association was seen for incidence of asthma by 36 months of age.
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Affiliation(s)
- Randi J Bertelsen
- Department of Food, Water and Cosmetics, Norwegian Institute of Public Health, Oslo, Norway; Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC.
| | - Anne Lise Brantsæter
- Department of Exposure and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway
| | - Maria C Magnus
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC; Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Margaretha Haugen
- Department of Exposure and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway
| | - Ronny Myhre
- Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway
| | - Bo Jacobsson
- Department of Genes and Environment, Norwegian Institute of Public Health, Oslo, Norway; Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gothenburg, Sweden
| | - Matthew P Longnecker
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
| | - Helle M Meltzer
- Department of Exposure and Risk Assessment, Norwegian Institute of Public Health, Oslo, Norway
| | - Stephanie J London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
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133
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The potential link between gut microbiota and IgE-mediated food allergy in early life. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:7235-56. [PMID: 24351744 PMCID: PMC3881164 DOI: 10.3390/ijerph10127235] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2013] [Revised: 11/30/2013] [Accepted: 12/03/2013] [Indexed: 12/15/2022]
Abstract
There has been a dramatic rise in the prevalence of IgE-mediated food allergy over recent decades, particularly among infants and young children. The cause of this increase is unknown but one putative factor is a change in the composition, richness and balance of the microbiota that colonize the human gut during early infancy. The coevolution of the human gastrointestinal tract and commensal microbiota has resulted in a symbiotic relationship in which gut microbiota play a vital role in early life immune development and function, as well as maintenance of gut wall epithelial integrity. Since IgE mediated food allergy is associated with immune dysregulation and impaired gut epithelial integrity there is substantial interest in the potential link between gut microbiota and food allergy. Although the exact link between gut microbiota and food allergy is yet to be established in humans, recent experimental evidence suggests that specific patterns of gut microbiota colonization may influence the risk and manifestations of food allergy. An understanding of the relationship between gut microbiota and food allergy has the potential to inform both the prevention and treatment of food allergy. In this paper we review the theory and evidence linking gut microbiota and IgE-mediated food allergy in early life. We then consider the implications and challenges for future research, including the techniques of measuring and analyzing gut microbiota, and the types of studies required to advance knowledge in the field.
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134
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Abstract
Food allergies are increasing in prevalence at a higher rate than can be explained by genetic factors, suggesting a role for as yet unidentified environmental factors. In this review, we summarize the state of knowledge about the healthy immune response to antigens in the diet and the basis of immune deviation that results in immunoglobulin E (IgE) sensitization and allergic reactivity to foods. The intestinal epithelium forms the interface between the external environment and the mucosal immune system, and emerging data suggest that the interaction between intestinal epithelial cells and mucosal dendritic cells is of particular importance in determining the outcome of immune responses to dietary antigens. Exposure to food allergens through non-oral routes, in particular through the skin, is increasingly recognized as a potentially important factor in the increasing rate of food allergy. There are many open questions on the role of environmental factors, such as dietary factors and microbiota, in the development of food allergy, but data suggest that both have an important modulatory effect on the mucosal immune system. Finally, we discuss recent developments in our understanding of immune mechanisms of clinical manifestations of food allergy. New experimental tools, particularly in the field of genomics and the microbiome, are likely to shed light on factors responsible for the growing clinical problem of food allergy.
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Affiliation(s)
- M Cecilia Berin
- Pediatric Allergy and Immunology, Box 1198, One Gustave L. Levy Place, New York, NY 10029, USA.
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135
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Toxin-producing Clostridium difficile strains as long-term gut colonizers in healthy infants. J Clin Microbiol 2013; 52:173-9. [PMID: 24172156 DOI: 10.1128/jcm.01701-13] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Clostridium difficile is a colonizer of the human gut, and toxin-producing strains may cause diarrhea if the infectious burden is heavy. Infants are more frequently colonized than adults, but they rarely develop C. difficile disease. It is not known whether strains of C. difficile differ in the capacity to colonize and persist in the human gut microbiota. Here, we strain typed isolates of C. difficile that had colonized 42 healthy infants followed from birth to ≥12 months of age by using PCR ribotyping of the 16S-23S rRNA intergenic spacer region. The isolates were also characterized regarding carriage of the toxin genes tcdA, tcdB, and cdtA/B and the capacity to produce toxin B in vitro. Most strains (71%) were toxin producers, and 51% belonged to the 001 or 014 ribotypes, which often cause disease in adults. These ribotypes were significantly more likely than others to persist for ≥6 months in the infant micobiota, and they were isolated from 13/15 children carrying such long-term-colonizing strains. Ribotype 001 strains were often acquired in the first week of life and attained higher population counts than other C. difficile ribotypes in newborn infants' feces. Several toxin-negative ribotypes were identified, two of which (GI and GIII) were long-term colonizers, each found in one infant. Our results suggest that the toxin-producing C. difficile ribotypes 001 and 014 have special fitness in the infantile gut microbiota. Toxin-producing strains colonizing young children for long time periods may represent a reservoir for strains causing disease in adults.
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136
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Three main factors define changes in fecal microbiota associated with feeding modality in infants. J Pediatr Gastroenterol Nutr 2013; 57:461-6. [PMID: 23752082 DOI: 10.1097/mpg.0b013e31829d519a] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVES There are many differences in the fecal infant microbiota associated with various feeding methods. The aim of this study was to examine the major differences in the fecal microbiota of breast-fed (BF) and formula-fed (FF) infants and to describe the principal bacterial components that would explain the variability in the predominant bacterial families and genus clusters. METHODS Fecal samples from 58 infants, 31 of whom were exclusively BF and 27 of whom were exclusively FF with a standard formula in agreement with the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition recommendations, were analyzed by fluorescent in situ hybridization combined with flow cytometry. Principal component analysis was used to maximize the information gained for the predominant bacterial families and genus clusters using a minimal number of bacterial groups. RESULTS The predominant detected group was Bifidobacterium, followed by Enterobacteriaceae and Bacteroides in both BF and FF infants. The Lactobacillus group was the only independent variable associated with FF infants. We also found that 3 principal components were sufficient to describe the association between the bacterial group, genus, and species studied in BF and FF infants; however, these components differed between BF and FF infants. For the former, the 3 factors found were Bifidobacterium/Enterobacteriaceae, Lactobacillus/Bacteroides, and Clostridium coccoides/Atopobium; for the latter, Bifidobacterium/Enterobacteriaceae, Bacteroides and C coccoides were observed. CONCLUSIONS There is a clear clustering of components of infant microbiota based on the feeding method.
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137
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de Weerth C, Fuentes S, de Vos WM. Crying in infants: on the possible role of intestinal microbiota in the development of colic. Gut Microbes 2013; 4:416-21. [PMID: 23941920 PMCID: PMC3839988 DOI: 10.4161/gmic.26041] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Up to around a quarter of all infants cry excessively and unsoothably during their first months of life. This phenomenon has been termed "infant colic." In most cases, physicians are unable to determine the cause of the colicky behavior. In a recent study, and by means of comprehensive and deep analyses of more than 1000 intestinal phylotypes, we found that infants with colic showed lower microbiota diversity and stability than control infants in the first weeks of life. Colic-control differences in the abundance of certain bacteria were also found at 2 weeks. These microbial signatures possibly explain the colic phenotype. In this addendum we discuss other recent publications on the subject and present previously unpublished analyses of our own. We address possible mechanisms behind the links between microbiota and crying, and present future directions that could further help elucidate the hypothesized relations between intestinal microbiota and infant colic.
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Affiliation(s)
- Carolina de Weerth
- Behavioural Science Institute; Radboud University Nijmegen; Nijmegen, the Netherlands,Correspondence to: Carolina de Weerth,
| | - Susana Fuentes
- Laboratory of Microbiology; Wageningen University; Wageningen, the Netherlands
| | - Willem M de Vos
- Laboratory of Microbiology; Wageningen University; Wageningen, the Netherlands,Department of Basic Veterinary Medicine and Department of Bacteriology and Immunology; University of Helsinki; Helsinki, Finland
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138
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Garn H, Neves JF, Blumberg RS, Renz H. Effect of barrier microbes on organ-based inflammation. J Allergy Clin Immunol 2013; 131:1465-78. [PMID: 23726530 DOI: 10.1016/j.jaci.2013.04.031] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 04/17/2013] [Accepted: 04/23/2013] [Indexed: 12/22/2022]
Abstract
The prevalence and incidence of chronic inflammatory disorders, including allergies and asthma, as well as inflammatory bowel disease, remain on the increase. Microbes are among the environmental factors that play an important role in shaping normal and pathologic immune responses. Several concepts have been put forward to explain the effect of microbes on the development of these conditions, including the hygiene hypothesis and the microbiota hypothesis. Recently, the dynamics of the development of (intestinal) microbial colonization, its effect on innate and adaptive immune responses (homeostasis), and the role of environmental factors, such as nutrition and others, have been extensively investigated. Furthermore, there is now increasing evidence that a qualitative and quantitative disturbance in colonization (dysbiosis) is associated with dysfunction of immune responses and development of various chronic inflammatory disorders. In this article the recent epidemiologic, clinical, and experimental evidence for this interaction is discussed.
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Affiliation(s)
- Holger Garn
- Institute of Laboratory Medicine, Philipps-Universität Marburg, Marburg, Germany
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139
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Nauta AJ, Ben Amor K, Knol J, Garssen J, van der Beek EM. Relevance of pre- and postnatal nutrition to development and interplay between the microbiota and metabolic and immune systems. Am J Clin Nutr 2013; 98:586S-93S. [PMID: 23824726 DOI: 10.3945/ajcn.112.039644] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Early-life programming is becoming an established concept that states that the environment during early development affects health and disease in adulthood, probably via epigenetic mechanisms such as DNA methylation, histone modifications, RNA silencing, or a combination. Accumulating evidence suggests that nutrition during pregnancy and early postnatal life is one of the most important environmental cues that programs microbiological, metabolic, and immunologic development. The neonatal period is crucial for the early microbial colonization of the almost sterile gastrointestinal tract of the newborn infant. These first colonizers play an important role in host health because they are involved in nutritional, immunologic, and physiologic functions. Evidence from animal and human studies indicates that the composition of the gut microbiota has an effect on body composition, digestion, and metabolic homeostasis. Furthermore, the functionality of the metabolism develops after birth when the newborn is first exposed to nutrition via the gastrointestinal tract. Exposure to environmental microbial components is also suggested to have a key role in the maturation process of the immune system, and in turn the immune system shapes the composition of the microbiota. Therefore, the use of nutritional strategies to program the microbiota composition to favor a more beneficial bacterial population and to support the development of the metabolic and immune systems may provide a good opportunity to prevent later health problems such as obesity, diabetes, and allergy.
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Affiliation(s)
- Alma J Nauta
- Danone Research-Centre for Specialised Nutrition, Singapore.
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140
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Oozeer R, van Limpt K, Ludwig T, Ben Amor K, Martin R, Wind RD, Boehm G, Knol J. Intestinal microbiology in early life: specific prebiotics can have similar functionalities as human-milk oligosaccharides. Am J Clin Nutr 2013; 98:561S-71S. [PMID: 23824728 DOI: 10.3945/ajcn.112.038893] [Citation(s) in RCA: 114] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Human milk is generally accepted as the best nutrition for newborns and has been shown to support the optimal growth and development of infants. On the basis of scientific insights from human-milk research, a specific mixture of nondigestible oligosaccharides has been developed, with the aim to improve the intestinal microbiota in early life. The mixture has been extensively studied and has been shown to be safe and to have potential health benefits that are similar to those of human milk. The specific mixture of short-chain galacto-oligosaccharides and long-chain fructo-oligosaccharides has been found to affect the development of early microbiota and to increase the Bifidobacterium amounts as observed in human-milk-fed infants. The resulting gut ecophysiology is characterized by high concentrations of lactate, a slightly acidic pH, and specific short-chain fatty acid profiles, which are high in acetate and low in butyrate and propionate. Here, we have summarized the main findings of dietary interventions with these specific oligosaccharides on the gut microbiota in early life. The gut ecophysiology in early life may have consequences for the metabolic, immunologic, and even neurologic development of the child because reports increasingly substantiate the important function of gut microbes in human health. This review highlights major findings in the field of early gut colonization and the potential impact of early nutrition in healthy growth and development.
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Affiliation(s)
- Raish Oozeer
- Danone Research-Centre for Specialised Nutrition, Wageningen, Netherlands.
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141
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Penders J, Gerhold K, Stobberingh EE, Thijs C, Zimmermann K, Lau S, Hamelmann E. Establishment of the intestinal microbiota and its role for atopic dermatitis in early childhood. J Allergy Clin Immunol 2013; 132:601-607.e8. [PMID: 23900058 DOI: 10.1016/j.jaci.2013.05.043] [Citation(s) in RCA: 202] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Revised: 05/29/2013] [Accepted: 05/31/2013] [Indexed: 01/15/2023]
Abstract
BACKGROUND Perturbations in the intestinal microbiota may disrupt mechanisms involved in the development of immunologic tolerance. The present study aimed to examine the establishment of the infant microbiota and its association to the development of atopic dermatitis (AD). METHODS Within a randomized, placebo-controlled trial on the prevention of AD by oral supplementation of a bacterial lysate between week 5 and the end of month 7, feces was collected at the ages of 5 weeks (n = 571), 13 weeks (n = 332), and 31 weeks (n = 499) and subjected to quantitative PCRs to detect bifidobacteria, bacteroides, lactobacilli, Escherichia coli, Clostridium difficile, and Clostridium cluster I. RESULTS Birth mode, breast-feeding but also birth order had a strong effect on the microbiota composition. With increasing number of older siblings the colonization rates at age 5 weeks of lactobacilli (P < .001) and bacteroides (P = .02) increased, whereas rates of clostridia decreased (P < .001). Colonization with clostridia, at the age of 5 and 13 weeks was also associated with an increased risk of developing AD in the subsequent 6 months of life (odds ratioadjusted = 2.35; 95% CI, 1.36-3.94 and 2.51; 1.30-4.86, respectively). Mediation analyses demonstrated that there was a statistically significant indirect effect via Clostridium cluster I colonization for both birth mode and birth order in association to AD. CONCLUSION The results of this study are supportive for a role of the microbiota in the development of AD. Moreover, the "beneficial" influence of older siblings on the microbiota composition suggests that this microbiota may be one of the biological mechanisms underlying the sibling effect.
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Affiliation(s)
- John Penders
- Department of Medical Microbiology, School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Epidemiology, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | - Kerstin Gerhold
- Department of Pediatric Pneumology and Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ellen E Stobberingh
- Department of Medical Microbiology, School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Carel Thijs
- Department of Epidemiology, School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | | | - Susanne Lau
- Department of Pediatric Pneumology and Immunology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Eckard Hamelmann
- University Children's Hospital, Ruhr-Universität Bochum, Bochum, Germany
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142
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The management of paediatric allergy: not everybody's cup of tea--10-11th February 2012. Curr Opin Allergy Clin Immunol 2013; 13 Suppl 1:S1-50. [PMID: 23377496 DOI: 10.1097/aci.0b013e32835e8b94] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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143
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Marrs T, Bruce KD, Logan K, Rivett DW, Perkin MR, Lack G, Flohr C. Is there an association between microbial exposure and food allergy? A systematic review. Pediatr Allergy Immunol 2013; 24:311-320.e8. [PMID: 23578298 DOI: 10.1111/pai.12064] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2013] [Indexed: 10/27/2022]
Abstract
The environmental factors driving the recent increase in the prevalence of food allergy (FA) are unclear. Since associations have been demonstrated between microbial exposure and the likelihood of eczema and respiratory allergies, we reviewed the evidence for FA. Medline was systematically searched from inception to the end of July 2012 for studies investigating links between FA and environmental exposures, likely to influence microbial exposure, such as Caesarean delivery, family size, day-care attendance, childhood infections, immunizations and antibiotic use. We selected studies reporting food challenge data, reported doctor-diagnosed (RDD) FA and food sensitization. Methodological differences and study heterogeneity precluded meta-analysis. A total of 46 studies were identified, of which 28 (60.9%) were prospective and 13 (28.3%) used food challenges to diagnose FA. Caesarean delivery was investigated in 13 studies, of which three infant cohorts demonstrated an increase in challenge-proven FA (one cohort) and food sensitization (two cohorts), and one cross-sectional study reported increased RDDFA. Four studies investigated the effect of having siblings, with one infant cohort demonstrating less challenge-proven FA and a cross-sectional study showing a decrease in RDDFA. Attending childcare before 6 months was associated with less challenge-proven FA in one cohort. A cross-sectional survey identified an inverse relationship between hepatitis A serology and peanut sensitization. One of eleven trials investigating probiotics demonstrated a quicker acquisition of milk tolerance amongst allergic infants. Factors influencing microbial exposure may be partly responsible for rising FA burden, but further prospective studies using double-blind placebo controlled food challenges as an outcome are required.
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Affiliation(s)
- Tom Marrs
- Department of Paediatric Allergy, Division of Asthma, Allergy and Lung Biology, King's College London, London, UK.
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144
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Diversity of intestinal microbiota in infancy and the risk of allergic disease in childhood. Curr Opin Allergy Clin Immunol 2013; 13:257-62. [DOI: 10.1097/aci.0b013e328360968b] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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145
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Grishin A, Papillon S, Bell B, Wang J, Ford HR. The role of the intestinal microbiota in the pathogenesis of necrotizing enterocolitis. Semin Pediatr Surg 2013; 22:69-75. [PMID: 23611609 PMCID: PMC3647029 DOI: 10.1053/j.sempedsurg.2013.01.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Development of necrotizing enterocolitis (NEC) requires a susceptible host, typically a premature infant or an infant with congenital heart disease, enteral feedings and bacterial colonization. Although there is little doubt that microbes are critically involved in the pathogenesis of NEC, the identity of specific causative pathogens remains elusive. Unlike established normal adult gut microbiota, which is quite complex, uniform, and stable, early postnatal bacterial populations are simple, diverse, and fluid. These properties complicate studies aimed at elucidating characteristics of the gut microbiome that may play a role in the pathogenesis of NEC. A broad variety of bacterial, viral, and fungal species have been implicated in both clinical and experimental NEC. Frequently, however, the same species have also been found in physiologically matched healthy individuals. Clustered outbreaks of NEC, in which the same strain of a suspected pathogen is detected in several patients suggest, but do not prove, a causative relationship between the specific pathogen and the disease. Studies in Cronobacter sakazakii, the best characterized NEC pathogen, have demonstrated that virulence is not a property of a bacterial species as a whole, but rather a characteristic of certain strains, which may explain why the same species can be pathogenic or non-pathogenic. The fact that a given microbe may be innocuous in a full-term, yet pathogenic in a pre-term infant has led to the idea of opportunistic pathogens in NEC. Progress in understanding the infectious nature of NEC may require identifying specific pathogenic strains and unambiguously establishing their virulence in animal models.
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146
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Azad MB, Konya T, Maughan H, Guttman DS, Field CJ, Sears MR, Becker AB, Scott JA, Kozyrskyj AL. Infant gut microbiota and the hygiene hypothesis of allergic disease: impact of household pets and siblings on microbiota composition and diversity. Allergy Asthma Clin Immunol 2013; 9:15. [PMID: 23607879 PMCID: PMC3655107 DOI: 10.1186/1710-1492-9-15] [Citation(s) in RCA: 180] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2012] [Accepted: 03/07/2013] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Multiple studies have demonstrated that early-life exposure to pets or siblings affords protection against allergic disease; these associations are commonly attributed to the "hygiene hypothesis". Recently, low diversity of the infant gut microbiota has also been linked to allergic disease. In this study, we characterize the infant gut microbiota in relation to pets and siblings. METHODS The study population comprised a small sub-sample of 24 healthy, full term infants from the Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort. Mothers reported on household pets and siblings. Fecal samples were collected at 4 months of age, and microbiota composition was characterized by high-throughput signature gene sequencing. RESULTS Microbiota richness and diversity tended to be increased in infants living with pets, whereas these measures were decreased in infants with older siblings. Infants living with pets exhibited under-representation of Bifidobacteriaceae and over-representation of Peptostreptococcaceae; infants with older siblings exhibited under-representation of Peptostreptococcaceae. CONCLUSIONS This study provides new evidence that exposure to pets and siblings may influence the early development of the gut microbiota, with potential implications for allergic disease. These two traditionally protective "hygiene hypothesis" factors appear to differentially impact gut microbiota composition and diversity, calling into question the clinical significance of these measures. Further research is required to confirm and expand these findings.
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Affiliation(s)
- Meghan B Azad
- Department of Pediatrics, University of Alberta, 3-527 Edmonton Clinic Health Academy 11405 - 87th Avenue, Edmonton, AB, T6G IC9, Canada
| | - Theodore Konya
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Heather Maughan
- Cell & Systems Biology, University of Toronto, Toronto, ON, Canada
| | - David S Guttman
- Cell & Systems Biology, University of Toronto, Toronto, ON, Canada
| | - Catherine J Field
- Agriculture, Food & Nutritional Sciences, University of Alberta, Edmonton, AB, Canada
| | - Malcolm R Sears
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Allan B Becker
- Pediatrics & Child Health, University of Manitoba, Winnipeg, MB, Canada ; Manitoba Institute of Child Health, Winnipeg, Canada
| | - James A Scott
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anita L Kozyrskyj
- Department of Pediatrics, University of Alberta, 3-527 Edmonton Clinic Health Academy 11405 - 87th Avenue, Edmonton, AB, T6G IC9, Canada ; Manitoba Institute of Child Health, Winnipeg, Canada
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147
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Penders J, Stobberingh EE, Savelkoul PHM, Wolffs PFG. The human microbiome as a reservoir of antimicrobial resistance. Front Microbiol 2013; 4:87. [PMID: 23616784 PMCID: PMC3627978 DOI: 10.3389/fmicb.2013.00087] [Citation(s) in RCA: 169] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Accepted: 03/27/2013] [Indexed: 12/12/2022] Open
Abstract
The gut microbiota is amongst the most densely populated microbial ecosystem on earth. While the microbiome exerts numerous health beneficial functions, the high density of micro-organisms within this ecosystem also facilitates horizontal transfer of antimicrobial resistance (AMR) genes to potential pathogenic bacteria. Over the past decades antibiotic susceptibility testing of specific indicator bacteria from the microbiome, such as Escherichia coli, has been the method of choice in most studies. These studies have greatly enlarged our understanding on the prevalence and distribution of AMR and associated risk factors. Recent studies using (functional) metagenomics, however, highlighted the unappreciated diversity of AMR genes in the human microbiome and identified genes that had not been described previously. Next to metagenomics, more targeted approaches such as polymerase chain reaction for detection and quantification of AMR genes within a population are promising, in particular for large-scale epidemiological screening. Here we present an overview of the indigenous microbiota as a reservoir of AMR genes, the current knowledge on this “resistome” and the recent and upcoming advances in the molecular diagnostic approaches to unravel this reservoir.
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Affiliation(s)
- John Penders
- Department of Medical Microbiology, Maastricht University Medical Centre+ Maastricht, Netherlands
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148
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Sjöberg F, Nowrouzian F, Rangel I, Hannoun C, Moore E, Adlerberth I, Wold AE. Comparison between terminal-restriction fragment length polymorphism (T-RFLP) and quantitative culture for analysis of infants' gut microbiota. J Microbiol Methods 2013; 94:37-46. [PMID: 23583598 DOI: 10.1016/j.mimet.2013.04.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 03/30/2013] [Accepted: 04/04/2013] [Indexed: 10/26/2022]
Abstract
The infantile intestinal microbiota is a major stimulus for immune maturation. Both culture and DNA-based methods can be used for microbiota characterization, but few studies have systematically compared their performance for analysis of the gut microbiota. Here, we examined fecal samples obtained on six occasions between one week and 12 months of age from six vaginally delivered infants. After quantitative aerobic and anaerobic culture of the samples on selective and non-selective media, DNA was extracted from the fecal samples and analyzed regarding 16S rRNA gene polymorphism by terminal-restriction fragment length polymorphism (T-RFLP). A database was constructed for direct identification of T-RFLP peaks by analysis of pure-culture bacteria and analysis of a limited number of samples by 16S rRNA cloning and sequencing. Bacterial genera present at >10⁶ CFU/g feces, as determined by quantitative culture, were generally readily detected by T-RFLP, while culture on selective media was more sensitive in detecting facultative anaerobes with lower population counts. In contrast, T-RFLP more readily than culture detected several anaerobic species, also taxa that could not be identified using the database. T-RFLP readily identified bacteria to the genus level and also provided some sub-genus discrimination. Both T-RFLP and culture identified Bifidobacterium, Clostridium and Bacteroides spp. among the most common colonizers of the infantile microbiota throughout the first year of life. T-RFLP analysis showed that microbiota complexity was high in the first weeks of life, declined to a minimum at 1-2 months of age, and thereafter increased again. Principal component analysis revealed that early samples (1 week-6 months) chiefly differed between individual infants, while 12-month samples were similar between children, but different from the early samples. Our results indicate that T-RFLP has high sensitivity and adequate taxonomic discrimination capacity for analysis of gut microbiota composition, but that both culture and molecular based analysis have limitations and both approaches may be needed to obtain a full picture of the complex gut microbiota.
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Affiliation(s)
- Fei Sjöberg
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Guldhedsgatan 10A, S-413 46 Gothenburg, Sweden.
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149
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Cahenzli J, Balmer ML, McCoy KD. Microbial-immune cross-talk and regulation of the immune system. Immunology 2013; 138:12-22. [PMID: 22804726 DOI: 10.1111/j.1365-2567.2012.03624.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 02/14/2012] [Accepted: 07/10/2012] [Indexed: 12/13/2022] Open
Abstract
We are all born germ-free. Following birth we enter into a lifelong relationship with microbes residing on our body's surfaces. The lower intestine is home to the highest microbial density in our body, which is also the highest microbial density known on Earth (up to 10(12) /g of luminal contents). With our indigenous microbial cells outnumbering our human cells by an order of magnitude our body is more microbial than human. Numerous immune adaptations confine these microbes within the mucosa, enabling most of us to live in peaceful homeostasis with our intestinal symbionts. Intestinal epithelial cells not only form a physical barrier between the bacteria-laden lumen and the rest of the body but also function as multi-tasking immune cells that sense the prevailing microbial (apical) and immune (basolateral) milieus, instruct the underlying immune cells, and adapt functionally. In the constant effort to ensure intestinal homeostasis, the immune system becomes educated to respond appropriately and in turn immune status can shape the microbial consortia. Here we review how the dynamic immune-microbial dialogue underlies maturation and regulation of the immune system and discuss recent findings on the impact of diet on both microbial ecology and immune function.
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Affiliation(s)
- Julia Cahenzli
- Department of Clinical Research, Universitätsklinik für Viszerale Chirurgie und Medizin Inselspital, University of Bern, Bern, Switzerland
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150
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Roos S, Dicksved J, Tarasco V, Locatelli E, Ricceri F, Grandin U, Savino F. 454 pyrosequencing analysis on faecal samples from a randomized DBPC trial of colicky infants treated with Lactobacillus reuteri DSM 17938. PLoS One 2013; 8:e56710. [PMID: 23468874 PMCID: PMC3585302 DOI: 10.1371/journal.pone.0056710] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 01/16/2013] [Indexed: 01/22/2023] Open
Abstract
Objective To analyze the global microbial composition, using large-scale DNA sequencing of 16 S rRNA genes, in faecal samples from colicky infants given L. reuteri DSM 17938 or placebo. Methods Twenty-nine colicky infants (age 10–60 days) were enrolled and randomly assigned to receive either Lactobacillus reuteri (108 cfu) or a placebo once daily for 21 days. Responders were defined as subjects with a decrease of 50% in daily crying time at day 21 compared with the starting point. The microbiota of faecal samples from day 1 and 21 were analyzed using 454 pyrosequencing. The primers: Bakt_341F and Bakt_805R, complemented with 454 adapters and sample specific barcodes were used for PCR amplification of the 16 S rRNA genes. The structure of the data was explored by using permutational multivariate analysis of variance and effects of different variables were visualized with ordination analysis. Results The infants’ faecal microbiota were composed of Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes as the four main phyla. The composition of the microbiota in infants with colic had very high inter-individual variability with Firmicutes/Bacteroidetes ratios varying from 4000 to 0.025. On an individual basis, the microbiota was, however, relatively stable over time. Treatment with L. reuteri DSM 17938 did not change the global composition of the microbiota, but when comparing responders with non-responders the group responders had an increased relative abundance of the phyla Bacteroidetes and genus Bacteroides at day 21 compared with day 0. Furthermore, the phyla composition of the infants at day 21 could be divided into three enterotype groups, dominated by Firmicutes, Bacteroidetes, and Actinobacteria, respectively. Conclusion L. reuteri DSM 17938 did not affect the global composition of the microbiota. However, the increase of Bacteroidetes in the responder infants indicated that a decrease in colicky symptoms was linked to changes of the microbiota. Trial Registration ClinicalTrials.gov NCT00893711
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Affiliation(s)
- Stefan Roos
- Department of Microbiology, Swedish University of Agricultural Sciences, Uppsala, Sweden
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