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Chan CWH, Yuet Wa Chan J, Leung TF, Choi KC, Tsui SKW, Wong CL, Chow KM. Altered Gut Microbiome and Environmental Factors Associated with Development of Eczema in Hong Kong Infants: A 4-Month Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207634. [PMID: 33092052 PMCID: PMC7589899 DOI: 10.3390/ijerph17207634] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/13/2020] [Accepted: 10/15/2020] [Indexed: 12/17/2022]
Abstract
Eczema is a multifactorial skin disease that affects 20% of children worldwide and has a complex relationship with microbial, nutritional, parental and environmental factors. In this study, we investigated the potential association of eczema with the gut microbiome and environmental factors. One hundred and fifty-two newborn subjects and their mothers were recruited within 10 days postnatally at the Prince of Wales Hospital in Hong Kong, China and asked to complete questionnaires on allergies, maternal diet and environmental assessment at enrolment. Then, the participants were classified as with or without eczema at four months after birth based on the Comprehensive Early Childhood Allergy Questionnaire (CECAQ) and SCORing Atopic Dermatitis (SCORAD) index (n = 48, with 24 in each group). Stool samples were collected from both groups at the same time. Microbial DNA was extracted from each stool sample, and 16S rRNA sequencing was performed to analyze the gut microbiome profiles of the subjects. Our results indicated that the abundance of Bifidobacterium was significantly higher in the eczema group than in the control group (p = 0.04). A multivariable logistic regression analysis was conducted, and the results showed that the father’s education level and maternal intake of cereal products and nutritional supplements during pregnancy were associated with the development of eczema (p = 0.008, 0.032 and 0.015, respectively). In conclusion, this study provided preliminary information about the potential risk factors of eczema development in Hong Kong infants in support of a future full study.
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Affiliation(s)
- Carmen Wing Han Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; (C.W.H.C.); (K.C.C.); (C.L.W.); (K.M.C.)
| | - Judy Yuet Wa Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; (C.W.H.C.); (K.C.C.); (C.L.W.); (K.M.C.)
- Correspondence: ; Tel.: +852-39433515
| | - Ting Fan Leung
- Department of Paediatrics, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong;
- Hong Kong Hub of Paediatric Excellence, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; (C.W.H.C.); (K.C.C.); (C.L.W.); (K.M.C.)
| | - Stephen Kwok Wing Tsui
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong;
| | - Cho Lee Wong
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; (C.W.H.C.); (K.C.C.); (C.L.W.); (K.M.C.)
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong; (C.W.H.C.); (K.C.C.); (C.L.W.); (K.M.C.)
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New Insights into Immunological Involvement in Congenital Disorders of Glycosylation (CDG) from a People-Centric Approach. J Clin Med 2020; 9:jcm9072092. [PMID: 32635232 PMCID: PMC7408855 DOI: 10.3390/jcm9072092] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 06/27/2020] [Accepted: 06/28/2020] [Indexed: 02/08/2023] Open
Abstract
Congenital disorders of glycosylation (CDG) are rare diseases with variable phenotypes and severity. Immunological involvement remains a largely uncharted topic in CDG, mainly due to lack of robust data. To better characterize immune-related manifestations’ prevalence, relevance, and quality-of-life (QoL) impact, we developed electronic questionnaires targeting (1) CDG patients and (2) the general “healthy” population. Two-hundred and nine CDG patients/caregivers and 349 healthy participants were included in this study. PMM2-CDG was the most represented CDG (n = 122/209). About half of these participants (n = 65/122) described relevant infections with a noteworthy prevalence of those affecting the gastrointestinal tract (GI) (63.1%, n = 41/65). Infection burden and QoL impact were shown as infections correlated with more severe clinical phenotypes and with a set of relevant non-immune PMM2-CDG signs. Autoimmune diseases had only a marginal presence in PMM2-CDG (2.5%, n = 3/122), all being GI-related. Allergy prevalence was also low in PMM2-CDG (33%, n = 41/122) except for food allergies (26.8%, n = 11/41, of PMM2-CDG and 10.8%, n = 17/158, of controls). High vaccination compliance with greater perceived ineffectiveness (28.3%, n = 17/60) and more severe adverse reactions were described in PMM2-CDG. This people-centric approach not only confirmed literature findings, but created new insights into immunological involvement in CDG, namely by highlighting the possible link between the immune and GI systems in PMM2-CDG. Finally, our results emphasized the importance of patient/caregiver knowledge and raised several red flags about immunological management.
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Di Mauro A, Baldassarre ME, Brindisi G, Zicari AM, Tarantini M, Laera N, Capozza M, Panza R, Salvatore S, Pensabene L, Fanelli M, Laforgia N. Hydrolyzed Protein Formula for Allergy Prevention in Preterm Infants: Follow-Up Analysis of a Randomized, Triple-Blind, Placebo-Controlled Study. Front Pediatr 2020; 8:422. [PMID: 32903747 PMCID: PMC7438860 DOI: 10.3389/fped.2020.00422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 06/18/2020] [Indexed: 12/16/2022] Open
Abstract
Background: Allergic diseases are a major public health burden worldwide. Evidence suggests that early nutrition might play a key role in the future development of allergies and the use of hydrolyzed protein formulas have been proposed to prevent allergic disease, mainly in term infants with risk factors. Aim: To evaluate the preventive effect of a hydrolyzed protein formula vs. an intact protein formula on allergy development in preterm infants with or without risk factors. Methods: We performed a 3-year follow-up study of a previous triple-blind, placebo-controlled randomized trial. Evidence of atopic dermatitis, asthma and IgE-mediated food allergies were evaluated according to a validated parental questionnaire (Comprehensive Early Childhood Allergy Questionnaire). Food sensitization was also investigated by skin prick test at 3 years of chronological age. Results: Of the 30 subjects in the intact protein formula group and 30 in the extensively hydrolyzed formula group, respectively 18 and 16 completed the 3-year follow-up and entered the final analysis. No group differences in the incidence of atopic dermatitis, asthma, IgE-mediated food allergies, and food sensitization were found. Conclusion: Despite the small number of cases, extensively hydrolyzed protein formula seems to be ineffective in allergic diseases prevention in preterm neonates. Further adequately powered, randomized controlled trials evaluating hydrolyzed protein formula administration to prevent allergic diseases in preterm neonates are needed.
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Affiliation(s)
- Antonio Di Mauro
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Maria Elisabetta Baldassarre
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Giulia Brindisi
- Pediatrics Department, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Anna Maria Zicari
- Pediatrics Department, Umberto I Hospital, Sapienza University, Rome, Italy
| | - Martina Tarantini
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Nicla Laera
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Manuela Capozza
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Raffaella Panza
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
| | - Silvia Salvatore
- Department of Pediatric, Ospedale "F. Del Ponte", University of Insubria, Varese, Italy
| | - Licia Pensabene
- Pediatric Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Margherita Fanelli
- Department of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy
| | - Nicola Laforgia
- Section of Neonatology and Neonatal Intensive Care Unit, Department of Biomedical Science and Human Oncology, "Aldo Moro" University of Bari, Bari, Italy
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Kuiper IN, Svanes C, Benediktsdottir B, Bertelsen RJ, Bråbäck L, Dharmage SC, Holm M, Janson C, Jögi R, Malinovschi A, Matheson M, Moratalla JM, Real FG, Sánchez-Ramos JL, Schlünssen V, Timm S, Johannessen A. Agreement in reporting of asthma by parents or offspring - the RHINESSA generation study. BMC Pulm Med 2018; 18:122. [PMID: 30053806 PMCID: PMC6062946 DOI: 10.1186/s12890-018-0687-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 07/05/2018] [Indexed: 12/02/2022] Open
Abstract
Background Self-report questionnaires are commonly used in epidemiology, but may be susceptible to misclassification, especially if answers are given on behalf of others, e.g. children or parents. The aim was to determine agreement and analyse predictors of disagreement in parents’ reports of offspring asthma, and in offspring reports of parents’ asthma. Methods In the Respiratory Health in Northern Europe, Spain and Australia (RHINESSA) generation study, 6752 offspring (age range 18–51 years) and their parents (age range 39–66 years) reported their own and each other’s asthma status. Agreement between asthma reports from offspring and parents was determined by calculating sensitivity, specificity, positive and negative predictive value and Cohen’s kappa. The participants’ own answers regarding themselves were defined as the gold standard. To investigate predictors for disagreement logistic regression analyses were performed to obtain odds ratios (OR) with 95% confidence intervals (CI) for sex, smoking status, education, comorbidity and severity of asthma. Results Agreement was good for parental report of offspring early onset asthma (< 10 years, Cohen’s kappa 0.72) and moderate for offspring later onset asthma (Cohen’s kappa 0.46). Specificity was 0.99 for both, and sensitivity was 0.68 and 0.36, respectively. For offspring report of maternal and paternal asthma the agreement was good (Cohen’s kappa 0.69 and 0.68), specificity was 0.96 and 0.97, and sensitivity was 0.72 and 0.68, respectively. The positive predictive value (PPV) was lowest for offspring report of maternal asthma (0.75), and highest for parents’ report of early onset asthma in the offspring (0.83). The negative predictive value (NPV) was high for all four groups (0.94–0.97). In multivariate analyses current smokers (OR = 1.46 [95% CI 1.05, 2.02]) and fathers (OR = 1.31 [95% CI 1.08, 1.59]) were more likely to report offspring asthma incorrectly. Offspring wheeze was associated with reporting parental asthma incorrectly (OR = 1.60 [95% CI 1.21, 2.11]), both under- and over reporting. Conclusions Asthma reports across generations show moderate to good agreement, making information from other generations a useful tool in the absence of direct reports. Electronic supplementary material The online version of this article (10.1186/s12890-018-0687-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ingrid N Kuiper
- Department of Occupational Medicine, Haukeland University Hospital, N-5021, Bergen, Norway.
| | - Cecilie Svanes
- Department of Occupational Medicine, Haukeland University Hospital, N-5021, Bergen, Norway.,Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | - Randi J Bertelsen
- Department of Occupational Medicine, Haukeland University Hospital, N-5021, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Lennart Bråbäck
- Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Shyamali C Dharmage
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Mathias Holm
- Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Rain Jögi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Melanie Matheson
- Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Jesús Martínez Moratalla
- Servicio de Salud de Castilla, Servicio de Neumología del Complejo Hospitalario Univerisitario de Albacete, La Mancha, Albacete, Spain
| | - Francisco Gómez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Gynecology and Obstetrics, Haukeland University Hospital, Bergen, Norway
| | | | - Vivi Schlünssen
- Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark.,National Research Center for the Working Environment, Copenhagen, Denmark
| | - Signe Timm
- Department of Public Health, Danish Ramazzini Center, Aarhus University, Aarhus, Denmark
| | - Ane Johannessen
- Department of Occupational Medicine, Haukeland University Hospital, N-5021, Bergen, Norway.,Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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