Emerging evidence of the role of gut microbiota in the development of allergic diseases

Sjödin, Kotryna Simonyté; Vidman, Linda; Rydén, Patrik; West, Christina

doi:10.1097/aci.0000000000000277

Cited by 71 publications

(49 citation statements)

References 36 publications

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“…1,42 Definitive results await the accomplishment of multiple birth cohort studies with large sample sizes, long term follow up, and allergic outcomes that have been defined using carefully constructed and specific phenotypes. 43-45 …”

Section: Early Epidemiologic Studies Suggesting Effects Of Gut Microbmentioning

confidence: 99%

The infant gut bacterial microbiota and risk of pediatric asthma and allergic diseases

Johnson

Ownby

2017

Translational Research

118

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Among the many areas being revolutionized by the recent introduction of culture independent microbial identification techniques is investigation of the relationship between close contact with large animals, antibiotics, breast feeding, mode of birth, and other exposures during infancy as related to a reduced risk of asthma and allergic disease. These exposures were originally clustered under the “Hygiene Hypothesis” which has morphed into the “Microbiota Hypothesis”. This review begins by summarizing epidemiologic studies suggesting that the common feature of these allergy risk-related exposures is their influence on the founding and early development of a child's gut microbiota. Next studies using culture independent techniques are presented showing that the microbiota of children who have experienced the exposures of interest have altered gut microbiota. Finally, selected mouse and human studies are presented which begin to corroborate the protective exposures identified in epidemiologic studies by identifying mechanisms through which microbes can alter immune development and function. These microbially driven immune alterations demonstrate that microbial exposures in many cases could alter the risk of subsequent allergic disease and asthma. Hopefully a better understanding of how microbes influence allergic disease will lead to safe and effective methods for reducing the prevalence of all forms of allergic disease.

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Section: Early Epidemiologic Studies Suggesting Effects Of Gut Microbmentioning

confidence: 99%

The infant gut bacterial microbiota and risk of pediatric asthma and allergic diseases

Johnson

Ownby

2017

Translational Research

118

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“…Therefore, any disturbance on the intestinal microbiota development process in these early moments may have important implications for the infant’s health and also for the risk of disease later on life. Indeed, an aberrant early microbiota has been found to precede the development of diseases [9–11]. …”

Section: Introductionmentioning

confidence: 99%

“…During the last years, different animal studies have demonstrated that reduced exposure to microbes early in life is associated with an increased risk of later disease [11, 23]. Moreover, antibiotics-induced microbiota dysbiosis in early life leads to increased susceptibility to allergic and metabolic disorders [24–26].…”

Section: Introductionmentioning

confidence: 99%

Impact of intrapartum antimicrobial prophylaxis upon the intestinal microbiota and the prevalence of antibiotic resistance genes in vaginally delivered full-term neonates

et al. 2017

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BackgroundDisturbances in the early establishment of the intestinal microbiota may produce important implications for the infant’s health and for the risk of disease later on. Different perinatal conditions may be affecting the development of the gut microbiota. Some of them, such as delivery mode or feeding habits, have been extensively assessed whereas others remain to be studied, being critical to identify their impact on the microbiota and, if any, to minimize it. Antibiotics are among the drugs most frequently used in early life, the use of intrapartum antimicrobial prophylaxis (IAP), present in over 30% of deliveries, being the most frequent source of exposure. However, our knowledge on the effects of IAP on the microbiota establishment is still limited. The aim of the present work was to evaluate the impact of IAP investigating a cohort of 40 full-term vaginally delivered infants born after an uncomplicated pregnancy, 18 of which were born from mothers receiving IAP.ResultsFecal samples were collected at 2, 10, 30, and 90 days of age. We analyzed the composition of the fecal microbiota during the first 3 months of life by 16S rRNA gene sequencing and quantified fecal short chain fatty acids by gas chromatography. The presence of genes for resistance to antibiotics was determined by PCR in the samples from 1-month-old infants. Our results showed an altered pattern of intestinal microbiota establishment in IAP infants during the first weeks of life, with lower relative proportions of Actinobacteria and Bacteroidetes and increased of Preoteobacteria and Firmicutes. A delay in the increase on the levels of acetate was observed in IAP infants. The analyses of specific antibiotic resistance genes showed a higher occurrence of some β-lactamase coding genes in infants whose mothers received IAP.ConclusionsOur results indicate an effect of IAP on the establishing early microbiota during the first months of life, which represent a key moment for the development of the microbiota-induced host homeostasis. Understanding the impact of IAP in the gut microbiota development is essential for developing treatments to minimize it, favoring a proper gut microbiota development in IAP-exposed neonates.Electronic supplementary materialThe online version of this article (doi:10.1186/s40168-017-0313-3) contains supplementary material, which is available to authorized users.

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“…Further studies should aim at optimizing infant feeding regimens. Supporting the most favorable "tolerogenic" microenvironment in the gut during the period of food allergen introduction is also likely to involve "optimal" colonization of the gastrointestinal tract, breastfeeding, and other dietary factors with immunomodulatory capacity [39,40] .…”

Section: Resultsmentioning

confidence: 99%

“…There are data to suggest that starting complementary foods before 3-4 months of age may increase the risk of allergic disease [37,38] . At that age, the gut is more permeable and gastrointestinal colonization is not yet well established, which might contribute to the observed risk increase [39,40] . Consequently, many international infant feeding guidelines for allergy prevention recommend introduction of any solid food after 4 months of age [32][33][34][35][36] .…”

Section: The "Optimal" Window Of Introduction Of Complementary Foods mentioning

confidence: 99%

Introduction of Complementary Foods to Infants

West

2017

Ann Nutr Metab

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While earlier food allergy prevention strategies implemented avoidance of allergenic foods in infancy, the current paradigm is shifting from avoidance to controlled exposure. This review focuses on the outcome of recent randomized controlled trials, which have examined the early introduction of allergenic foods for allergy prevention, and discusses the implementation of results in clinical practice. In infants at high risk of allergic disease, there is now direct evidence that regular early peanut consumption will reduce the prevalence of peanut allergy, compared to avoidance. Many international infant feeding guidelines already recommend complementary foods, including allergenic foods, to be introduced from 4 to 6 months of age irrespective of family history risk. Interim guidelines from 10 International Pediatric Allergy Associations state that healthcare providers should recommend the introduction of peanut-containing products into the diets of infants at high risk of allergic disease in countries where peanut allergy is prevalent. Direct translation of the results obtained from a cohort of high-risk infants to the general population has proved difficult, and issues regarding feasibility, safety, and cost-effectiveness have been raised. Five randomized placebo-controlled trials have assessed the effects of early egg exposure in infancy with varying results. In a recent comprehensive meta-analysis, there was moderate-certainty evidence that early versus late introduction of egg was associated with a reduced egg allergy risk. Although promising, optimal timing, doses, and if the feeding regimen should be stratified according to infant allergy risk remain to be determined. The single study that assessed introduction of multiple foods from 3 months whilst breastfeeding compared with exclusive breastfeeding until 6 months of age showed no reduction in food allergy prevalence. Future research should aim at optimizing infant feeding regimens and support a tolerogenic gastrointestinal microenvironment during the period of food allergen introduction.

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Emerging evidence of the role of gut microbiota in the development of allergic diseases

Cited by 71 publications

References 36 publications

The infant gut bacterial microbiota and risk of pediatric asthma and allergic diseases

The infant gut bacterial microbiota and risk of pediatric asthma and allergic diseases

Impact of intrapartum antimicrobial prophylaxis upon the intestinal microbiota and the prevalence of antibiotic resistance genes in vaginally delivered full-term neonates

Introduction of Complementary Foods to Infants

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