Microbiota and Derived Parameters in Fecal Samples of Infants with Non-IgE Cow’s Milk Protein Allergy under a Restricted Diet

Abstract

Cow’s milk protein allergy (CMPA) is the most common food allergy in infancy. Non-IgE mediated (NIM) forms are little studied and the responsible mechanisms of tolerance acquisition remain obscure. Our aim was to study the intestinal microbiota and related parameters in the fecal samples of infants with NIM-CMPA, to establish potential links between type of formula substitutes, microbiota, and desensitization. Seventeen infants between one and two years old, diagnosed with NIM-CMPA, were recruited. They were all on an exclusion diet for six months, consuming different therapeutic protein hydrolysates. After this period, stool samples were obtained and tolerance development was evaluated by oral challenges. A control group of 10 age-matched healthy infants on an unrestricted diet were included in the study. Microbiota composition, short-chain fatty acids, calprotectin, and transforming growth factor (TGF)-β1 levels were determined in fecal samples from both groups. Infants with NIM-CMPA that consumed vegetable protein-based formulas presented microbiota colonization patterns different from those fed with an extensively hydrolyzed formula. Differences in microbiota composition and fecal parameters between NIM-CMPA and healthy infants were observed. Non-allergic infants showed a significantly higher proportion of Bacteroides compared to infants with NIM-CMPA. The type of protein hydrolysate was found to determine gut microbiota colonization and influence food allergy resolution in NIM-CMPA cases.

Bifidobacterium breve M‐16V alters the gut microbiota to alleviate OVA‐induced food allergy through IL‐33/ST2 signal pathway

“…The study indicated that Bacteroidetes were significantly enriched in patients with FA (Berni Canani et al, 2018). Whereas a significantly higher rate was found in nonallergic infants compared to infants with FA (Diaz et al, 2018). Moreover, there is not enough data on whether the Epsilonproteobacteria and Campylobacterales affect allergic diseases, and further research is needed to clarify the mechanism.…”

The infant gut microbiome as a microbial organ influencing host well-being

“…According to a very recent study, the presence of a Clostridiales taxa Anaerostipes (i.e., in particular the species Anaerostipes caccae) has been associated with a reduction of the risk of food allergy in infant [71]. Furthermore, gut microbiota composition seems to play a role in food allergy resolution in infants suffering from cow's milk protein allergy [72].…”

Microbiological and Immunological Markers in Milk and Infant Feces for Common Gastrointestinal Disorders: A Pilot Study

“…Moreover, in this study fecal samples of CMPA infants were also characterized by a higher abundance of the genus Rothia and the families Lachnospiraceae, Peptostreptococcaceae and Eggerthellaceae. Lachnospiraceae and Peptostreptococcaceae have been previously reported to be enriched in the gut microbiota of CMPA infants, but the significance of their presence remains unclear [15,26,[29][30][31][32][33]. Remarkably, Eggerthellaceae was more abundant in the milk of mothers of CMPA infants.…”

“…Recent studies have shown that selected bacterial species and their metabolites (such as short-chain fatty acids) may positively modulate immune tolerance mechanisms [33]. Although some studies have postulated a possible association between allergy and an altered microbiota pattern [11], the gut microbiota of infants suffering non-IgE-mediated CMPA remains uncharacterized [30], partly because of the difficulty in establishing an unambiguous diagnosis [31].…”