It is becoming more and more clear that changes in the gut microbiome in infants can play a role in developing atopic diseases at later ages. However, a strong link between changes in microbiome and occurrence of food sensitizations have not been described. In order to investigate this relationship, a large observation study of infant microbiota and sensitization patterns was established. Using 16S rRNA amplicon sequencing, fecal microbiota in 1422 Canadian full-term infants was measured twice. Atopic sensitization outcomes were measured by skin prick tests at age 1 year and 3 years. The association between gut microbiota trajectories, based on longitudinal shifts in community clusters, and atopic sensitization outcomes at age 1 and 3 years were determined. Other relevant factors such as ethnicity and early-life exposures influencing microbiota trajectories were assessed.
These investigators identified 4 developmental trajectories of gut microbiota, shaped by birth mode and varied by ethnicity. The trajectory with persistently low Bacteroides abundance and high Enterobacteriaceae/Bacteroidaceae ratio throughout infancy increased the risk of sensitization to food allergens, particularly to peanuts at age 3 years by 3-fold. A much higher likelihood for peanut sensitization was found if infants with this trajectory were born to mothers with an Asian ethnicity. It was characterized by a deficiency in sphingolipid metabolism and persistent Clostridioides difficile colonization. Importantly, this trajectory of depleted Bacteroides abundance mediated the association between Asian ethnicity and food sensitization.
The study results are thus remarkable and reveal different developmental trajectories of the gut microbiota in the first year of life. These trajectories are influenced by genetic, environmental, and other early-life factors, in which birth mode played the most significant role. The risk of food sensitization was higher in infants with persistently low levels of Bacteroides, with a greater risk for infants born to Asian mothers or colonized by C. difficile.
The findings of this study could lead to the development of microbiota-based preventive or therapeutic intervention strategies for food allergy in toddlers. One can even imagine that it could lead to identification of risk factors for development of atopic diseases at later life and thus, at adjustment and prevention of this.
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