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Published on: August 7, 2017
Longitudinal Changes in Early Nasal Microbiota and the Risk of Childhood Asthma
Laura Toivonen1,2, Sinikka Karppinen2, Linnea Schuez-Havupalo2
1Department of Emergency Medicine, Massachusetts General Hospital and Harvard Medical School, Harvard University, Boston, Massachusetts; laura.toivonen@utu.fi.
Insights
Longitudinal changes in early nasal microbiota, particularly a lack of Moraxella, are linked to a higher risk of childhood asthma. Altered nasal microbiota patterns in early life indicate a significant risk for developing asthma.
Area of Science:
- Microbiology
- Pediatric Medicine
- Immunology
Background:
- The airway microbiota's role in childhood asthma development is not fully understood.
- Longitudinal changes in the nasal microbiota during early childhood are dynamic and their association with asthma risk requires investigation.
Purpose of the Study:
- To investigate the association between longitudinal changes in early nasal microbiota and the risk of developing asthma up to age 7.
- To identify distinct nasal microbiota profiles in early childhood and their predictive value for asthma.
Main Methods:
- Prospective, population-based birth cohort study following 704 children from birth to age 7.
- Nasal microbiota analyzed using 16S ribosomal RNA gene sequencing at 2, 13, and 24 months.
- Unsupervised machine learning identified longitudinal microbiota profiles, analyzed for association with asthma diagnosis at age 7.
Main Results:
- Four distinct longitudinal nasal microbiota profiles were identified between 2 and 13 months.
- A persistent Moraxella sparsity profile was associated with a significantly higher risk of asthma (aOR, 2.74; 95% CI, 1.20-6.27).
- Similar associations were found for longitudinal changes up to 24 months.
Conclusions:
- Altered longitudinal nasal microbiota patterns in early childhood are associated with a high risk of developing asthma.
- Findings support the development of primary prevention strategies for childhood asthma, including early risk identification and microbiota modification.
- This research opens new avenues for asthma risk modification through microbiota-targeted interventions.
Objectives:
Although the airway microbiota is a highly dynamic ecology, the role of longitudinal changes in airway microbiota during early childhood in asthma development is unclear. We aimed to investigate the association of longitudinal changes in early nasal microbiota with the risk of developing asthma.
Methods:
In this prospective, population-based birth cohort study, we followed children from birth to age 7 years. The nasal microbiota was tested by using 16S ribosomal RNA gene sequencing at ages 2, 13, and 24 months. We applied an unsupervised machine learning approach to identify longitudinal nasal microbiota profiles during age 2 to 13 months (the primary exposure) and during age 2 to 24 months (the secondary exposure) and examined the association of these profiles with the risk of physician-diagnosed asthma at age 7 years.
Results:
Of the analytic cohort of 704 children, 57 (8%) later developed asthma. We identified 4 distinct longitudinal nasal microbiota profiles during age 2 to 13 months. In the multivariable analysis, compared with the persistent Moraxella dominance profile during age 2 to 13 months, the persistent Moraxella sparsity profile was associated with a significantly higher risk of asthma (adjusted odds ratio, 2.74; 95% confidence interval, 1.20-6.27). Similar associations were observed between the longitudinal changes in nasal microbiota during age 2 to 24 months and risk of asthma.
Conclusions:
Children with an altered longitudinal pattern in the nasal microbiota during early childhood had a high risk of developing asthma. Our data guide the development of primary prevention strategies (eg, early identification of children at high risk and modification of microbiota) for childhood asthma. These observations present a new avenue for risk modification for asthma (eg, microbiota modification).
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