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Published on: June 24, 2020
Longitudinal disease-associated gut microbiome differences in infants with food protein-induced allergic
Victoria M Martin1,2,3,4, Yamini V Virkud1,3,4,5, Ehud Dahan6
1Food Allergy Center, Massachusetts General Hospital, Boston, MA, USA.
Insights
Infant gut microbiome differences, including specific bacteria like Enterobacteriaceae and Clostridiales, are linked to food protein-induced allergic proctocolitis (FPIAP) even before symptoms appear, offering insights into early allergy development.
Area of Science:
- Microbiome research
- Pediatric allergy
- Immunology
Background:
- Pediatric allergic diseases, including food allergies, are rising.
- Food protein-induced allergic proctocolitis (FPIAP) is an early non-IgE-mediated food allergy in infancy.
- The gut microbiome's role in FPIAP pathogenesis is under investigation, with limited longitudinal data.
Purpose of the Study:
- To investigate the infant gut microbiome's association with FPIAP development.
- To identify microbial differences preceding FPIAP symptom onset.
- To establish a foundation for understanding FPIAP and subsequent food allergy pathogenesis.
Main Methods:
- Analysis of 954 longitudinal samples from 160 infants (81 FPIAP cases, 79 controls) aged 1 week to 1 year.
- Utilized 16S rRNA gene sequencing within the Gastrointestinal Microbiome and Allergic Proctocolitis (GMAP) study.
- Employed a nested case-control design for robust comparison.
Main Results:
- Significant differences in gut microbiome composition were observed in infants with FPIAP compared to controls.
- A higher abundance of Enterobacteriaceae and a lower abundance of Clostridiales were noted during the symptomatic period.
- Taxonomic differences were detectable even prior to FPIAP symptom onset.
- No consistent longitudinal differences in microbial richness or stability were found.
Conclusions:
- This study is the first to identify distinct infant gut microbiome profiles associated with FPIAP, some predating symptom onset.
- Findings provide a basis for further mechanistic studies into FPIAP and later childhood food allergies.
- Highlights the potential of early microbiome analysis in understanding pediatric allergic disease development.
Background:
Complex interactions between the gut microbiome and immune cells in infancy are thought to be part of the pathogenesis for the marked rise in pediatric allergic diseases, particularly food allergies. Food protein-induced allergic proctocolitis (FPIAP) is commonly the earliest recognized non-immunoglobulin E (IgE)-mediated food allergy in infancy and is associated with atopic dermatitis and subsequent IgE-mediated food allergy later in childhood. Yet, a large prospective longitudinal study of the microbiome of infants with FPIAP, including samples prior to symptom onset, has not been done.
Results:
Here, we analyzed 954 longitudinal samples from 160 infants in a nested case-control study (81 who developed FPIAP and 79 matched controls) from 1 week to 1 year of age by 16S rRNA ribosomal gene sequencing as part of the Gastrointestinal Microbiome and Allergic Proctocolitis (GMAP) study. We found key differences in the microbiome of infants with FPIAP, most strongly a higher abundance of a genus of Enterobacteriaceae and a lower abundance of a family of Clostridiales during the symptomatic period. We saw some of these significant taxonomic differences even prior to symptom onset. There were no consistent longitudinal differences in richness or stability diversity metrics between infants with FPIAP and healthy controls.
Conclusions:
This study is the first to identify differences in the infant gut microbiome in children who develop FPIAP, some even before they develop symptoms, and provides a foundation for more mechanistic investigation into the pathogenesis of FPIAP and subsequent food allergic diseases in childhood. Video abstract.
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