Establishment of the intestinal microbiota and its role for atopic dermatitis in early childhood

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY

卷:132

Article

Penders, John^1,2  Gerhold, Kerstin³  Stobberingh, Ellen E.¹  Thijs, Carel²  Zimmermann, Kurt⁴  Lau, Susanne³  Hamelmann, Eckard⁵ 

[1] Maastricht Univ, Med Ctr, Sch Nutr Toxicol & Metab, Dept Med Microbiol, NL-6200 MD Maastricht, Netherlands

[2] Maastricht Univ, Sch Publ Hlth & Primary Care, Dept Epidemiol, NL-6200 MD Maastricht, Netherlands

[3] Charite Univ Med Berlin, Dept Pediat Pneumol & Immunol, Berlin, Germany

[4] SymbioPharm, Herborn, Germany

[5] Ruhr Univ Bochum, Univ Childrens Hosp, Bochum, Germany

关键词: Microbiota;    atopic dermatitis;    birth mode;    siblings;    mediation analysis;   

DOI  :  10.1016/j.jaci.2013.05.043

来源: Elsevier

【 摘 要 】

Background: Perturbations in the intestinal microbiota may disrupt mechanisms involved in the development of immunologic tolerance. The present study aimed to examine the establishment of the infant microbiota and its association to the development of atopic dermatitis (AD). Methods: Within a randomized, placebo-controlled trial on the prevention of AD by oral supplementation of a bacterial lysate between week 5 and the end of month 7, feces was collected at the ages of 5 weeks (n = 571), 13 weeks (n = 332), and 31 weeks (n = 499) and subjected to quantitative PCRs to detect bifidobacteria, bacteroides, lactobacilli, Escherichia coli, Clostridium difficile, and Clostridium cluster I. Results: Birth mode, breast-feeding but also birth order had a strong effect on the microbiota composition. With increasing number of older siblings the colonization rates at age 5 weeks of lactobacilli (P < .001) and bacteroides (P = .02) increased, whereas rates of clostridia decreased (P < .001). Colonization with clostridia, at the age of 5 and 13 weeks was also associated with an increased risk of developing AD in the subsequent 6 months of life (odds ratio(adjusted) = 2.35; 95% CI, 1.36-3.94 and 2.51; 1.30-4.86, respectively). Mediation analyses demonstrated that there was a statistically significant indirect effect via Clostridium cluster I colonization for both birth mode and birth order in association to AD. Conclusion: The results of this study are supportive for a role of the microbiota in the development of AD. Moreover, the beneficial'' influence of older siblings on the microbiota composition suggests that this microbiota may be one of the biological mechanisms underlying the sibling effect.

【 授权许可】

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