Longitudinal disease-associated gut microbiome differences in infants with food protein-induced allergic proctocolitis

Abstract

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.

Comparative Analysis of Fecal Microbiota Between Infants With Cow Milk-induced Proctocolitis and Healthy Controls

“…Furthermore, a subsequent study, using a subset of GMAP participants during the 0-2 months period, identi ed distinct microbial differences. Speci cally, the study revealed higher levels of an unidenti ed genus within Enterobacteriaceae and lower levels of an unidenti ed family within Clostridiaceae in FPIAP cases compared to controls [22]. In our study there were no difference in relative abundance of Clostridiaceae and Enterobactericeae between the two groups.…”

From gut to skin: exploring the potential of natural products targeting microorganisms for atopic dermatitis treatment

“…51 Gut microbiota has a crucial role in the development of allergic diseases such as intestinal inflammatory diseases, asthma, and AD. [52][53][54] Metabolites produced by the gut microbiota, such as amino acid metabolites, short chain fatty acids (SCFAs), and oligosaccharides, can form a mucosal layer and constitute the intestinal barrier to prevent microorganisms from entering the bloodstream and causing infection. 55 There are numerous factors that affect the immune equilibrium between the gut microbiota and the host, including diet, disease, and others.…”

Development of IgE-mediated food allergies in children with history of food protein-induced allergic proctocolitis: a series of five cases

“…There is a mounting body of evidence that the gut microbiota is impacted directly by diet, inflammation, and environment, and the microbiota subsequently impacts disease state ( 12 ). Recent data from the Gastrointestinal Microbiome and Allergic Proctocolitis study demonstrated key differences in the microbiome of infants with FPIAP, specifically a higher abundance of a genus of Enterobacteriaceae and a lower abundance of a family of Clostridiales during the symptomatic period, with some differences noted prior to symptom onset ( 13 ). The authors concluded that complex cross talk between the intestinal microbiome, food antigens, intestinal inflammation, and the innate immune system early in life likely contributes to the mechanisms responsible for either healthy tolerance or food allergy development ( 13 ).…”