我们研究了226名牛奶过敏的儿童，他们在婴儿期就被纳入食物过敏观察研究组。收集3 - 16个月时的粪便样本，对患儿进行纵向随访，进行临床评估、牛奶特异性IgE水平、入组时、6个月、12个月、之后每年进行一次，直到8岁。肠道微生物组采用16s rRNA测序，微生物组分析采用微生物生态学定量研究(QIIME)、群落系统发育研究(PICRUSt)和元基因组谱统计分析(STAMP)。
226名儿童中128名(56.6%)的牛奶过敏在8岁时消失。3 - 6个月时的肠道菌群组成与8岁时牛奶过敏反应的消除有关(PERMANOVA P = .047)，牛奶过敏问题的解决与婴儿肠道菌群中梭菌和厚壁菌的富集有关。元基因组功能预测支持牛奶过敏消除的受试者中道微生物组脂肪酸代谢的减少 (η2 = 0.43;方差分析P = .034)。
Clin Exp Allergy
Early-life gut microbiome composition and milk allergy resolution
Gut microbiota may play a role in the natural history of cow's milk allergy.
We sought to examine the association between early-life gut microbiota and the resolution of cow's milk allergy.
We studied 226 children with milk allergy who were enrolled at infancy in the Consortium of Food Allergy observational study of food allergy. Fecal samples were collected at age 3 to 16 months, and the children were followed longitudinally with clinical evaluation, milk-specific IgE levels, and milk skin prick test performed at enrollment, 6 months, 12 months, and yearly thereafter up until age 8 years. Gut microbiome was profiled by 16s rRNA sequencing and microbiome analyses performed using Quantitative Insights into Microbial Ecology (QIIME), Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt), and Statistical Analysis of Metagenomic Profiles (STAMP).
Milk allergy resolved by age 8 years in 128 (56.6%) of the 226 children. Gut microbiome composition at age 3 to 6 months was associated with milk allergy resolution by age 8 years (PERMANOVA P = .047), with enrichment of Clostridia and Firmicutes in the infant gut microbiome of subjects whose milk allergy resolved. Metagenome functional prediction supported decreased fatty acid metabolism in the gut microbiome of subjects whose milk allergy resolved (η2 = 0.43; ANOVA P = .034).
Early infancy is a window during which gut microbiota may shape food allergy outcomes in childhood. Bacterial taxa within Clostridia and Firmicutes could be studied as probiotic candidates for milk allergy therapy.
SupindaBunyavanichMD,MPHabNanShenMSaAlexanderGrishinPhDbRobertWoodMDcWesleyBurksMDdPeterDawsonPhDeStacie M.JonesMDfDonald Y.M.LeungMD, PhDgHughSampsonMDbScottSichererMDbJose C.ClementePhDah