Atopic dermatitis and inflammatory skin disease
Intestinal microbiota in infants at high risk for allergy: Effects of prebiotics and role in eczema development

https://doi.org/10.1016/j.jaci.2017.05.054Get rights and content
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Background

Development of the gut microbiota in infancy is important in maturation of the immune system. Deviations in colonization patterns have been associated with allergic manifestations such as eczema, but exact microbiome dysfunctions underlying allergies remain unclear. We studied the gut microbiota of 138 infants at increased risk of allergy, participating in a clinical trial investigating the effectiveness of a partially hydrolyzed protein formula supplemented with nondigestible oligosaccharides on the prevention of eczema.

Objective

The effects of interventions and breast-feeding on fecal microbiota were investigated. Additionally, we aimed to identify microbial patterns associated with the onset of eczema.

Methods

Bacterial taxonomic compositions in the first 26 weeks of life were analyzed by using 16S rRNA gene sequencing. Additionally, fecal pH and microbial metabolite levels were measured.

Results

Fecal microbial composition, metabolites, and pH of infants receiving partially hydrolyzed protein formula supplemented with nondigestible oligosaccharides was closer to that of breast-fed infants than that of infants receiving standard cow's milk formula. Infants with eczema by 18 months showed discordant development of bacterial genera of Enterobacteriaceae and Parabacteroides species in the first 26 weeks, as well as decreased acquisition of lactate-utilizing bacteria producing butyrate, namely Eubacterium and Anaerostipes species, supported by increased lactate and decreased butyrate levels.

Conclusions

We showed that a partially hydrolyzed protein infant formula with specific prebiotics modulated the gut microbiota closer to that of breast-fed infants. Additionally, we identified a potential link between microbial activity and onset of eczema, which might reflect a suboptimal implementation of gut microbiota at specific developmental stages in infants at high risk for allergy.

Key words

Allergy
eczema
gastrointestinal
microbiome
microbiota
short-chain fatty acids
butyrate
lactate
prebiotics
infants

Abbreviations used

LUB
Lactate-utilizing and butyrate-producing bacterium
MCPT
Monte Carlo permutation test
OTU
Operational taxonomic unit
pHF-OS
Partially hydrolyzed protein infant formula containing oligosaccharides
PRC
Principal response curve
SCFA
Short-chain fatty acid

Cited by (0)

This study was funded by Danone Nutricia Research. Work in the Kroll laboratory was supported by funding from the National Institute for Health Research (NIHR) Biomedical Research Centre based at Imperial Healthcare NHS Trust and Imperial College London.

Disclosure of potential conflict of interest: H. Wopereis and J. Knol are employees of Danone Nutricia Research. K. Sim, A. Shaw, and J. S. Kroll have received grants from the UK National Institute of Health Research. J. O. Warner has received a grant, travel support, and fees for participation in review activities from Danone Nutricia Research; is on scientific advisory boards for Airsonette, MicroTest Matrices, and UCB; has provided expert testimony for a private legal firm; has received grants from Airsonette; has received payment for lectures from Airsonette and Pfizer China; owns stock/stock options in London Allergy Clinic; and has received travel support from Monash University and Hospital.